So we’ve looked at a number of
different autoimmune diseases.
Let’s now have a look at how
one can treat these diseases.
So where there is something missing;
so for example, in Hashimoto’s
disease there is a destructive
thyroiditis leading to hypothyroidism.
That means that the patient does not secrete
sufficient levels of thyroid hormone.
One can simply give a artificial
form of the hormone to the patient.
So you’re replacing the thyroxine that
is needed by the patient, as a tablet.
In type I diabetes, the insulin can be given by
injection or islet cells can be transplanted.
In pernicious anemia, vitamin
B12 injections can be given.
Where there is an overproduction of hormones, as we see in
Graves’ disease with the overproduction of thyroid hormones.
One can use inhibitors
of that process.
So using thyroid peroxidase inhibitors,
or by giving a radioactive form of iodine.
Iodine is required for the
generation of the thyroid hormones.
So dietary iodine is normally taken up and specifically taken
to the thyroid where it’s needed to produce thyroid hormone.
So if a radioactive version of iodine is given to a patient,
that is also taken straight to the thyroid and the
radiation from that isotope I131, will damage the thyroid
cells preventing excessive production of thyroid hormone.
And a third approach that is used
in Graves’ disease is subtotal
thyroidectomy, where some of the thyroid is surgically removed.
In myasthenia gravis,
thymectomy can be used.
Another approach is to use
In multiple sclerosis, at least in some patients, the use of
interferon-β can be an extremely powerful therapeutic approach.
And cytokine inhibitors are now used
in a number of autoimmune conditions.
Anti-TNF specifically is used in rheumatoid arthritis
and similar rheumatological type autoimmune diseases.
Adhesion molecule inhibitors can be used, for example in
multiple sclerosis - natalizumab which is a monoclonal antibody
against the α4 integrin can the prevent cells of the immune
system crossing the blood brain barrier and entering the CNS.
Disease modifying anti-rheumatic drugs
(DMARDs) are used in rheumatological
conditions - methotrexate, sulfasalazine, gold salts and so on.
Nonsteroidal anti-inflammatory drugs are
used in SLE, rheumatoid arthritis, autoimmune
hemolytic anemia, Goodpasture’s syndrome and
a number of other autoimmune conditions.
In rheumatoid arthritis, one can
use a monoclonal antibody against
the CD20 molecule which is present on the surface of B-cells.
Anti-mitotic drugs, the variety of which
are listed there, can be used in autoimmune
thrombocytopenic purpura, SLE, myasthenia
gravis and autoimmune hemolytic anemia.
And pooled normal human immunoglobulin has a beneficial effect
in Guillain-Barre syndrome and in myasthenia gravis.