Principles of Immunopharmacology

Principles of

Immunopharmacology

Edited by Frans P. Nijkamp and Michael J. Parnham

Birkhäuser Verlag

Basel

Boston

Berlin

ISBN-10: 3-7643-5804-1 Birkhäuser Verlag, Basel – Boston – Berlin ISBN-13: 978-3-7643-5804-4 Birkhäuser Verlag, Basel – Boston – Berlin

The publisher and editor can give no guarantee for the information on drug dosage and administration contained in this publication. The respective user must check its accuracy by consulting other sources of reference in each individual case.

The use of registered names, trademarks etc. in this publication, even if not identified as such, does not imply that they are exempt from the relevant protective laws and regulations or free for general use.

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on micro- films or in other ways, and storage in data banks. For any kind of use, permission of the copyright owner must be obtained.

© 2005 Birkhäuser Verlag, P.O. Box 133, CH-4010 Basel, Switzerland Part of Springer Science+Business Media

Printed on acid-free paper produced from chlorine-free pulp. TCF

˚˚

Cover design: Micha Lotrovsky, CH-4106 Therwil, Switzerland Cover illustration: Mechanisms in type I hypersensitivity (allergy) Printed in Germany

ISBN-10: 3-7643-5804-1 ISBN-13: 978-3-7643-5804-4

9 8 7 6 5 4 3 2 1 www.birkhauser.ch

Frans P. Nijkamp Faculty of Pharmacy

Department of Pharmacology and Pathophysiology Sorbonnelaan 16

3584 CA Utrecht The Netherlands

Michael J. Parnham PLIVA Research Institute Ltd.

Prilaz baruna Filipovi ´ca 29 HR-10 000 Zagreb Croatia

Library of Congress Cataloging-in-Publication Data

Principles of immunopharmacology / edited by F.P. Nijkamp, M.J. Parnham.-- 2nd ed.

p. ; cm.

Includes bibliographical references and index.

ISBN-13: 978-3-7643-5804-4 (alk. paper) ISBN-10: 3-7643-5804-1 (alk. paper)

1. Immunopharmacology. I. Nijkamp, Franciscus Petrus, 1947- II. Parnham, Michael J., 1951- [DNLM: 1. Immunity--drug effects. 2. Adjuvants, Immunologic-pharmacology. 3. Immunologic Tests. 4. Immunosuppressive Agents--pharmacology. 5. Immunotherapy.

QW 540 P957 2005]

RM370.P75 2005 616.07’9--dc22

2005048217

Bibliographic information published by Die Deutsche Bibliothek

Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie;

detailed bibliographic data is available in the internet at http://dnb.ddb.de

Contents

Preface to the first edition . . . xv

Preface to the second edition . . . xvi

Abbreviations . . . xvii

A Mechanisms of immunity A.1 Hematopoiesis, including lymphocyte development and maturation Introduction: acquisition of specificity . . . 3

Hematopoiesis. . . 3

T and B lymphocytes: common origin from hematopoietic stem cells . . . 6

Specificity: rearrangement of genes encoding antigen receptors . . . 7

T lymphocyte maturation in the thymus . . . 8

B lymphocyte development in the bone marrow. . . 11

Mature T and B lymphocytes: tolerance . . . 14

T and B lymphocyte development and maturation: relevance for immunopharmacology . . . 14

Summary. . . 15

Selected readings . . . 16

Recommended website . . . 16

References . . . 16

A.2 T cell-mediated immunity Introduction . . . 19

Biology of the T lymphocyte immune response. . . 19

Composition of the T cell network . . . 20

T cell subset markers . . . 22

Effectors of T cell-mediated immunity . . . 23

Mechanisms of T cell-mediated cytotoxicity . . . 24

Mechanisms of T cell activation . . . 25

Tolerance. . . 26

Summary. . . 28

Selected readings . . . 28

A.3 Antibody diversity and B cell-mediated immunity Antibodies and immunoglobulins . . . 29

Structure of immunoglobulins . . . 29

The generation of antibody diversity . . . 30

B cell receptor and signal transduction . . . 32

B lymphocyte costimulation . . . 34

Cytokine regulation. . . 36

T cell-independent B lymphocyte activation . . . 36

Primary and secondary antibody response . . . 37

Biological functions of antibodies . . . 39

Clinical relevance and future prospects . . . 41

Summary. . . 43

Selected readings . . . 43

Recommended websites . . . 43

References . . . 44

A.4 Cytokines Introduction . . . 45

Differentiation factors . . . 46

Activation and growth factors of lymphocytes . . . 48

Mediators of inflammation . . . 51

Regulatory factors of immune reactions . . . 54

Chemokines . . . 54

Inhibition of cytokines. . . 58

Summary and outlook. . . 60

Selected readings . . . 60

Recommended website . . . 60

References . . . 60

A.5 Innate immunity – phagocytes, natural killer cells and the complement system Phagocytes . . . 63

Natural killer cells . . . 72

The complement system . . . 75

Summary. . . 79

Selected readings . . . 79

References . . . 79

A.6 Inflammatory mediators and intracellular signalling Introduction . . . 81

Eicosanoids . . . 81

Platelet-activating factor (PAF) . . . 87

Toll-like receptors . . . 89

Cytokines . . . 89

Chemokines and their intracellular signalling. . . 92

Neuropeptides. . . 93

Kinins . . . 93

Nitric oxide . . . 95

Reactive oxygen species . . . 98

Amines . . . 99

Summary. . . 101

Selected readings . . . 101

References . . . 101

A.7 Immune response in human pathology: infections caused by bacteria, viruses, fungi, and parasites Infections . . . 105

Natural resistance . . . 105

vi

Specific resistance . . . 107

Defence against bacteria, viruses, fungi, and parasites . . . 109

Pathogenesis of shock. . . 110

Human immunodeficiency virus infection . . . 112

Vaccines and vaccination. . . 113

Infections in the new millennium . . . 114

Summary. . . 115

Acknowledgements. . . 115

Selected readings . . . 115

Recommended websites . . . 115

A.8 Immune response in human pathology: hypersensitivity and autoimmunity Introduction . . . 117

Hypersensitivity. . . 117

Autoimmunity . . . 123

Conclusion . . . 125

Summary. . . 126

Selected readings . . . 126

Recommended website . . . 126

References . . . 126

A.9 Cancer immunity Introduction: cancer immunity from a historical perspective . . . 129

Key players in the immune responses against cancer. . . 130

Expression of targets for the immune system by cancer cells. . . 132

Immunotherapy of cancer . . . 136

Conclusions and future developments. . . 140

Summary. . . 141

Selected readings . . . 141

References . . . 142

A.10 Neuroimmunoendocrinology Historical background . . . 149

Regulation of the immune system by neuroendocrine hormones . . . 150

Neuroendocrine hormone release by immune system cells . . . 153

Functions of leukocyte-derived peptide hormones in vivo . . . 155

Summary and conclusions . . . 156

Acknowledgements. . . 157

Selected readings . . . 157

Recommended websites . . . 157

References . . . 157

B Immunodiagnosis B.1 Antibody detection Introduction . . . 163

Basic principle of immunoassays . . . 163

Antibody structure . . . 164

Clinical relevance of antibody detection . . . 164

vii

Contents

Antibody detection methods . . . 165

Summary. . . 170

Selected readings . . . 170

References . . . 170

B.2 Immunoassays Introduction . . . 171

Basic principles of assay design . . . 171

Components of immunoassays . . . 173

Data presentation and curve plotting . . . 175

Selected immunoassays . . . 176

Assay performance and validation. . . 178

Summary. . . 180

Selected readings . . . 181

References . . . 181

B.3 Flow cytometry Introduction . . . 183

Mechanistic principles . . . 183

Classification/types of assay . . . 185

Components/construction of assays . . . 187

Examples and their application . . . 192

Summary. . . 195

Selected readings . . . 195

References . . . 195

B.4 Gene arrays Introduction . . . 197

Principle of the technology . . . 197

Production of microarrays . . . 201

Application of microarrays. . . 203

Array data: acquisition, analysis and mining . . . 205

Examples of microarray experiments . . . 207

Summary. . . 210

Selected readings . . . 211

Recommended websites . . . 211

References . . . 211

B.5 Proteomics and applications within the drug development pipeline Introduction . . . 213

Traditional proteomics . . . 213

Array-based proteomics . . . 222

Summary. . . 225

Selected readings . . . 226

Recommended websites . . . 226

References . . . 226

viii

C Immunotherapeutics

C.1 Vaccines

Introduction . . . 231

Historical background . . . 231

Current vaccine categories . . . 232

Pharmacological effects of vaccination . . . 237

New developments . . . 239

Summary. . . 243

Selected readings . . . 244

Recommended websites . . . 244

References . . . 244

C.2 Sera and immunoglobulins Humoral immunity . . . 247

Antibody structure . . . 247

Effector functions of human Ig . . . 249

The catabolism of Ig . . . 254

Ig preparations for medical use . . . 254

Indications. . . 256

Dosage and administration . . . 258

Side-effects of Ig therapy . . . 258

Monoclonal Ab (mAb) . . . 260

Summary. . . 262

Selected readings . . . 262

Recommended websites . . . 263

References . . . 263

C.3 Anti-allergic drugs Introduction . . . 265

Disodium cromoglycate and nedocromil sodium (chromones). . . 265

Histamine receptor antagonists . . . 270

Anti-IgE. . . 275

Summary. . . 277

Selected readings . . . 277

References . . . 278

C.4 Drugs for the treatment of asthma and COPD Introduction . . . 281

Bronchodilators . . . 281

Controller drugs . . . 300

Mediator antagonists . . . 309

Steroid-sparing therapies. . . 312

New drugs for asthma and COPD. . . 314

Other drugs . . . 328

Summary. . . 329

Selected readings . . . 330

Recommended websites . . . 330

References . . . 330

ix

Contents

C.5 Immunostimulants in cancer therapy

Introduction . . . 345

Recombinant proteins . . . 345

Natural and synthetic BRMs . . . 357

Combination immunotherapy and cellular therapy . . . 363

Conclusion . . . 365

Summary. . . 366

Selected readings . . . 367

Recommended websites . . . 367

References . . . 368

C.6 Anti-infective activity of immunomodulators Introduction . . . 377

Cytokine immunomodulators . . . 378

Interferons and combinations . . . 379

Colony-stimulating factors . . . 381

Emerging cytokine therapies . . . 381

Synthetic immunomodulators . . . 383

Emerging therapies with synthetic immunomodulators . . . 384

Microbial immunomodulators . . . 386

Summary. . . 388

Recommended websites . . . 388

References . . . 389

C.7 Mild plant and dietary immunomodulators Introduction . . . 391

Plant immunostimulants . . . 391

Zinc. . . 394

Dietary antioxidants . . . 396

Phenolic compounds as immunomodulators . . . 400

Emerging therapies and summary . . . 403

Selected readings . . . 403

Recommended websites . . . 403

References . . . 403

C.8 Influence of antibacterial drugs on the immune system Introduction . . . 407

Antibacterial agents (ABA) and the immune system . . . 407

Class-specific immunomodulatory effects . . . 409

Non-antibacterial effects of antibacterial agents. Therapeutic implications . . . 426

Conclusions. . . 430

Summary. . . 430

Selected readings . . . 432

Recommended website . . . 433

References . . . 433

C.9 Immunosuppressives in transplant rejection Introduction . . . 441

Calcineurin inhibitors. . . 446

x

Inhibitors of growth factor modulation . . . 450

Cytotoxic drugs. . . 451

Other immunosuppressive drugs. . . 454

Biologicals . . . 455

New approaches and perspectives. . . 457

Summary. . . 460

Selected readings . . . 461

References . . . 461

C.10 Cytotoxic drugs Background. . . 465

Azathioprine . . . 465

Cyclophosphamide . . . 467

Fludarabine . . . 469

Methotrexate . . . 471

Mycophenolic acid . . . 474

Conclusions. . . 477

Summary. . . 477

Selected readings . . . 479

References . . . 479

C.11 Corticosteroids Introduction . . . 483

Chemical structures . . . 485

Modes of action . . . 485

Pharmacological effects. . . 487

Pharmacokinetics . . . 490

Clinical indications. . . 490

Side-effects . . . 492

Summary. . . 494

Selected readings . . . 494

Recommended websites . . . 494

References . . . 494

C.12 Non-steroidal anti-inflammatory drugs Introduction . . . 499

Mode of action of non-steroid anti-inflammatory drugs . . . 499

Cyclo-oxygenase-1 and cyclo-oxygenase-2 . . . 500

Structural basis for COX-2 selectivity . . . 503

Additional uses for selective COX-2 inhibitors. . . 504

COX-2 inhibitors and cancers . . . 504

Premature labour . . . 505

Alzheimer’s disease . . . 506

Other cyclo-oxygenases . . . 506

Summary. . . 506

Selected readings . . . 507

References . . . 508

xi

Contents

C. 13 Disease-modifying anti-rheumatic drugs

Introduction . . . 511

Pathophysiology of rheumatoid arthritis . . . 511

Corticosteroids . . . 512

Disease-modifying anti-rheumatic drugs (DMARD). . . 514

Methotrexate . . . 514

Antimalarials (chloroquine and hydroxychloroquine) . . . 520

Azathioprine . . . 521

Cyclosporin . . . 523

Gold complexes. . . 525

Leflunomide . . . 527

Penicillamine . . . 530

Sulfasalazine . . . 532

Tetracyclines (minocycline) . . . 533

Biological anti-rheumatic therapy . . . 535

Combination DMARD therapies . . . 536

Summary. . . 537

Selected readings . . . 539

References . . . 540

C.14 Perspectives of immunotherapy in the management of asthma and other allergic conditions Introduction . . . 545

General aspects of immunotherapy in allergy and asthma. . . 545

Non-specific immunomodulatory therapies . . . 546

Specific mediator antagonists . . . 546

Anti-cytokine therapy . . . 547

Cytokine therapy. . . 547

Specific immunotherapy . . . 548

Mechanisms of immunotherapy . . . 548

SIT for asthma. . . 549

Comparison of SIT with other types of treatment for asthma . . . 549

Effects on natural history of allergic disease . . . 549

Future directions . . . 550

Conclusions. . . 551

Summary. . . 552

Selected readings . . . 552

References . . . 552

D Immunotoxicology D.1 Immunotoxicology Introduction . . . 559

Mechanisms of immunotoxicity by pharmaceuticals . . . 560

Procedures for preclinical testing of direct immunotoxicity . . . 570

Procedures for preclinical testing of sensitizing capacity . . . 574

Procedures for immunotoxicity testing in humans . . . 577

Immunotoxicity regulations . . . 579

Conclusions. . . 584

Summary. . . 585

Selected readings . . . 585

References . . . 585

xii

Appendices

Appendix C.1 . . . 593

Appendix C.3 . . . 598

Appendix C.5 . . . 602

Appendix C.6 . . . 605

Appendix C.7 . . . 606

Appendix C.8 . . . 610

Appendix C.12/1 . . . 611

Appendix C.12/2 . . . 618

Appendix C.13 . . . 623

Appendix D.1 . . . 625

Glossary . . . 627

List of contributors . . . 645

Index . . . 651

xiii

Contents

immunomodulatory drugs can be distinguished from their beneficial therapeutic effects.

Currently, it is only possible to obtain an overview of these various aspects of immunopharmacology by reading a range of immunological, pharmacolog- ical, diagnostic and toxicological literature. Good immunological textbooks are available, while immunopharmacology is covered mainly in terms of the inflammatory response. Principles of Immuno- pharmacology is intended to provide for the first time in a single volume a basic understanding of immunological mechanisms, a review of important immunodiagnostic tools and a description of the main pharmacological agents which modify the immune response, together with an introduction to immunotoxicology. As such we hope that it will be useful as a reference text for physicians, researchers and students with a rudimentary knowledge of immunology.

We, the editors, are grateful to all the authors who have invested their time and effort into this volume.

We have received continuous help and encourage- ment from Petra Gerlach and Katrin Serries of Birkhäuser Verlag and particular thanks are due to Dinij van der Pal for administrative assistance.

Frans P. Nijkamp Michael J. Parnham

March, 1999 The rapid developments in immunology in recent

years have dramatically expanded our knowledge of mammalian host defence mechanisms.The molecu- lar mechanisms of cellular interactions during immune responses have been unravelled, the intra- cellular responses involved in signal transduction delineated and an ever-increasing number of soluble mediators of immune and inflammatory reponses have been discovered.

The initial result of this explosion of knowledge has been to provide the researcher and the clinician with an arsenal of diagnostic tools with which the immunological bases of disease processes can be investigated. This has made disease diagnosis much more precise,enabling the physician to tailor therapy much more closely to the individual patient’s needs.

However, better understanding of disease processes only provides a gradual improvement in therapy.This is because the new molecular targets that have been uncovered must first be tested as potential bases for immunomodulatory drug actions and then the new compounds must be subject to extensive develop- ment studies.As a result of the molecular unravelling of the immune system,we now understand more pre- cisely the mechanisms of action of some established therapies, such as anti-allergic and anti-asthma agents, including the corticosteroids. New rational treatments based on molecular mechanisms also are now entering clinical practice and are making their mark on cancer, infectious and autoimmune disease therapy.

Concomitantly with these advances in under- standing of molecular mechanisms of immunity, immunodiagnosis and immunotherapy, it has become possible to test more accurately the way in which a variety of drug classes interact with the immune system. It is of particular importance to reg- ulatory authorities that the toxic side-effects of

Preface to the first edition

therapy and immunotoxicology in a single volume, we have also introduced a new double-column for- mat to provide easier access to the text. Important statements are highlighted and instead of giving annotations in the margins, key terms are now indi- cated in the text and presented in a glossary* at the end of the book.A new appendix summarises impor- tant characteristics of commercially available thera- peutic agents.

We are very grateful to many of the contributors to the first edition,who have kindly revised and mod- ified their chapters, as well as to the additional authors who have added totally new information.

The preparation of this second edition has been the result of close collaboration with Dr. Hans-Detlef Klüber and his colleagues at Birkhäuser Verlag.

Thanks for all your help, advice and hard work. We hope you, the reader, will find the new edition useful and informative.

Frans P. Nijkamp Michael J. Parnham

March, 2005

* Words included in the glossary are highlighted in the text with

.

Our knowledge of immunological processes and their modulation has progressed considerably since the first edition of Principles of Immunopharmacolo- gy. Molecular mechanisms have been elucidated so that we are now in a position to understand many of the complex pathways leading from surface stimula- tion to cellular responses. We now appreciate much better that the innate immune response is also regu- lated by far more external and internal stimuli than was previously realised and are starting to under- stand the role of memory and regulatory cells.

Advances in genomics and proteomics have enabled the identification of many genes and new proteins that are intimately involved in the responses of the immune system.We have sought to include the most important of these advances in the first part of this second edition of Principles of Immunopharma- cology. In addition to including new mechanisms in the section on the immune response, we have also included the new techniques of the genomic and proteomic revolution in the diagnostics section, as methods such as microarrays have now become an essential aspect of cellular analyses.

Inevitably, our increased understanding of immune mechanisms has opened opportunities for the development of novel drugs to treat inflamma- tion and disorders of the immune system.Biologicals are now commanding worldwide interest, both in research and development and in clinical practice.

The section on therapy has now been expanded to accommodate these new therapeutic approaches, as well as describing our improved understanding of the mechanisms of action of established agents.The final section on immunotoxicology has also been updated, particularly with regard to new regulatory changes.

While maintaining the unique approach of pro- viding sections on immunology, immunodiagnostics,

Preface to the second edition

A23187: calcium ionophore

AA: arachidonic acid

AAA: abdominal aortic aneurysm

Ab: antibodies, antibody

ABA: antibacterial agents

ABC trans-

porter: ATP-binding cassette transporter

aca: anticomplementary activity

ACE: angiotensin converting enzyme

ACTH: corticotropin, adrenocorticotrophic hormone

ADCC: antibody-dependent cellular cytotoxicity

ADP: adenosine diphosphate

AFC: antibody-forming cell assay

Ag: antigen

AGP: acid glycoprotein

AgR: antigen receptor

AHA: autoimmune haemolytic anemia

AICD: activation-induced cell death

AICAR: 5-aminoimidazole-4-carboxamide

ribonucleotide

AID: activation-induced cytidine deaminase

AIDS: acquired immune deficiency

syndrome

ALG: anti-lymphocyte globulin

ALL: acute lymphocytic leukemia

ALS: amyotrophic lateral sclerosis

ALXR: affinity G-protein coupled lipoxin receptors

AML: acute myelogenous leukemia

AML: acute myeloid leukaemia

ANC: absolute neutrophil count

ANLL: acute non-lymphocytic leukemia

ANP: atrial natriuretic peptide

AP-1: activator protein-1

AP50: complement activity that causes 50%

haemolysis via the alternative route

APC: allophycocyanin

APC: antigen-presenting cell

βARK: β-adrenergic receptor kinase

ATF-2: activating transcription factor

ATG: anti-thymocyte globulin

ATL: aspirin-triggered lipoxins

ATP: adenosine triphosphate

AVP: arginine vasopressin

AZA: azathioprine

BAGE: B antigen

BAL: bronchoalveolar lavage

BALT: bronchus-associated lymphoid tissue

BCG: bacille Calmette-Guérin

B-CLL: B-chronic lymphocytic leukemia

BCR: B cell receptor

BCR-ABL: breakpoint cluster region-Abelson

BDP: beclomethasone dipropionate

BFU: burst-forming unit

BLNK: B cell linker protein

BM: bone marrow

BMT: bone marrow transplantation

B-NHL: B-non-Hodgkin’s lymphoma

BPI: bactericidal permeability increasing protein

BRM: biological response modifier

BT: Buehler test

Btk: Bruton’s tyrosine kinase

C/E: cellular/extracellular concentration ratio

C: constant (gene segment)

C3b: large fragment of complement factor 3

C5a: small fragment of complement factor 5

Ca

: calcium ion

Ca

: intracellular calcium

CAD: coronary artery disease

CAM: cell adhesion molecule

CaM: cytokine-activated monocyte

CCD: charge-coupled device

Abbreviations

CCL1: CC chemokine-1

CD: cluster of differentiation

CD40L: CD40 ligand

cDNA: complementary deoxyribonucleic acid

CDR: complementarity determining region

CEA: carcinoembryonic antigen

CF: cystic fibrosis

CFA: complete Freund’s adjuvant

CFTR: cystic fibrosis transmembrane conduc- tance regulator

CFU: colony-forming unit

CGD: chronic granulomatous disease

cGMP: cyclic guanosine monophosphate

CGRP: calcitonin gene-related peptide CH50: complement activity that causes 50%

haemolysis via the classical route

CHC: chronic hepatitis C

C

N: constant domain number N of the heavy

chain (N = 1, 2 or 3 for IgA, IgD and IgG and 1, 2, 3 or 4 for IgE and IgM) Cl –

: chloride ion

CL: class

CML: chronic myelogenous leukemia

CMP: cytidine monophosphate

CNS: central nervous system

COMT: catechol-o-methyl transferase

Con A: concavalin A

COPD: chronic obstructive pulmonary disease

COX: cyclo-oxygenase

CpG DNA: synthetic oligodeoxyribonucleotides con- taining CpG-dinucleotides

CpG: cytosine-phosphate-guanosine

CPMP: E.U. Committee on Proprietary Medicinal Products

CR: complement receptor

CRAC: Ca

release-activated Ca

current

CRH: corticotropin-releasing hormone

CRMO: chronic recurrent multifocal osteomyelitis

CRP: C-reactive protein

CsA: cyclosporin A

CSAID: cytokine suppressive antiinflammatory drugs

CSF: colony-stimulating factor

CT: chemotaxis

CTL: cytotoxic T lymphocyte

CX3CL1: fractalkine

CXC or CXCL: CXC chemokine

CXCR: CXC chemokine receptor

CY: cyclophosphamide

Cy5/Cy3: cyanine dye 5 and 3 CYP isoforms: cytochrome P450 isoforms

CYP: cyclophilin

cysLT: cysteinyl leukotrienes

D: diversity (gene segment)

DAF: decay-accelerating protein

DAG: diacylglycerol

DAO: diamine oxidase

DC: dendritic cell

2DE: two-dimensional gel electrophoresis

DHODH: dihydroorotate dehydrogenase

DISC: death-inducing signaling complexes

DLI: donor leukocyte infusion

DLN: draining lymph nodes

DMARD: disease modifying anti-rheumatic drugs DN T cells: double negative T cells

DNA: deoxyribonucleic acid

DNAM-1: DNAX accessory molecule 1

dNTP: desoxynucleoside triphosphates

DP: PGD receptor

DPB: diffuse panbronchiolitis

DRESS: Drug Rash with Eosinophilia and Systemic Symptoms

DSF: disease-free survival

DTH: delayed-type hypersensitivity

DTP: diphtheria-tetanus-polio

EAE: encephalomyelitis

EAE: experimental auto-immune

encephalomyelitis

EBV: Epstein-Barr virus

EDTA: ethylene diamine tetraacetic acid EGCG: epigallocatechin-3-gallate EGFR: epidermal growth factor receptor eGPx: extracellular glutathione peroxidase ELISPOT: enzyme-linked immunospot assay

ELK-1: member of ETS oncogene family

EMEA: European Agency for the Evaluation of Medicines

ENA-78: epithelial neutrophil-activating protein-78

ENC: endotoxin neutralizing capacity

eNOS: endothelial nitric oxide synthase

EP: PGE receptor

Ep-CAM: epithelial cell adhesion molecule

xviii

EPO: erythropoietin E-selectin: endothelial selectin

ESI: electrospray ionization

EST: expressed sequence tags

Fab: antigen-binding fragment of immuno-

globulins

Fabc: monovalent antigen-binding fragment of immunoglobulins comprising one Fab and Fc part

FasL: Fas ligand

Fc receptor: receptor for the constant binding fragment of immunoglobulins

Fc γRI: Fc gamma receptor I

Fc εRI: receptor I for IgE

Fc γRIIb: receptor IIb for immunoglobulin G

Fc: constant fragment of immunoglobulin

FcRn: neonatal receptor for IgG

FDA: U.S. Food and Drug Administration

FEV

: forced expiratory volume in 1 second

FGF: fibroblast growth factor

FKBP: FK506-binding proteins

FLAP: five-lipoxygenase-activating-protein fMLP: formyl-methionyl-leucyl-phenylalanine

FP: PGF receptor

FSH: follicle-stimulating hormone

5-FU: 5-fluorouracil

G-CSF: granulocyte-colony stimulating factor

GAGE: G antigen

GALT: gut-associated lymphoid tissue G-CSF: granulocyte colony-stimulating factor

GH: growth hormone

GHRH: growth hormone releasing hormone

GI: gastro-intestinal

GlyCAM-1: glycosylation-dependent cell adhesion molecule 1

GM-CSF: granulocyte-monocyte colony-stimulating factor

GMP: Good Manufacturing Practice

GMP: guanosine monophosphate

gp: glycoprotein

GPCR: G protein-coupled receptor

GPI: glycosylphosphatidyl inositol

GPMT: guinea pig maximization test

GR: corticosteroid receptor

GRE: glucocorticoid response element

GSH: glutathione

GSH-Px: glutathione peroxidase

GTP: guanosine triphosphate

GVHD: graft-versus-host disease

GVT: graft-versus-tumor

H&N: squamous cell carcinoma occurring in the head and neck region

H: histamine

H

O

: hydrogen peroxide

HAART: highly active antiretroviral therapy

HAE: hereditary angio-oedema

HAMA: human anti-mouse antibody

HBD: human- β defensin

HBsAg: hepatitis B surface antigen

HBV: hepatitis B virus

HCMV: human cytomegalovirus

HCV: hepatitis C virus

HDAC: histone deacetylase

HDL: high-density lipoprotein

HDT: high-dose chemotherapy

Her-2/neu: human epidermal receptor-2/neurological HER-2: human epidermal growth factor R 2

HETE: hydroxyeicosatetraenoic acid

HFA: hydrofluoroalkane

HGPRT: hypoxanthine-guanine phosphoribosyl- transferase

Hib:

HIV: human immunodeficiency virus

HLA: human leukocyte antigen

HMT: histamine N-methyltransferase

HMW: high molecular weight

HOCl: hypochlorous acid

HOP: HSP70/HSP90 organizing protein

HPA: hypothalamo-pituitary adrenal axis

HPETE: hydroperoxyeicosatetraenoic acids

HPT: hypothalamic pituitary thyroid

HPV: human papilloma virus

HRF: homologous restriction factor

HSA: human serum albumin

HSC: hematopoietic stem cells

HSP: heat shock protein

HSR: heat shock response

5-HT: serotonin

HTL: helper T lymphocyte

i. d.: intradermal(ly)

i. m.: intramuscular(ly)

xix

Abbreviations

i. v.: intravenous(ly)

IAR: immediate asthma response

IC: intracellular

iC3b: inactivated large fragment of complement factor 3

IC

: inhibitory concentration 50% (concentra- tion which inhibits 50% of activity) ICAM: intercellular adhesion molecule ICAM-1: intercellular adhesion molecule-1 ICAT: isotope-coded affinity tagging ICE: interleukin-1 α converting enzyme

ICH: International Conference on Harmoniza-

tion of Technical Requirements for Registration of Pharmaceuticals for Human Use

IEF: isoelectric focusing

IFN: interferon

IFN- γ: interferon gamma

Ig: immunoglobulin

IgA: immunoglobulin A

IgD: immunoglobulin D

IgE: immunoglobulin E

IGF-1: insulin-like growth factor-1

IgG: immunoglobulin G

IgG Ab: immunoglobulin G antibodies

IgM: immunoglobulin M

IgX: immunoglobulin X (X = A, D, E, G or M)

IL: interleukin

IL-1: interleukin 1

IL-2: interleukin 2

IL-6: interleukin 6

IL-10: interleukin 10

IL-12: interleukin 12

IL-1R: interleukin-1 receptor

IMPDH: inosine monophosphate dehydrogenase

INH: isoniazide

iNOS: inducible nitric oxide synthase

INR: immediate nasal response

IP: inducible protein

IP: PGI

receptor

IP

: inositol 1,4,5-triphosphate

IPC: interferon-producing cell

IPG: immobilized pH gradient

IPV: inactivated polio vaccine

IRAK: interleukin-1 receptor-associated kinase

IRM: immune response modifier

IRS: insulin receptor substrates

IS: immunological synapse

ITAM: immunoreceptor tyrosine-based activation motif

ITIM: immunoreceptor tyrosine-based inhibition motif

ITP: idiopathic thrombocytopenic purpurea

IU: international unit

IVIG: intravenous immunoglobulin

I- κB: inhibitor- κB

J: joining (gene segment)

JAK/STAT: Janus activated kinase/signal transducer activator transcription

JAK: Janus-activated kinase

JC virus: a human polyoma virus

JNK: c-jun N-terminal kinase

K

: calcium-activated potassium channel

kDa: kilo Dalton

KIR: killer cell immunoglobulin-like receptor

L: ligand

LABA: long-acting inhaled β

-agonists

LAD: leukocyte adhesion deficiency

LAF: lymphocyte-activation factor

LAK: lymphokine-activated killer

LAR: late asthma response

LBP: LPS-binding protein

LDL: low-density lipoproteins

LFA-1: leukocyte function-associated antigen-1

LH: luteinizing hormone

LHRH: luteinizing hormone releasing hormone

LLNA: local lymph node assay

LMP: latent membrane protein

LMW: low molecular weight

L-NAME: L-NG-nitro-arginine methyl ester

L-NMMA: L-NG-monomethyl arginine

LNR: late nasal response

5-LO: 5’-lipoxygenase

LOXs: lipoxygenases

LPS: lipopolysaccharide

LRR: leucine-rich repeat

LT: leukotriene

LTB

: leukotriene B

mAb monoclonal antibody(ies)

Mac-1: macrophage adhesion protein-1 (CR3)

xx

MAdCAM-1: mucosal addressin cell adhesion molecule 1

MAGE: melanoma antigen

Mal: MyD88-adapter-like

MALDI: matrix-assisted laser desorption/ionisation

MALT: mucosa-associated lymphoid tissue

MAO: monoamine oxidase

MAPK: mitogen-activated protein kinase MART: melanoma antigen recognized by T cells

MASP: MBL-associated serine protease

MBL: mannan-binding lectin

MCAT: mass-coded abundance tagging

MCP: membrane cofactor protein

MCP-1: monocyte chemotactic protein 1

M-CSF: macrophage colony-stimulating factor

MDI: metered-dose inhaler

MDP: muramyl dipeptides

MDR: multiple drug resistance

MG: myasthenia gravis

mHAg: minor histocompatibility antigen

MHC: major histocompatibility complex

MHLW: Ministry of Health, Labour and Welfare in Japan

MIC: minimal inhibitory concentration

mIg: membrane-bound immunoglobulin

MIMP: methyl inosine monophosphate

MKK: MAPK kinase kinase

MLV: multilamellar vesicles

MMP: matrix metalloproteinase

MMR: measles-mumps-rubella

MOA: mechanism of action

MODS: multiple organ dysfunction syndrome

MOX: monooxygenase

MPA: mycophenolic acid

M Φ: macrophages

MPL: monophosphoryl lipid A

MPO: myeloperoxidase

MPTP: 1-methyl-4-phenyl 1,2,3,6-tetrahydro- pyridine

Mr: molecular mass

mRNA: messenger ribonucleic acid

MS/MS: tandem mass spectrometry

MS: mass spectrometry

MS: multiple sclerosis

MSH: melanocyte-stimulating hormone

α-MSH: α-melanocyte stimulating hormone

MTD: maximum tolerated dose

mTOR: mammalian target of rapamycin

MTP-PE: muramyl tripeptide phos- phatidylethanolamide

MTX: methotrexate

MudPIT: multidimensional protein identification technology

NADPH: nicotinamide adenine dinucleotide phosphate, reduced form

NDV: Newcastle disease virus

NF- κB: nuclear factor kappa-B

NFAT: nuclear factor of activated T cells

NGF: nerve growth factor

NHL: non-Hodgkin’s lymphoma

NIEHS: U.S. National Institute of Environmental Health Sciences

NIOSH: U.S. National Institute for Occupational Safety and Health

NK: natural killer (cells)

NKA: neurokinin A

NKB: neurokinin B

NKR: natural killer receptors nNOS: neuronal nitric oxide synthase

NO: nitric oxide

NOD: nucleotide-binding oligomerisation

domain protein

NOXs: non-phagocytic oxidases

NSAID: non-steroidal anti-inflammatory drugs (N)SCLC: (non) small-cell lung cancer

NTP: U.S. National Toxicology Program

NY-ESO: New York-esophagus

O

: superoxide

ODN: oligodeoxynucleotide

OECD: Organization for Economic Co-operation

and Development

OID: optimal immunomodulatory dose

ONOO

: peroxynitrite

OPV: oral polio vaccine

OS: overall survival

PAF: platelet-activating factor

PALE: post-antibiotic leukocyte enhancement PALS: periarteriolar lymphoid sheath of spleen PAMP: pathogen-associated molecular pattern

PBL: peripheral blood leukocyte

PBMCs: peripheral blood mononuclear cells

xxi

Abbreviations

PBP: penicillin-binding protein

PBS: phosphate buffered saline

PCR: polymerase chain reaction

pDC: plasmacytoid dendritic cell

PDE: phosphodiesterases

PDGF: platelet-derived growth factor

PE: phycoerythrin

PECAM-1: platelet-endothelial-cell adhesion molecule 1

PEG: polyethylene glycol

PerCP: peridinin chlorophyll protein

PFN: perforin

PFS: progression-free survival

PGE

: prostaglandin E

PGI

: prostacyclin

PGN: peptidoglycan

P-gP: P-glycoprotein

PGs: prostaglandins

PHA: phytohaemagglutinin

pI: isoelectric point

PI3 kinase: phosphatidylinositol-3-kinase

PIP2: phosphatidyl-4,5-inositol bisphosphate PIP3: phosphatidylinositol (3,4,5) trisphosphate

PKB: protein kinase B

PKC- α: protein kinase C- α

PKC: protein kinase C

PLA

: phospholipase A

PLC: phospholipase C

PLD: phospholipase D

PLNA: popliteal lymph node assay

PMA: phorbol myristate acetate

PMBC: peripheral mononuclear blood cells

PMF: peptide mass fingerprinting

PML-RAR α: promyelocytic leukemia-retinoic acid receptor α

PMN: polymorphonuclear leukocyte

PNH: paroxysmal nocturnal haemoglobinurea

POMC: proopiomelanocortin

PPH: phosphatidate phosphohydrolase

PRL: prolactin

PRR: pattern recognition receptor

PSA: prostate-specific antigen

PSCT: peripheral stem cell transplant PSGL-1: P-selectin glycoprotein ligand-1 PSMA: prostate-specific membrane antigen

PTCA: percutaneous transluminal coronary

angioplasty

PTK: protein tyrosine kinase

PTM: post-translational modification

Px: peroxidase

QSAR: quantitative structure-activity relation- ship

QTOF: quadrupole time-of-flight

RA: reporter antigen

RA: rheumatoid arthritis

RAG: recombinant activation gene protein RANTES: regulated on activation, normal T cell

expressed and secreted

RA-PLNA: reporter antigen popliteal lymph node assay

RBL: rat basophil leukaemia

RDA: recommended daily allowance

r.f.: radio frequency

RFS: recurrence-free survival

RIVM: Rijks Institute voor Volksgezondheit en Milieu (Dutch National Institute for Public Health and the Environment)

RNA: ribonucleic acid

RNCl: secondary N-chloramine

ROS: reactive oxygen species

rRNA: ribosomal RNA

RSV: respiratory syncytial virus

RT: reverse transcription

s.c.: subcutaneous

S: Svedberg coefficient or chemical symbol

for sulphur

SAP: serum amyloid protein

SAPHO: synovitis acne pustulosis hyperostosis osteitis

SAR: structure-activity relationship

SRBC: sheep red blood cells

SARS: severe acute respiratory syndrome

SCF: stem cell factor

SCID: severe combined immunodeficient

(mouse)

(N)SCLC: (non) small-cell lung cancer

SCT stem cell transplantation

SD: standard deviation or solvent-detergent SDS-PAGE: sodium dodecyl sulphate polyacryl amid

gel electrophoresis

Sel P: selenoprotein P

xxii

SEREX: serological identification of antigens by recombinant expression cloning

SG: serglycin

SH2: src-homology 2

SHIP: SH2-containing inositol phosphatase SHP: SH2-containing protein tyrosine phos-

phatase

sIgX: surface immunoglobulin of class X (for X see IgX)

SIRP: signal regulatory protein

SIRS: systemic inflammatory response syndrome

SJS: Stevens-Johnson syndrome

SLE: systemic lupus erythematosus

SLP: S-layer protein

SMAC: supramolecular activation complexes

SMX: sulfamethoxazole

SOD: superoxide dismutase

SOM: somatostatin

SP: substance P

SRBC: sheep red blood cells

SRS-A: slow-reacting substance of anaphylaxis STAT: signal transducers and activators of

transcription

STZ: streptozotocin

T- α1: thymosin- α1

TAA: tumor-associated antigen

TACE: TNF- α converting enzyme

TAP: transporter associated with antigen processing

TCC: terminal complement complex

TCD: T cell-depleted

TCGF: T cell growth factor

TCR: T cell receptor (for antigen)

TDI: toluene diisocyanate

TdT: terminal deoxynucleotidyl transferase

TEN: toxic epidermal necrolysis

TGF- β: transforming growth factor- β

TGF: transforming growth factor

Th: T helper cell

TIL: tumor-infiltrating lymphocyte

TIR: Toll/IL-1 receptor

TIRAP: TIR adapter protein

TLR: Toll-like receptor

TLRL: Toll-like receptor ligand

TMP: trimethoprim

TNF: tumor necrosis factor

TNF- α: tumour necrosis factor- α

TNFR: TNF receptor

TNFSFL: TNF-super family ligand

TOF: time-of-flight

Tollip: Toll/IL-1R-interacting protein

TP: TXA

receptor

TPEN: (N,N,N,N’-teterakis (2-pyridilmethyl) ethylenediamine

T-PLL: T-prolymphocytic leukemia

TR: thioredoxin reductase

TRAF: TNF receptor-associated factor TRAIL: TNF-related apoptosis-inducing ligand TREC: T-cell receptor excision circle

Treg: regulatory T cell

TRH: thyrotropin-releasing hormone

TRIF: TIR domain-containing adapter inducing

IFN- β

TSH: thyrotropin

TX: thromboxane

UMP: uridine monophosphate

V/Q: ventilation-perfusion

V: variable (gene segment)

VCAM: vascular cell adhesion molecule VE-cadherin Vascular endothelium cadherin VEGF: vascular endothelial cell growth factor VIP: vasoactive intestinal polypeptide

VLA: very late antigen

WBC: white blood cells

WHO: World Health Organization

XLA: X-linked agammaglobulinemia

ZAP70: zeta chain-associated protein 70

xxiii

Abbreviations