Modulation of Cytokine Function: Therapeutic Applications

Abstract

Publisher Summary This chapter illustrates that cytokines are important therapeutic targets in a range of diseases and has given an overview of current approaches being used to modify the activity of “pathological” cytokines. Anticytokine therapy is now in the clinic with blocking antibodies, antagonists, and inhibitors of release being clinically evaluated in phase II/III trials and other modalities (e.g., anti-LPS antibodies), waiting, uncomfortably, on the U.S. Food and Drug Administration (FDA) decision to license. Largely, with protein products, this can depend on the skills of the molecular biologist and the production engineers and the vagaries of the human immune system. Proteins (antibodies, soluble receptors, and natural antagonists) represent the first phase of anticytokine therapy. These may have use in the treatment of acute conditions (e.g., septic shock) and life-threatening diseases such as cancer. The choice among the various proteinaceous drugs depends on their efficacy and cost. However, there are still many problems to be overcome in the development of cytokine-modulatory drugs, and it is only with the second phase of development of nonpeptide agents that one can confidently predict that anticytokine reagents will be clinically used for the more common but nonfatal diseases, such as rheumatoid arthritis and osteoarthritis.