Advertisement

Current Principles and Perspectives in the Treatment of Autoimmune Disease

  • H. H. Peter
Conference paper

Abstract

Autoimmune diseases are thought to result from a dysregulation of the immune system leading to loss of self-tolerance and autoaggression via antigen-specific T and B cell responses. Whether or not these responses are directed against true autoantigens or cross-reacting epitopes of microbial origin remains a matter of intense debate and research (Schwimmbeck et al. 1987; Steglitz et al. 1989; Hermann 1991; Smiley and Hoffmann 1991; Kaufmann 1990). Nevertheless, an ever-increasing number of high-titer autoantibodies of the IgG and IgA isotypes are being reported (Brostoff et al. 1991; Pisetzky 1991). Most of these autoantibodies are associated with distinct clinicopathologic conditions. Thus, various types of antinuclear antibodies (ANA) are specific markers of certain collagen vascular diseases, antimitochondrial antibodies (ANA) are associated with autoimmune liver disease and antineutrophil cytoplasmic autoantibodies (ANA) with necrotizing granulomatous vasculitis or crescentic glomerulonephritis (Jennette and Falk 1992).

Keywords

Systemic Lupus Erythematosus Crescentic Glomerulonephritis Autoimmune Liver Disease Total Lymphoid Irradiation Autoimmune Pathogenesis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Balaban EP, Zashin SJ, Geppert TD, Lipsky PE (1991) Treatment of systemic sclerosis with antithymocyte globulin. Arthritis Rheum 34: 244–245PubMedCrossRefGoogle Scholar
  2. Brooks P (1992) Current issues of methotrexate and cyclosporine. Curr Opin Rheumatol 4: 309–313PubMedCrossRefGoogle Scholar
  3. Brostoff J, Scadding GK, Male D, Roitt IM (1991) Clinical immunology. Gower Medical, LondonGoogle Scholar
  4. Dubois EL (1956) Prednisone and prednisolone in the treatment of systemic lupus erythematosus. JAMA 161: 427–433Google Scholar
  5. Dwyer JM (1992) Manipulation of the immune system with immune globulin. N Engl J Med 326: 107–116PubMedCrossRefGoogle Scholar
  6. Jeurissen MEC, Toderbooms AM, van de Putte LBA et al. (1991) Methotrexate versus azathioprine in the treatment of rheumatoid arthritis. Arthritis Rheum 34: 961–972PubMedCrossRefGoogle Scholar
  7. Jennette JC, Falk RJ (1992) Disease associations and pathogenic role of antineutrophil cytoplasmic autoantibodies in vasculitis. Curr Opin Rheumatol 4: 9–15PubMedGoogle Scholar
  8. Hermann E, Lohse AW, Van der Zee R, Van Eden E, Mayet WJ, Probst P, Poralla T, Meyer zum Büschenfelde KH, Fleischer B (1991) Synovial fluid-derived Yersinia-reactive T cells responding to human 65-kDa heat-shock protein and heat-stressed antigen-presenting cells. Eur J Immunol 21: 2139–2143PubMedCrossRefGoogle Scholar
  9. Hofschneider PH, Lemmel EM, Gans W et al. (1992) Double blind controlled phase III multicenter clinical trial with interferon gamma in rheumatoid arthritis. Rheumatol Int. 12: 175–185CrossRefGoogle Scholar
  10. Kalden JR (1985) Plasmapheresis. In: Gupta S, Talal N (eds) Immunology of rheumatic diseases. Plenum Medical, New York, pp 741–765CrossRefGoogle Scholar
  11. Kaufmann SHE (1990) Heat shock proteins: a link between rheumatoid arthritis and infection? Curr Opin Rheumatol 2: 430–432PubMedCrossRefGoogle Scholar
  12. Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Labrum E, Eek M, Mowinkel P, Hovi K, Forre O (1991) Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 338: 900–902CrossRefGoogle Scholar
  13. Klippel JH (1987) Immunosuppressive therapy. In: Lahita RG (ed) Systemic lupus erythematosus. Wiley, New York, pp 923–945Google Scholar
  14. McCune WJ, Friedman AW (1992) Immunosuppressive drug therapy for rheumatic disease. Curr Opin Rheumatol 4: 314–321PubMedCrossRefGoogle Scholar
  15. Morell A, Nydegger KE (eds) (1986) Clinical use of intravenous immunoglobulins. Academic, LondonGoogle Scholar
  16. Pisetzky DS (1991) Autoantibodies and their idiotypes. Curr Opin Rheumatol 3: 731–737CrossRefGoogle Scholar
  17. Reiter C, Kakavand B, Rieber EP, Schattenkirchner M, Riethmüller G, Krüger K (1991) Treatment of rheumatoid arthritis with monoclonal anti CD4 antibody M-T151. Arthritis Rheum 34: 525–536PubMedCrossRefGoogle Scholar
  18. Rook AH, Freundlich B, Jegasothy BV et al. (1992) Treatment of systemic sclerosis with extracorporeal photochemotherapy — results of a multicenter trial. Arch Dermatol 128: 337–346PubMedCrossRefGoogle Scholar
  19. Schwimmbeck PL, Yu DT, Oldstone MB (1987) Antibodies to HLA-B27 in the sera of HLA-B27+ patients with ankylosing spondylitis and Reiter’s syndrome: molecular mimicry with Klebsiella pneumoniae as potential mechanism of autoimmune disease. J Exp Med 171: 1635–1647Google Scholar
  20. Skeith KJ, Davies P (1992) New horizons in the medical treatment of rheumatoid arthritis. Curr Opin Rheumatol 4: 365–371PubMedCrossRefGoogle Scholar
  21. Smiley JD, Hoffmann WL (1991) The role of infections in rheumatic diseases: molecular mimicry between bacterial and human stress proteins. Am J Med Sci 301: 138–149PubMedCrossRefGoogle Scholar
  22. Steglitz H, Fosmire S, Lipsky P (1989) Identification of a 2-MD from Shigella flexneri plasmid associated with reactive arthritis. Arthritis Rheum 32: 937–946CrossRefGoogle Scholar
  23. Strober SM, Farinas EH, Field EH et al. (1988) Treatment of lupus nephritis with total lymphoid irradiation: observations during a 12–79 month follow-up. Arthritis Rheum 31: 850–858PubMedCrossRefGoogle Scholar
  24. Trentham DE (1992) Novel immunomodulating and immunotherapies and novel therapies and strategies for inflammatory arthropathy. Curr Opin Rheumatol 4: 322–324PubMedCrossRefGoogle Scholar
  25. Wilske KR, Healey LA (1989) Remodelling the pyramid: a concept whose time has come. J Rheumatol 16: 557–565Google Scholar
  26. Wrouth DC, Smilek DE, Mitchell DJ, Steinman L, McDevitt HO (1989) Antigen recognition in autoimmune encephalomyelitis and the potential for peptide-mediated immunotherapy. Cell 59: 247–255CrossRefGoogle Scholar
  27. Zeidler H, Raspe HH (1990a) Systemische Pharmakotherapie. In: Zeidler H (ed) Rheumatologie. IMG, vol 6. Urban and Schwarzenberg Munich, pp 314–327Google Scholar
  28. Zeidler H, Raspe HH (1990b) Lokale Therapie. In: Zeidler H (ed) Rheumatologie. IMG, vol 6. Urban and Schwarzenberg, Munich, pp 328–334Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • H. H. Peter

There are no affiliations available

Personalised recommendations