The immune response is an essential network of cells,
tissues, and organs that work together to provide a defence mechanism for the host
organism. The primary targets of the immune system are microbes, parasites, and
fungi that can cause infections. However, the system may become defective, disorganized
or overactive, reacting to host tissues and causing disorders such as arthritis,
allergic reactions and implicated in other conditions such as diabetes melittus
among others, probably due to the recently identified Th 17. With such vital role,
a mechanism of modulating the action of the system is essential.
The immune system is composed of two arms that work closely
together, the innate immune system being more active early in an immune response
while the adaptive immunity becomes progressively dominant over time.
Current medications used to modulate the immune system
mainly exploit the mechanism of action of the immune system, blocking or enhancing
some essential steps in the immune response cascade to provide their actions.
In the critically ill patient, the role of the immune
system becomes even more evident as various conditions may come into play simultaneously,
hence the essence of the current study.
During the review of the article, ‘Immunomodulation in the critically ill’
a publication of the British Journal of Anaesthesia, the reviewer will provide
a summary of the article, then analyse the structure followed by a critique
of the work. This will be followed by an analysis of the objectivity and stability
of the article. The review will also analyse the tables presented in the article.
Recent advances related to the topic will also be examined followed by a conclusion
of the article review.
E, Reinhart K, Opal S, et al. Efficacy and safety of tifaco-gin (recombinant tissue
factor pathway inhibitor) in severe sepsis:a randomized controlled trial. Journal
of American Medical Association 2003; 290:238 – 47
BG: Long-term experience with interferon beta-1b (Betaferon) in multiple sclerosis.
Journal of Neurology 2005;252(Suppl 3):iii28
Gleeson, Michael A. Heneghan. British Society of Gastroenterology (BSG) guidelines
for management of autoimmune hepatitis. Gut, 2010 doi:10.1136/gut.2010.235259
HF, El Sakka NE, Webster NR, Lowes DA, Cuthbertson BH. Activated protein C inhibits
chemotaxis and interleukin-6 release by human neutrophils without affecting other
neutrophil functions. Br J Anaesth2008;100: 815 –9
AH et al: Cyclosporine A monotherapy versus cyclosporine A and methotrexate combination
therapy in patients with early rheumatoid arthritis: A double blind randomised placebo
controlled trial. Annals of the Rheumatic Diseases 2003;62:291.
& Gilman’s. Manual of Pharmacology and Therapeutics, Professor of Pharmacology
& Medicine University of California, 5th ed. San Diego LaJolla, California
R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease
of the newborn. Arch Dis Child Fetal Neonatal Ed. 2003;88:F6-10
C et al: Immunobiology: The Immune System in Health and Disease, 6th ed.
Current Biology Publications, 2005.
M. Ritter, Lionel D. Lewis, Timothy GK. Mant and Albert Ferro. A textbook of Clinical
Pharmacology and Therapeutics 5th ed. London, 2008; 399-407
GB, Trevor JA. Basic and Clinical Pharmacology 11th edition. 2009; 363-435.
RW, Harisdangkul V: Mycophenolate mofetil: Selective T cell inhibition. The American Journal of Medical Science.
et al.; Reduced plasma levels of soluble interleukin-7 receptor during graft-versus-host
disease (GVHD) in children and adults. BMC Immunology 2014, 15:25 doi:10.1186/1471-2172-15-25
HP and Dale MM. Rang and dale Pharmacology. 6th edition. Churchill Livingestone
Elsevier 2007; 481-488, 538-541
Oever et al.; The discriminative capacity of soluble Toll-like receptor (sTLR)2
and sTLR4 in inflammatory diseases. BMC Immunology 2014, 15:55 doi:10.1186/s12865-014-0055-y
Patil, A.V. Jaydeokar, D.D. Bandawane. Immunomodulators: A pharmacological review.
International Journal of Pharmacy and Pharmaceutical Sciences, vol 4, suppl 1, 2012