[Biotherapy of auto-immune diseases : past, present and future perspectives].
During the last decade, new biotherapies have been developed for the treatment of systemic autoimmune diseases. These new approaches are based on a better understanding of the auto-immune response. Targets of these new treatments are the main steps of the immune response. These new treatments include: B lymphocytes inhibitors, inhibitors of the costimulation between antigen-presenting cells and T lymphocytes, T lymphocytes inhibitors, B and T lymphocytes inhibitors, modulators of the cytokine network, complement system inhibitors, and chemokines and integrins inhibitors. Advances in molecular biology, genetics and immunology have accelerated our understanding of auto-immune diseases, and allow identification of new targets. Development of new biotechnological tools with longer half-lives and increased affinity is an important next step. In spite of these exciting new perspectives, a systematic risk/benefit evaluation of these new treatments appears mandatory because immunity plays a key role in the control of infectious and tumor diseases. Further research is also needed to evaluate the cost/effectiveness ratio of these new therapies.
Arnaud
Laurent
L
Service de médecine interne 2, Centre de référence des maladies auto-immunes et systémiques rares, Hôpital Pitié-Salpêtrière, AP-HP, Université Paris 6, F-75013 Paris Cedex 13, France.
Haroche
Julien
J
Piette
Jean-Charles
JC
Amoura
Zahir
Z
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy*; D053264:B-Cell Activating Factor / Q000037:antagonists & inhibitors; D001402:B-Lymphocytes / Q000276:immunology; D002464:Cell Migration Inhibition / Q000187:drug effects; D018925:Chemokines / Q000037:antagonists & inhibitors; D003165:Complement System Proteins / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D016023:Integrins / Q000037:antagonists & inhibitors; D007378:Interleukins / Q000037:antagonists & inhibitors; D000069283:Rituximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D053264:B-Cell Activating Factor; D018925:Chemokines; D007155:Immunologic Factors; D016023:Integrins; D007378:Interleukins; C505719:TNFSF13B protein, human; D014409:Tumor Necrosis Factor-alpha; C448700:epratuzumab; D000069283:Rituximab; C511911:belimumab; D003165:Complement System Proteins; C481642:eculizumab; C456519:visilizumab; C520522:zanolimumab