March 10, 2000 (New York) -- New drugs aimed at attacking the underlying molecular causes of autoimmune diseases may one day offer hope to millions of people who live with conditions such as lupus, rheumatoid arthritis, and multiple sclerosis, say experts speaking at a conference at the New York University Medical Center. Researchers are also trying to determine whether male hormones might offer some protection from these diseases, which strike women disproportionately.
At the conference, experts discussed a type of drug called biologic response modifiers. These drugs, including Enbrel (etanercept) and Remicade (infliximab) work by interfering with a chemical called tumor necrosing factor, which is thought to cause inflammation and joint damage in rheumatoid arthritis.
"Our hope is to see such drugs developed for other autoimmune disorders," Steven B. Abramson, MD, professor of medicine and pathology at NYU School of Medicine, tells WebMD. "If we understand at a molecular level what's accounting for each event, we can then target drugs toward fixing the underlying mechanism."
Abramson, who is also the chairman of the department of rheumatology at the Hospital for Joint Disease and NYU Medical Center, spoke at the conference sponsored by Women's Optimum Wellness Now (OWN), a volunteer group focusing on women's health issues.
There are more than 80 different autoimmune diseases. In healthy people, the immune system fights off foreign invaders like bacteria and viruses, but in those with autoimmune diseases, the immune system attacks the host's own organs.
"Oftentimes, autoimmune diseases can be devastating," Abramson says. "For reasons we are only beginning to understand, they disproportionately strike women." For example, lupus -- a blanket term for several forms of an inflammatory disease that attacks joints, skin, kidney, and other parts of the body -- affects 15 females for every male.
"Males are protected and we need to know their secrets," adds Denise Faustman, MD, PhD, professor of medicine at Harvard Medical School and director of the immunology laboratory at Massachusetts General Hospital in Boston.
For these reasons, researchers are looking at the male hormone testosterone and supplements of DHEA, a weak male hormone. Two recent studies showed that women with mild to moderate lupus who took DHEA had fewer signs of the disease and had less need for steroids, according to information presented at the conference. Lupus is often treated with steroids, but steroids can have serious side effects, including blood-sugar problems, ulcers, and the brittle-bone disease osteoporosis.
"The most important message is that lupus is relatively common and most patients do reasonably well," says Harry Spiera, MD, clinical professor of medicine and division of rheumatology at Mount Sinai Medical center. "We have taken a lot of baby steps and we are waiting for a giant steps like Jonas Salk made when he discovered the polio vaccine."
Spiera predicts that scientists will make such a giant step in the next 10-20 years.
All autoimmune diseases may be identical from a scientific standpoint, so "if we do not look at these diseases in total, like we do cancer, we will never have a cure; we will only have therapies," says Virginia Ladd, president and executive director of American Autoimmune Related Diseases Association (AARDA).
A bill now before Congress asks the National Institutes of Health to establish an autoimmune disease office as the NIH has for AIDS and cancer. Such an office could fund and conduct research on all autoimmune diseases, Ladd says.
For more information on autoimmune diseases, visit the AARDA web site (http://www.aarda.org).
- Autoimmune diseases, including lupus, rheumatoid arthritis, and multiple sclerosis, occur when the body's immune system turns on itself.
- New drug treatments that aim to attack the underlying molecular causes of the disease are available for some autoimmune diseases, and have shown preliminary success.
- Some people would like to see the establishment of an office within the NIH dedicated to the study of autoimmune diseases, because they may all stem from the same biological cause.