Targeted Immunosuppression: Precision Treatment for Liver and Gastrointestinal Tract

Presentation Description / Summary: Immunosuppressive therapy, including glucocorticoids, is often used to treat gastrointestinal and hepatic diseases. While the same classes of drugs that are used to attain systemic immunosuppression can also be used to treat gastrointestinal and hepatic diseases, often their "local" use in these two organs requires different strategies than those that are needed for systemic immunosuppression. Following a general overview of the use of immunosuppressive agents for the treatment of hepatic and gastrointestinal disease, specific topics for discussion will include the trend towards using less immunosuppressive agents for the treatment of inflammatory bowel disease (IBD), criteria for choosing when to use immunosuppressive agents when treating IBD, the use of glucocorticoids with gastrointestinal focused effects such as budesonide, the use of chlorambucil and cyclosporine for the treatment of IBD and protein-losing enteropathy (PLE), and the use of cyclosporine for the treatment of canine inflammatory hepatopathies. Recent relevant work from the Mississippi State University Pharmacodynamic Laboratory research team evaluating concentrations of cyclosporine in intestinal and hepatic tissues in dogs receiving low dose cyclosporine, and the effects of the drug on local T cell function in these organs, will be introduced and discussed.

Learner Outcomes: 1. Understand the decision-making process involved when determining whether immunosuppressive agents should be used to treat hepatic and gastrointestinal diseases. 2. Know the common immunosuppressive agents, and their formulations, that can be used to treat hepatic and gastrointestinal diseases. 3. Develop a "big picture" understanding of why the systemic effects of immunosuppressive agents may not be applicable when considering "local" effects in the liver and intestinal tract.