Immunotherapies in rheumatologic disorders.
Over the past several decades, rheumatology has directed its focus to understanding and countering the immune dysregulation underlying autoimmune diseases with rheumatologic manifestations. Older therapies, effective though poorly understood, are being scrutinized anew and are yielding the immune-modulating mechanisms behind their efficacy. New therapies, the "biologics," are drugs tailored to address specific immune defects and imbalances. This article discusses the current standard and biologic immunotherapies of the rheumatic diseases, correlating our current understanding of their mechanisms with dysfunctions believed to be present in the major autoimmune syndromes, especially rheumatoid arthritis and systemic lupus erythematosus.
Division of Rheumatology, Department of Internal Medicine, Southern Illinois University School of Medicine, PO Box 19636, Springfield, IL 62794-9636, USA. amiller3@siumed.edu
Anne V
AV
Miller
Sriya K M
SK
Ranatunga
D000069594:Abatacept; D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D000068582:Certolizumab Pegol; D003078:Colchicine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D000068800:Etanercept; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D018796:Immunoconjugates / Q000627:therapeutic use; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use; D007555:Isoxazoles / Q000627:therapeutic use; D000077339:Leflunomide; D008727:Methotrexate / Q000627:therapeutic use; D008911:Minocycline / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000276:immunology; D000069283:Rituximab; D012460:Sulfasalazine / Q000627:therapeutic use; D000079424:Tumor Necrosis Factor Inhibitors
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D018796:Immunoconjugates; D007140:Immunoglobulin Fab Fragments; D007074:Immunoglobulin G; D053590:Interleukin 1 Receptor Antagonist Protein; D007555:Isoxazoles; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D000079424:Tumor Necrosis Factor Inhibitors; D011092:Polyethylene Glycols; D012460:Sulfasalazine; D000069283:Rituximab; D006886:Hydroxychloroquine; C511911:belimumab; D000069594:Abatacept; D016572:Cyclosporine; C531377:rilonacept; D003520:Cyclophosphamide; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D008911:Minocycline; D000077339:Leflunomide; D009173:Mycophenolic Acid; C502936:tocilizumab; D001379:Azathioprine; D000068800:Etanercept; D003078:Colchicine; D000068582:Certolizumab Pegol; D008727:Methotrexate