title: Integrative continuum: accelerating therapeutic advances in rare autoimmune diseases.
abstract: Autoimmune diseases are chronic, life threatening, and of burgeoning public health concern. They rank among the 10 most common causes of death in women, and some have incidence rates surpassing those of heart disease and cancer. Emerging information regarding molecular and cellular mechanisms affords opportunities for the discovery of novel therapeutic strategies or the repurposing of FDA-approved pharmacologic agents. Yet, obstacles to drug development amplify as an inverse function of the incidence of rare autoimmune disease; challenges include heterogeneous clinical presentation, paucity of definitive biomarkers, and poorly validated measures of therapeutic response. An integrative continuum model to address these challenges is being applied to neuromyelitis optica (NMO)-a potentially devastating neurodegenerative process that has had limited therapeutic options. This model links target discovery with pharmacologic application to accelerate improved clinical efficacy. The application of such innovative strategies may help researchers overcome barriers to therapeutic advances in NMO and other rare autoimmune diseases.
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California 90024, USA. doctor@kvh3.com
authors.forename: Katja
authors.initials: K
authors.lastname: Van Herle
authors.forename: Jacinta M
authors.initials: JM
authors.lastname: Behne
authors.forename: Andre
authors.initials: A
authors.lastname: Van Herle
authors.forename: Terrence F
authors.initials: TF
authors.lastname: Blaschke
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Smith
authors.forename: Michael R
authors.initials: MR
authors.lastname: Yeaman
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D009471:Neuromyelitis Optica / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D011634:Public Health; D035583:Rare Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D014481:United States; D014486:United States Food and Drug Administration