Immunologic approaches to the therapy of auto-immune salivary gland disease.
A variety of immunologic mechanisms may theoretically give rise to disease in the salivary glands. Among them are abnormal antibody production, hyper-reactive T-lymphocytes, and mono- or oligoclonal expansions of B-lymphocytes. While it is not clear which, if any, of these mechanisms are of prime importance in the immunopathology of salivary gland disease, they provide a framework within which to discuss theoretical approaches to the treatment of auto-immune salivary gland disease. Among the techniques used to decrease antibody-induced damage are non-steroidal anti-inflammatory agents, plasmapheresis, and corticosteroids. Cyclosporin, monoclonal antibodies, and biologic response-modifiers may be used to modulate T-cell function, and anti-idiotype antibodies or immunosuppressive agents may be used to treat malignant expansions of B-cells. Although the generally benign nature of auto-immune salivary gland disease precludes the use of many of the potentially toxic treatment regimens discussed here, the appreciation of these approaches to immunomodulation provides a basis upon which to develop new and innovative therapeutic strategies.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000917:Antibody Formation; D000936:Antigen-Antibody Complex; D001327:Autoimmune Diseases / Q000628:therapy*; D001402:B-Lymphocytes / Q000276:immunology; D003524:Cyclosporins / Q000627:therapeutic use; D006801:Humans; D007130:Immunoglobulin Idiotypes / Q000276:immunology; D007376:Interleukin-2 / Q000627:therapeutic use; D008213:Lymphocyte Activation / Q000187:drug effects; D010956:Plasmapheresis; D012466:Salivary Gland Diseases / Q000276:immunology / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology
D000305:Adrenal Cortex Hormones; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D000936:Antigen-Antibody Complex; D003524:Cyclosporins; D007130:Immunoglobulin Idiotypes; D007376:Interleukin-2