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Autoimmune Diseases: Therapy

by Peter Delves, PhD
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    00:01 So we’ve looked at a number of different autoimmune diseases.

    00:06 Let’s now have a look at how one can treat these diseases.

    00:12 So where there is something missing; so for example, in Hashimoto’s disease there is a destructive thyroiditis leading to hypothyroidism.

    00:22 That means that the patient does not secrete sufficient levels of thyroid hormone.

    00:26 One can simply give a artificial form of the hormone to the patient.

    00:32 So you’re replacing the thyroxine that is needed by the patient, as a tablet.

    00:39 In type I diabetes, the insulin can be given by injection or islet cells can be transplanted.

    00:50 In pernicious anemia, vitamin B12 injections can be given.

    00:57 Where there is an overproduction of hormones, as we see in Graves’ disease with the overproduction of thyroid hormones.

    01:06 One can use inhibitors of that process.

    01:09 So using thyroid peroxidase inhibitors, or by giving a radioactive form of iodine.

    01:17 Iodine is required for the generation of the thyroid hormones.

    01:21 So dietary iodine is normally taken up and specifically taken to the thyroid where it’s needed to produce thyroid hormone.

    01:29 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.

    01:56 In myasthenia gravis, thymectomy can be used.

    02:04 Another approach is to use anticholinesterase drugs.

    02:12 In multiple sclerosis, at least in some patients, the use of interferon-β can be an extremely powerful therapeutic approach.

    02:24 And cytokine inhibitors are now used in a number of autoimmune conditions.

    02:30 Anti-TNF specifically is used in rheumatoid arthritis and similar rheumatological type autoimmune diseases.

    02:40 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.

    02:58 Disease modifying anti-rheumatic drugs (DMARDs) are used in rheumatological conditions - methotrexate, sulfasalazine, gold salts and so on.

    03:10 Nonsteroidal anti-inflammatory drugs are used in SLE, rheumatoid arthritis, autoimmune hemolytic anemia, Goodpasture’s syndrome and a number of other autoimmune conditions.

    03:22 In rheumatoid arthritis, one can use a monoclonal antibody against the CD20 molecule which is present on the surface of B-cells.

    03:31 Anti-mitotic drugs, the variety of which are listed there, can be used in autoimmune thrombocytopenic purpura, SLE, myasthenia gravis and autoimmune hemolytic anemia.

    03:43 And pooled normal human immunoglobulin has a beneficial effect in Guillain-Barre syndrome and in myasthenia gravis.


    About the Lecture

    The lecture Autoimmune Diseases: Therapy by Peter Delves, PhD is from the course Hypersensitivity and Autoimmune Disease.


    Included Quiz Questions

    1. Rheumatoid arthritis
    2. Pernicious anemia
    3. Goodpasture’s syndrome
    4. Type I diabetes
    5. Hashimoto’s disease
    1. This treatment addresses the deficiency without depending on the Intrinsic factor or H+K+ ATPase
    2. This treatment results in the upregulation of Intrinsic factor which will correct the B12 deficiency
    3. This treatment will result in excretion of excess B12 which will initiate the body's regulatory mechanisms, resulting in correction of deficiency
    4. This treatment would help replace Intrinsic factor which is being destroyed by autoantibodies
    5. This treatment addresses the deficiency by providing the precursors for the factors needed to produce Intrinsic Factor
    1. Monoclonal antibody
    2. DMARDs
    3. NSAIDs
    4. Steroids
    5. Anti-mitotic agents

    Author of lecture Autoimmune Diseases: Therapy

     Peter Delves, PhD

    Peter Delves, PhD


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