Immunosuppressants in Oral Medicine: A Review

Immunomodulators in Dentistry, an Updated Review

“…To avoid negative effects and hasten the healing process, immunomodulators should be used with steroids hence these medications fall within the (1) category of "steroid sparing medicines" Steroid-sparing m e d i c a t i o n s a r e c a t e g o r i s e d a s : a l k y l a t i n g a ge n t s , A n t i m e t a b o l i t e a n d a n t i b i o t i c / c a l c i n e u r i n (12) Inhibitors Cyclophosphamide: Alkylating agent, Cyclophosphamide binds to DNA, more effective against B cell. Advised dose-1 gm IV /4 weeks .Used to treat Pemphigus, Wegener's granulomatosis, Granulomatosis with polyangitis, SLE, and Scleroderma.…”

“…Advised dose-1 gm IV /4 weeks .Used to treat Pemphigus, Wegener's granulomatosis, Granulomatosis with polyangitis, SLE, and Scleroderma. Adverse effects -acute bone marrow suppression, carcinogenesis, teratogenicity, interstitial lung fibrosis, and susceptibility to infections, sterility, amenorrhea, (12) nephrotoxicity, cystitis, and cardiovascular problems Cyclosporine: The fungus species Beauveria Nivea produces cyclosporine, a calcineurin inhibitor. It suppresses T cells' antigen-triggered signal transduction, reducing the (3) (18) production of numerous lymphokines.…”

“…DAPSONE: Dapsone (sulfone antibiotic) inhibits neutrophil chemotaxis by inhibiting myeloperoxidase and acts as an anti-inflammatory against PMN. Indicated for the treatment of epidermolysis bullosa, Behcet's illness, recurrent aphthous (12) (16) stomatitis, erythema multiforme. Dose-25 to 50 mg/ day.…”

“…Recommended dosage: 15 mg/week, with 1 mg/day of folate. Hepatotoxicity, marrow suppression, mouth ulcers, and alopecia are undesirable (12) (16) consequences.…”

“…Cytokine release s y n d ro m e , h i g h t e m p e r a t u re , c h i l l s , h e a d a c h e , nausea/vomiting, diarrhoea, and abdominal discomfort are side effects. It is not frequently used since it can cause severe pulmonary oedema, acute respiratory distress syndrome, and (12) cardiovascular collapse.…”