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Curr Opin Immunol. 2009 Dec;21(6):648-57. doi: 10.1016/j.coi.2009.09.008. Epub 2009 Oct 12.

Novel targeted therapies for autoimmunity.

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Department of Medicine, Duke University Medical Center, Box 3874 DUMC, Durham, NC 27710, USA.


The emergence of new targeted therapies is rapidly improving the treatment of autoimmune disease. These drugs have been variably designed to deplete specific T and B cell subsets, interrupt receptor-ligand interactions, and inhibit the activity of inflammatory mediators relevant to immune function. Abatacept, a co-stimulatory blocker, and rituximab, a B cell depleting antibody, are among the approved therapies seeking new indications, while the newer therapies include Fc receptor-non-binding CD3-specific antibodies, IL-12/23 antibodies, an IL-6 receptor antagonist, a sphingosine-1-phosphate agonist, and small molecule inhibitors of intracellular protein kinases. Antigen-specific therapies are in their infancy, but the latest results administering glutamic acid dehydrogenase peptide to type 1 diabetics are promising. In the future, treatment strategies may increasingly explore the use of drug combinations acting at multiple sites of aberrant immunoregulation to achieve disease quiescence and immune tolerance.

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