Journal of Nanomedicine & Biotherapeutic Discovery
Open Access

Emerging Role of Immunotherapy in the Treatment of Autoimmune Diseases

Wei Zhang^{* *}Correspondence: Wei Zhang, Department of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China, Email:

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Description

Autoimmune diseases arise when the immune system incorrectly attacks the body’s own tissues, leading to chronic inflammation and tissue damage. Traditional treatments have primarily focused on broad immunosuppression to reduce symptoms. However, these approaches often come with significant side effects and do not address the underlying cause of the disease. Immunotherapy, which has revolutionized cancer treatment by joining the body’s immune system to target malignancies, is now emerging as a hopeful strategy for treating autoimmune diseases. This article explores the potential of immunotherapy in modulating immune responses, the latest advancements in the field, and the challenges that need to be addressed for its successful application in autoimmune diseases. Autoimmune diseases affect millions of people worldwide and encompass a wide range of conditions, including rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis. These diseases are characterized by an overactive immune response that targets healthy tissues, leading to chronic inflammation and progressive damage. Traditional treatments, such as corticosteroids and Disease-Modifying Antirheumatic Drugs (DMARDs), aim to reduce inflammation and slow disease progression. However, they often provide only symptomatic relief and can cause significant side effects due to broad immunosuppression.

Immunotherapy, which has gained significant attention in oncology, offers a novel approach by specifically targeting immune pathways involved in disease pathogenesis. Immunotherapy for autoimmune diseases aims to restore immune tolerance by selectively modulating the immune system. Immune Checkpoint inhibitors and agonists: While immune checkpoint inhibitors like anti-PD-1 and anti-CTLA-4 have been used in cancer to boost immune responses, in autoimmune diseases, checkpoint agonists are being explored to promote tolerance and prevent immune-mediated tissue damage. Tregs play a critical role in maintaining immune tolerance. Therapies aimed at expanding or enhancing the function of Tregs, such as low-dose Interleukin-2 (IL-2) therapy, are being studied for their potential to suppress autoreactive immune cells. Similar to CART cell therapy in cancer, adoptive cell transfer in autoimmune diseases involves the infusion of autologous or allogeneic T cells engineered to target specific antigens involved in the autoimmune response. Targeting pro-inflammatory cytokines, such as Tumor Necrosis Factor (TNF-α), IL-6, and IL-17, has been a successful strategy in treating autoimmune diseases. Novel cytokine-based therapies, including the blockade of IL-23 or IL-12/23 pathways, are being developed to further refine this approach.

Several immunotherapeutic approaches are currently under investigation in clinical trials for various autoimmune diseases such as rheumatoid arthritis, where T cell depletion therapies, such as abatacept (CTLA-4-Ig), and the blockade of IL-6 signaling (tocilizumab) have shown efficacy in reducing symptoms and disease progression in rheumatoid arthritis. In Multiple Sclerosis (MS) the use of anti-CD20 monoclonal antibodies (e.g., ocrelizumab) has been effective in depleting B cells, leading to reduced relapse rates and slowing disease progression in MS patients. As well as in Systemic Lupus Erythematosus (SLE), targeting the B Lymphocyte Stimulator (BLyS) pathway with belimumab has shown promise in reducing disease activity and flares in SLE patients, whereas Type 1 Diabetes (T1D) is a immunotherapy aimed at preserving β-cell function through the use of anti-CD3 antibodies and IL-2/Treg therapy is under investigation, with early studies showing potential in delaying disease progression.

Although immunotherapy shows significant potential, numerous challenges must be tackled. Identifying specific biomarkers that predict response to immunotherapy is vital for developing personalized treatment strategies. Balancing efficacy and ensuring safety in immunotherapy requires balancing the reduction of the autoimmune response with the prevention of excessive immunosuppression, which could increase the risk of infections or malignancies. The long-term benefits and risks of immunotherapy in autoimmune diseases remain unclear, requiring more extensive clinical trials and post-marketing surveillance. The high cost of immunotherapy may limit its accessibility, particularly in resource-limited settings, highlighting the need for cost-effective strategies. Immunotherapy represents an encouraged edge in the treatment of autoimmune diseases, offering the potential to modulate the immune system in a more targeted and effective manner than traditional therapies. While challenges remain, ongoing research and clinical trials are paving the way for innovative treatments that could significantly improve outcomes for patients with autoimmune diseases. As our understanding of immune mechanisms deepens, the integration of immunotherapy into clinical practice is likely to expand, potentially transforming the management of these complex conditions.