Currently there are no cures for Auto Immune diseases, although there is a wide range of treatment options, effective in managing the symptoms, minimising organ and tissue damage, and preserve organ/system function.  Treatment options, usually under specialist supervision, include:

 

 

Steroidal Anti-inflammatories: typically called: Corticosteroids.  Corticosteroids are produced in laboratories to mimic the natural hormone produced in our Adrenal Glands, called cortisol.   When prescribed in doses that exceed your body’s usual levels, corticosteroids suppress inflammation and immune activity, by inhibiting production of interleukin-1.  This can reduce the signs and symptoms of inflammatory rheumatologic conditions, such as arthritis and asthma.  Marketed under the names:  Prednisone and Presdnisole, Cortisone, Methylprednisone.

 

 

Non steroidal anti-inflammatory (NSAIDS, pronounced: en-saids): NSAIDS are the most prescribed anti-inflammatory.  They are COX (a protein which triggers change in the body) inhibators, and non-narcotic (non addictive).  They are typically both analgesic (pain relief) and antipyretic (fever reducing).  At low doses they are effective in treating heart disease, and at higher doses are classified effective at treating inflammatory diseases such as arthritis.  These include: asprin, ibuprofen and naproxen.

 

 

Immunosuppressive medications: Drugs which suppress the immune system. Immunosuppressive drugs can be classified according to their specific mode of action, typically, they can be classified into 3 main groups:

Glucocorticoids: Glucocorticoids 9ie. trade-name: Cortisone, Cortisole, Prednisone, Prednisolone, Methyprednisolone) are potent anti-inflammatories, and are used to suppress various allergic or inflammatory responses, including Autoimmune management.  Glucocorticoids suppress the cell mediated and humoral immunity. They act by inhibiting genes that code for the cytokines Interleukin 1 – 8, and TNF-γ, the most important of which is IL-2.  Smaller cytokine production reduces the T cell proliferation. This diminishes both B cell clone expansion and antobody synthesis. In other words, glucocorticoids not only suppress immune response, but also inhibit the two main products of inflammation, prostaglandins and leukotrienes.

Cytostatics/Antimetabolites: Cystostatics inhibit cell division while Antimetabolites (ie, trade-name: methotrexate, azathioprine, mercaptopurine) inhibit nucleic acids, which include: folic acid analogues, purine analogues, pyrimidine analogues and protein syntheses.  Such substances are often similar in structure to the metabolite that they interfere with, such as the antifolates.  The presence of antimetabolites can have toxic effects on cells, such as halting cell growth and cell division so these compounds are used as chemotherapy for cancer treatment.  Methotrexate: is a folic acid analogue. It binds dihydrofolate reductase and prevents synthesis of tetrahydrifolate. It is used in the treatment of autoimmune diseases (for example rheumatoid arthritis or Behcet’s Disease) and in transplantations.  Azathioprine (Imuran) is the main immunosuppressive cytotoxic substance.  It is extensively used to control transplant rejection reactions. It is nonenzymatically cleaved to mercaptopurine that acts as a purine analogue and an inhibitor of DNA synthesis. Mercaptopurine itself can also be administered directly.

Immunophilins: Immunophilins are targeted by immunosurppresive drugs such as Sirolimus (earlier Rapamycin), Cyclosporine and Tacrolimus.  For these drugs in particular, known immunophilins such as Cyclosporin, catalyze the cis-trans isomerization of peptide bonds, particularly X-Pro peptide bonds. It has been in use since 1983 and is one of the most widely used immunosuppressive drugs. It is a cyclic fungal peptide, composed of 11 amino acids.

 

 

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