Chronic inflammation represents the key pathogenic event of many diseases, autoimmune rheumatic diseases, such as psoriasis, inflammatory bowel diseases, asthma, multiple sclerosis, atherosclerosis, and others. Conventional therapies for many of these disorders do not lead to the resolution of the inflammatory disorder and are frequently associated with limited effectiveness and severe side effects.
Professor Joachim R. Kalden, Member of the Department for Molecular Immunology, Nikolaus-Fiebiger-Zentrum, University Medical School Erlangen-Nuremberg, presents therapeutic principles based on monoclonal antibodies.
"New therapeutic strategies had to be developed as based on our progressive knowledge of pathogenic mechanisms involved in different chronic inflammatory disease entities", says Kalden, who is also the former Director of the Department of Internal Medicine 3 (Rheumatology and Clinical Immunology) of the University Medical School Erlangen-Nuremberg.
Most of the progress made over the past years for the treatment of chronic inflammatory and autoimmune diseases is based on a method for the preparation of monoclonal antibodies on a large scale, as published 1975 by Köhler, Milstein and Jerne, who won the Nobel Prize in 1984. Today, therapeutic antibodies are essential assets for physicians fighting cancer, inflammation and infections.
Diseases where the medication with monoclonal antibodies have significantly changed our treatment options for patients are autoimmune rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis, psoriasis and chronic inflammatory bowel diseases such as Crohn's disease. Using monoclonal antibodies or fusion proteins in quite a number of these diseases it was demonstrated not only to block the chronic, progressive tissue destructive inflammatory process and to achieve low disease activity but also in some situations to achieve a remission. Before the introduction of these new treatment principles most of these diseases led very early to a disabling status of the patient combined with disability to continue to work, leading to unemployment.