The immune system is a composite of the means by which individual organisms maintain their individual integrity in the face of constant interaction with the environment and the continuous internal process of death and removal of host cells that allows for replacement and growth. Both the innate and adaptive divisions of the immune system are critical to the maintenance of homeostasis, physical integrity, and health. Intricately interactive pathways of cells, cell surface receptors, antibodies, and cytokines provide surveillance against invasive pathogens and nonself entities and internal destruction and removal of host senescent cells. The specificity and efficacy of these immune components interacting with their respective ligands provide the mechanistic basis of immune function. Several disease conditions occur upon immune dysfunction including immune deficiency, allergy, and autoimmunity. Chronic immune system activation accompanies essentially all of the myriad of chronic inflammatory diseases that currently plague our species with the manner and degree of immune contribution to these conditions a current area of intense interest and investigation by the biomedical community. The rapid technological advancement over the past few decades has profoundly influenced the scientific approaches that shape the therapeutic landscape. Undoubtedly, immunopharmacology is an important player in the modern era of transition toward precision medicine that is largely defined by the identification of patient-specific therapies. According to the Immunopharmacology Section - ImmuPhar of the International Union of Basic and Clinical Pharmacology (IUPHAR), immunopharmacology is considered to be the youngest area of pharmacology dealing with the selective modulation, mostly up- or down-regulation, of specific immune responses that are often accomplished by immune cell subsets with specialized functions. Although the recent biotechnological progress has made available new classes of drugs with improved selectivity, agents possessing immunomodulating activities have been used in clinical practice for more than 70 years. A pertinent example from the late 1940s is the counteraction of the inflammatory response upon administration of cortisone in patients with rheumatoid arthritis. Immunopharmacology is all about combinatorial therapy the use of multiple antitumor drugs that have different mechanisms of action. Optimal treatment protocols combine drugs that have no overlapping toxicities. These cytotoxic cocktails provide maximal cell killing efficacy and may slow or prevent resistant cancer cells from developing. Although relatively few studies have focused on the immunopharmacology of rexinoids in the context of cancer, documentation of rexinoid induced immunomodulatory effects combined with evidence of altered PD-L1 expression in tumors of mice upon treatment with a rexinoid provides justification for evaluation of the combination of rexinoids and checkpoint inhibitors for the treatment of cancer. Elevation of PD-L1 enhances the response to checkpoint blockade in tumors and elevated levels of PD-L1 in breast cancer patients is correlated with increased survival .Many clinical trials testing rexinoids in cancer patients have concluded that rexinoids are an excellent candidate for combination therapy based on their safety profile, this therapeutic combination has the potential to improve efficacy and is worthy of future investigations. Major applications of pharmaceutical industry are based on the particular reactions of a patient reacting to the drug.

Regards,

Elsa

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