title: Immunomodulator therapy: monoclonal antibodies, fusion proteins, cytokines, and immunoglobulins.
abstract: The immune system consists of a diverse array of immunocompetent cells and inflammatory mediators that exist in complex networks. These components interact through cascades and feedback circuits, maintaining physiologic inflammation (eg, tissue repair) and immunosurveillance. In various autoimmune and allergic diseases, a foreign antigen or autoantigen might upset this fine balance, leading to dysregulated immunity, persistent inflammation, and ultimately pathologic sequelae. In recent years, there has been tremendous progress delineating the specific components of the immune system that contribute to various aspects of normal immunity and specific disease states. With this greater understanding of pathogenesis coupled with advances in biotechnology, many immunomodulatory agents commonly called "biologic agents" have been introduced into the clinic for the treatment of various conditions, including immune globulins and cytokines. The 2 most common classes of approved biologic agents are mAbs and fusion proteins with exquisite specificity. These agents have the potential both to optimize outcomes through more thorough modulation of specific parts of the dysregulated immune response and to minimize toxicity compared with less specific methods of immunosuppression.
authors.affiliation: Division of Rheumatology, Allergy, and Immunology, University of California, San Diego, CA 92093-0943, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Javier
authors.initials: J
authors.lastname: Chinen
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D002464:Cell Migration Inhibition; D016207:Cytokines / Q000037:antagonists & inhibitors; D055808:Drug Discovery; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use*; D007167:Immunotherapy / Q000639:trends*; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D016207:Cytokines; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D018836:Inflammation Mediators; D011993:Recombinant Fusion Proteins