Imagine that your immune system turned against you and started fighting healthy cells and tissues instead of protecting them. Sounds like a bad dream, doesn't it? Millions of people all over the world have to deal with this every day. According to National Stem Cells Foundation (NSCF) statistics, around 4% of the world population is currently suffering from different types of autoimmune diseases. In these conditions, the body's own healthy cells are attacked by its immune system. There are different types of ADs, for example, rheumatoid arthritis to lupus, multiple sclerosis to Crohn's disease.

In this article, we'll talk about the different ways to treat autoimmune diseases.

Conventional Treatments for Autoimmune Diseases

These treatments are developed to ease the ADs' symptoms, reduce inflammation, and stop the progression of the disease.

1. Immunosuppressive medications: These drugs suppress the immune system.
2. Non-steroidal anti-inflammatory drugs (NSAIDs): Pain and inflammation are two common complaints of ADs. NSAIDs help combat these symptoms.
3. Corticosteroids: The prolonged inflammation of ADs causes pain, swelling, and damage to the organs. Corticosteroids are very good at reducing inflammation. They can also help with sudden flare-ups. Disease-modifying antirheumatic drugs: Methotrexate and sulfasalazine are two examples of DMARDs that have been shown to be effective in treating autoimmune diseases by modulating the immune response [2].

Biologic therapies for autoimmune diseases

Biologic treatments lower the inflammation and heal the damaged tissue by focusing on certain parts of the immune system. Biologics have shown promising results in managing autoimmune diseases [3].

• Monoclonal antibodies. These antibodies ease the symptoms and stop more damage from happening. For example, rheumatoid arthritis is treated with adalimumab (Humira), and Crohn's disease is treated with infliximab (Remicade).

• Cytokine inhibitors. These block-specific molecules are responsible for inflammation. Tocilizumab (Actemra) blocks the pro-inflammatory cytokine interleukin-6 (IL-6), which has been linked to autoimmune diseases such as rheumatoid arthritis.

• Rituximab. Some biologics work by targeting immune cells themselves rather than their signaling molecules or receptors. Rituximab (Rituxan), for example, depletes B cells, which play a role in autoimmune diseases like multiple sclerosis and lupus.

Emerging Approaches in Autoimmune Disease Treatment

As research and understanding of autoimmune diseases continue to grow, new approaches are being explored for the treatment of these complex conditions.

1.    Blocking T-cell immunity:

T cell activation in T cell-based immunity relies on the activation of two coreceptors, CD28 and CTLA-4, and their ligands, CD80 and CD86.

The development of a chimeric fusion protein, CTLA-4-IgG1, for the treatment of autoimmune diseases, is one of the biggest breakthroughs in medicine. It blocks CD80 and CD86 from binding CD28, which reduces autoreactive T-cell activation.

2.    Increased numbers of regulatory T cells:

Increasing regulatory T cell numbers is an additional useful strategy. This treatment involves isolating polyclonal regulatory T cells from blood by sorting for certain cell surface characteristics. Patients with autoimmune diseases are given larger, experimentally-grown T cells.

The major goal of this approach is to alter the immune system such that there are more regulatory T cells and fewer pathogenic/effector T cells.

3.    Tolerance induction by antigens:

Targeted self-antigens in autoimmune illnesses are the primary focus of this strategy. This strategy involves the administration of self-antigens to patients in an effort to dampen autoimmune reactions. Self-tolerance may be induced by modifying these self-antigens.

4.    Interleukin-2 signaling pathway manipulation:

Recombinant interleukin-2 (IL-2) and anti-IL-2 monoclonal antibody complexes have been shown in studies to selectively increase the proliferation and activity of regulatory T cells, therefore suppressing autoimmune reactions associated with autoimmune diseases [4].

5.    Gut microbiome modulation:

The trillions of bacteria residing in our digestive tract play a crucial role in regulating immunity. Recent research has shown that imbalances or disruptions in the gut microbiome can contribute to the development and progression of autoimmune diseases.

Microbiome modulation involves restoring balance to the microbial community in the gut. This can be done through various methods such as probiotic supplementation, prebiotic fiber intake, and dietary changes.

6.    Personalized medicine and targeted therapies:

This approach involves tailoring treatments based on an individual's specific genetic makeup, immune system function, and disease characteristics. By pinpointing the underlying mechanisms driving each person's condition, healthcare professionals can develop more precise and effective interventions. Examples include:

• Monoclonal antibody therapy. It involves using laboratory-created antibodies to block specific molecules involved in immune system dysfunction.

• Gene therapy. During gene therapy, faulty genes responsible for triggering autoimmune responses are corrected or modified.

• Intravenous immunoglobulin (IVIG) therapy. IVIG contains antibodies from healthy donors and helps modulate the abnormal immune response seen in autoimmune diseases.

7.    Dietary interventions and lifestyle changes:

Many individuals have found relief by making specific modifications to their diet and adopting healthier habits.

• Avoiding trigger foods: Eliminating trigger foods that may exacerbate symptoms or cause flare-ups is an important dietary intervention. These trigger foods can vary depending on the individual, but common triggers include gluten, dairy, processed sugars, and nightshade vegetables.

• Eating an anti-inflammatory diet: Fatty fish (salmon, mackerel) and flaxseeds are examples of foods high in omega-3 fatty acids, and they have been shown to have anti-inflammatory effects.

• Eating food rich in antioxidants. Inflammation is one of the major consequences of autoimmune diseases. Colorful fruits and vegetables packed with antioxidants also help combat inflammation.

In addition to modifying one's diet, people with autoimmune disorders might benefit from adopting other healthy lifestyle habits, such as engaging in regular exercise and learning to cope with stress in constructive ways.

Stem Cell Therapy (SCT) for Autoimmune Diseases

Stem cell therapy aims to repair damaged tissues, modulate the immune response, and restore normal function.

How does SCT Work in Treating Autoimmune Diseases?

There are two types of grafts. Autologous and allogeneic. Both approaches have shown potential in addressing autoimmune diseases.

• Autologous SCT uses the patient's own stem cells, minimizing the risk of rejection.

• Allogeneic SCT, on the other hand, involves stem cells from a donor and requires careful matching to prevent complications.

These cells are then processed and reintroduced into the patient's system, with the goal of replacing dysfunctional immune cells and promoting immune tolerance.

Numerous case studies demonstrate the positive impact of SCT on autoimmune diseases. For instance, multiple sclerosis patients who underwent SCT showed reduced disease activity and improved quality of life [5].

Conclusion

In conclusion, the landscape of treatment options for autoimmune diseases continues to evolve, offering hope and relief to millions of individuals affected by these conditions. Besides drug-based conventional treatment options for autoimmune diseases, new approaches are being used — from conventional approaches like immunosuppressive drugs to innovative stem cell therapies and personalized medicine. By fostering collaboration between medical professionals, researchers, and patients, we can strive towards improving the quality of life for those living with autoimmune diseases and ultimately move closer to a future with better outcomes and enhanced well-being.

References

1. Autoimmune disease. National Stem Cell Foundation. (n.d.). https://nationalstemcellfoundation.org/glossary/autoimmune-disease/#:~:text=Search%20Articles%2C%20News%2C%20Terms%20and,Crohn’s%20disease%2C%20psoriasis%20and%20scleroderma.
2. Benjamin O, Goyal A, Lappin SL. Disease-Modifying Antirheumatic Drugs (DMARD) [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507863/
3. Rosman, Z., Shoenfeld, Y., & Zandman-Goddard, G. (2013). Biologic therapy for autoimmune diseases: an update. BMC Medicine, 11, 88. https://doi.org/10.1186/1741-7015-11-88
4. Létourneau, S., van Leeuwen, E. M., Krieg, C., Martin, C., Pantaleo, G., Sprent, J., Surh, C. D., & Boyman, O. (2010). IL-2/anti-IL-2 antibody complexes show strong biological activity by avoiding interaction with IL-2 receptor alpha subunit CD25. Proceedings of the National Academy of Sciences of the United States of America, 107(5), 2171–2176. https://doi.org/10.1073/pnas.0909384107
5. Ng, S. A., & Sullivan, K. M. (2019). Application of stem cell transplantation in autoimmune diseases. Current opinion in hematology, 26(6), 392–398. https://doi.org/10.1097/MOH.0000000000000531