Immune system - drug metabolism interactions: Toxicological insight

From many years the inflammation is considered as one important determinant of susceptibility to intoxication by xenobiotic exposure. Inflammation and vaccination in most cases are connected with immune system stimulation and release of cytokines, adipokines, reactive oxygen species, nitric oxide, proteases, and lipid metabolites. That was accompanied by different extend of down-regulation of the main xenobiotic/drug metabolizing enzyme system cytochrome P450 (CYP) both in the liver and the adipose tissue. We need more knowledge of possible changes in the pharmacokinetics respectively in effectiveness and side effects of drugs used in chronically ill patients in case of occurrence of acute viral or bacterial infection in them or after the application of different vaccines. This would contribute significantly to the optimization of personal drug therapy avoiding toxicity or lack of effectiveness. Here we tried to summarize some of the main experimental and clinical data of altered drug metabolizing enzyme system in the case of changes in the immune system due to inflammation or vaccination.