A brainstorming thread to share spontaneous creative ideas and solutions for drug development to treat autoimmune diseases, inviting active discussion.
Prompt: No specific drugs available for treatment of autoimmunity. All the current approaches are merely suppressing the symptoms. When we can expect a drug for any or some of the autoimmune diseases? What is the main hurdle in the identification of drug targets? What all are the possible approaches toward drug development to treat autoimmune diseases?
I wish to talk about the basics first and explain why a drug is difficult.
See, normally in body there is a range of B and T cells that are generated and then further B cells are trained in Bone marrow and the T cells in Thymus.Amongs the entire range produced, those that interact with an antigen from the body are normally made to undergo apotosis and killed.This is at an early stage in utero when the baby has started developing.As early as four weeks and the training continues.meaning that all cells generated randomly if they interact with the antigen it is a self antigen and the cells must be killed.This is a normal process.But when the large number of processes are on, one or a few cells that were interacting with the self antigen escape death and they keep multiplying as usual by clonal expansion.The high diversity and radomness both prevent the drug.It can be an organ being damaged but which antigen and which epitope all prevent a drug formation.You can understand it simply as a outlier child in a class and one does not know, what child will play with what mischief and so the entire class cannot be punished.
That is a good generic way of thinking. It is the basis of autoimmunity.
In many autoimmune diseases, especially T cell mediated, the autoantigen is defined. That should facilitate targeted small molecule therapeutics as well as recent approaches such as CAR-T cell therapy, if the right experimental approach is taken, right?
I am sorry for the late reply.had issues signing in.Never mind.As far as Cancer and CarT cells are concerend.A small clarification again.See normal cells have several antigens on their cell surface typical characteristic of the cell type.This can be because they are multiplying slowly an dhave enough time to synthesise various proteins/enzymes. cancer cells on the other hand, do not exhibit almost any antigen but for the T cells to act there must be some antigen present.So now what we do in the lab is to introduce,a receptor that is recognising the antigen and hence bind the antibody and this initaites the complementary system too an dresults in the damage of those cancer cells that were dividing haywire and the growth could not be controlled.This is a very personal and time consuming exercise,and extremely costly plus a big drawback that I can add is, that things that look very easy in the lab may not be that efficient in the body.There are a lot more variables that we do not know about.