Autoimmune Disease: Treatment

Abstract

AbstractIn recent years, substantial progress has been made in understanding the mechanisms of inflammation and autoimmunity, providing new targets for the development of new treatment principles. Tumour necrosis factor α (TNFα) antagonists have been proven as a major progress in the treatment of different rheumatic and chronic inflammatory bowel diseases. The interleukin 1 (IL‐1) receptor antagonist has considerably improved our medication for the systemic juvenile arthritis and periodic fever syndromes, an anti‐IL‐6 receptor monoclonal antibody might be of value as well as abatacept, a cytotoxity lymphocyte‐associated antigen 4Ig (CTLA‐4Ig) fusion protein for the treatment of patients with rheumatic diseases who do not respond to TNF antagonists. The same is true for rituximab, a chimeric anti‐CD20 antibody.Key conceptsMode of action and indications for the treatment with traditional and new (cyclooxygenase II, COX‐II, inhibitors), Nonsteroidal anti‐inflammatory drugs (NSAIDs).Mode of action and indications of steroids for the treatment of autoimmune and chronic inflammatory diseases.Disease modifying and immunosuppressive drugs, there are different modes of action.The limitation of surgical approaches in the treatment of autoimmune and chronic inflammatory diseases such as thymectomy, splenectomy and synovectomy.The limitation of radiotherapy and total lymphoid irradiation for the treatment of autoimmune diseases.The limitation of plasmapheresis and leucapheresis as treatment principles for autoimmune diseases.Cellular and juvenile targets for immune intervention in autoimmune and chronic inflammatory diseases.Biologics for the treatment of autoimmune and chronic inflammatory diseases, modes of actions.Monoclonal antibodies and fusion proteins for targeting T cells, B cells, cytokines and adhesion molecules.Mechanisms that could help to reestablish self‐tolerance as well as the ultimate therapeutic goal in autoimmune diseases.