NNormally, the immune system defends the body against external attacks and tolerates its own constituents. observes Professor Divi Cornec, professor of rheumatology at Brest University Hospital and director of an Inserm laboratory (UMR 1227).
“In the maladies auto-immuneat a given moment, it turns against the body and attacks certain organs by mistake. The inflammation becomes chronic. »
More than a hundred different diseases
Multiple sclerosis, rheumatoid arthritis, type 1 diabetes, systemic lupus erythematosus, Sjögren’s syndrome, ankylosing spondylitis, psoriasis, vitiligo, Guillain-Barré syndrome… maladies auto-immune are constantly increasing.
The most common affect the endocrine system (Hashimoto’s thyroiditis, diabetes) and the skin (psoriasis, vitiligo), but they can affect all organs and tissues: eye, skin, intestinal mucosa, thyroid, insulin, collagen, etc., or even several organs. at the same time.
If dozens or even hundreds of genes are involved, we can’t talk about maladies genetics. It is only a “predisposing terrain”.
They will evolve throughout life
For the disease to occur, external factors such as infection, exposure to toxic substances, etc. are required. Then, they manifest themselves through different symptoms and the majority of them evolve chronically throughout the disease. life.
Phases of flare-ups (sometimes favored by stress) then alternate with periods of remission, lasting from several weeks to several years.
What are the preferred treatments?
The goal of treatments is to reduce the hyperactivity of the immune system without destroying it, that’s the complexity. In the therapeutic arsenal, the oldest is cortisone, used since the 1950s. “This immunosuppressant does not have a targeted action and it has many side effects, underlines Professor Cornec. It is therefore reserved for serious forms of maladies auto-immune. »
Then appearing, immunosuppressants block the proliferation of immune cells and make the immune system less active. But, if it is too weakened, it can promote certain infections or certain cancers. These treatments are therefore favored only when there is no specific medication for the disease.
Focus on new drugs
Since the 2000s, have arrived the first drugs from immunotherapy : anti-TNF alpha, then other immunotherapies and more recently Anti-Jack (Janus kinase inhibitors). These specific molecules are directed against one (or more) cytokine, a substance that attracts and activates cells of the immune system, some of which are particularly involved in inflammation.
They often help stabilize the disease. However, for some maladies auto-immune (Gougerot-Sjögren syndrome, systemic sclerosis, certain systemic lupus erythematosus, etc.), there is no validated or effective treatment in the majority of patients. Many drugs that target new cytokines are currently under investigation.
In Gougerot-Sjögren syndrome, for example, more than 10 molecules are the subject of clinical tests, 4 of which are in the last phase before marketing. “We will have the first results in a year and we can hope to have a drug on the market in 2 to 3 years,” rejoices Professor Cornec.
A tremendous hope for patients who currently only have symptomatic treatments that are not very effective.
Notre expert : Professor Divi Cornec, professor of rheumatology at Brest University Hospital and director of an Inserm laboratory (UMR 1227).
Source: www.topsante.com
