Biological response modifier


Biological response modifiers are substances that modify immune responses. They can be both endogenous and exogenous, and they can either enhance an immune response or suppress it. Some of these substances arouse the body's response to an infection, and others can keep the response from becoming excessive. Thus they serve as immunomodulators in immunotherapy, which can be helpful in treating cancer and in treating autoimmune diseases, such as some kinds of arthritis and dermatitis. Most BRMs are biopharmaceuticals, including monoclonal antibodies, interleukin 2, interferons, and various types of colony-stimulating factors. "Immunotherapy makes use of BRMs to enhance the activity of the immune system to increase the body's natural defense mechanisms against cancer", whereas BRMs for rheumatoid arthritis aim to reduce inflammation.
Some of the effects of BRMs include nausea and vomiting, diarrhea, loss of appetite, fever and chills, muscle aches, weakness, skin rash, an increased tendency to bleed, or swelling. For example, patients with Systemic Lupus Erythematosus who are treated with standard of care, including biologic response modifiers, experience a higher risk of mortality and opportunistic infection compared to the general population.

[Abciximab]

Clinical use: Acute coronary syndromes, percutaneous transluminal coronary angioplasty.
Toxicity: Bleeding, thrombocytopenia.

[Anakinra] (Kineret)

Clinical use: Rheumatoid arthritis.
Toxicity: Allergic response & neutropenia.

[Etanercept] (Enbrel)

Clinical use: Rheumatoid arthritis, psoriasis, ankylosing spondylitis.

[Infliximab] (Remicade)

Clinical use: Crohn's disease, rheumatoid arthritis, ankylosing spondylitis.
Toxicity: Respiratory infection, fever, hypotension. Predisposes to infections.

[Rituximab] (Rituxan)

Clinical use: Lymphoma and a variety of autoimmune diseases, although it may be ineffective in treating IgA-mediated diseases.

[Trastuzumab] (Herceptin)

Clinical use: Metastatic breast cancer.
Toxicity: Cardiotoxicity.

Natural BRMs

Extracts from some medicinal mushrooms are natural biological response modifiers.