title: The role of biologics in treatment of connective tissue disease-associated interstitial lung disease.
abstract: With an increased understanding of the molecular pathways of inflammation and autoimmunity, the development of targeted biological agents has revolutionized the management of connective tissue diseases (CTDs). There has been an explosion in the development of these drugs in the last decade, targeting diseases in diverse fields including: allergic disorders, oncology, neuroinflammatory disorders, inflammatory bowel disease, macular degeneration and CTDs. In this last field, commonly applied biologics fall into two categories: cytokine inhibitors and lymphocyte-targeted therapies. The former group includes the antitumour necrosis factor alpha (TNF-α), anti-interleukin (IL)-6 receptor monoclonal antibodies and IL-1 receptor antagonists, whilst the latter encompasses the anti-CD20, B-cell depleting, monoclonal antibody (mAb), Rituximab and the anti-T-cell activation agent, Abatacept. This review will examine our developing experience in the use of these agents in the treatment of CTD-related interstitial lung diseases, with a particular focus on B-cell depletion.
authors.affiliation: Bristol Interstitial Lung Disease Unit, North Bristol NHS Trust, Brunel Building, Southmead Hospital, Bristol BS10 5NB, UK.
authors.forename: C
authors.initials: C
authors.lastname: Sharp
authors.affiliation: Bristol Interstitial Lung Disease Unit, North Bristol NHS Trust, Brunel Building, Southmead Hospital, Bristol BS10 5NB, UK.
authors.forename: N
authors.initials: N
authors.lastname: Dodds
authors.affiliation: Bristol Interstitial Lung Disease Unit, North Bristol NHS Trust, Brunel Building, Southmead Hospital, Bristol BS10 5NB, UK.
authors.forename: L
authors.initials: L
authors.lastname: Mayers
authors.affiliation: Bristol Interstitial Lung Disease Unit, North Bristol NHS Trust, Brunel Building, Southmead Hospital, Bristol BS10 5NB, UK.
authors.forename: A B
authors.initials: AB
authors.lastname: Millar
authors.affiliation: Bristol Interstitial Lung Disease Unit, North Bristol NHS Trust, Brunel Building, Southmead Hospital, Bristol BS10 5NB, UK.
authors.forename: H
authors.initials: H
authors.lastname: Gunawardena
authors.affiliation: Bristol Interstitial Lung Disease Unit, North Bristol NHS Trust, Brunel Building, Southmead Hospital, Bristol BS10 5NB, UK Huzaifa.Adamali@nbt.nhs.uk.
authors.forename: H
authors.initials: H
authors.lastname: Adamali
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D003240:Connective Tissue Diseases / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000188:drug therapy*; D000069283:Rituximab / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D001688:Biological Products; D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab