免疫抑制療法の利点と欠点

Immunosuppressive drugs in the treatment of autoimmune diseases

自己免疫疾患においては，自己成分に対する過剰な免疫反応を抑制することを目的として，ステロイドホルモンや免疫抑制薬が投与される．自己免疫疾患に用いられる免疫抑制薬には，アルキル化薬，核酸代謝拮抗薬，カルシニューリン阻害薬がある．それぞれの薬剤は，作用機序や副作用の発現などが異なるため，薬剤の特徴，利点と欠点などを熟知して使用することが求められる．また，わが国では免疫抑制薬の自己免疫疾患への適応が限られていることにも注意が必要である．

Autoimmune diseases are abnormal immune reactions against self antigens.　In the treatment of autoimmune diseases, glucocorticoid hormones as well as immunosuppressive drugs are predominantly used to suppress increased immune responses and inflammation.　Three kinds of immunosuppressive drugs, alkylating agents, purine analogues, and calcineurin inhibitors, are widely used for the treatment of autoimmune diseases as well as various cancers and transplantation.　Since these drugs exhibit potent pharmacological effects on various types of cells, they may be life-saving drugs, but they also can induce life-threatening adverse effects.　Understanding of the clinical pharmacology of immunosuppressive drugs is essential in the treatment of autoimmune diseases.