Understanding the mechanisms of AI Diseases | Arthritis Information

Few researchers expect a single "magic bullet" to stall autoimmunity in its tracks or prevent it from happening in the first place. Likewise, the complexity of autoimmune diseases and the immune system itself make the concept of a cure very unlikely for these diseases in general, especially in the foreseeable future. For example, when discussing the idea of "curing" autoimmunity by manipulating the genes involved, David Hafler, Breakstone Professor of Neurology at Harvard Medical School and director of the division of molecular immunology at Brigham and Women's Hospital's Center for Neurologic Diseases, responds: "If we got rid of these genes, then we're exposing ourselves to the risk of other infections. It's a typical yin-yang in medicine and in life."

Despite the slim chance of a cure for these diseases, hope still exists. From an optimist's point of view, the bad news - complicated and variable causes of autoimmunity - can also be good news: Many therapeutic targets can be attacked.1 Nonetheless, treatment probably won't involve blocking any one pathway entirely. Instead, the best treatments will make slight modifications in several places. "The future is really novel pathways - to interact with novel pathways that offer the opportunity for different types of responses," says Brian Kotzin, vice president of medical sciences at Amgen in Thousand Oaks, Calif.Â

http://www.the-scientist.com/2007/05/01/s56/1/Allow me to translate this -

There ain't no hope so we'll not even look for the cure, instead, we'll make gazillions off of tweaking novel pathways so we can make 7B a year to infinity and beyond.

How in the heck some people can buy into this hogwash is beyond me.

Pip

[QUOTE=Pip!]Allow me to translate this - [/QUOTE]

Me Too! The newer meds have made a huge difference in my life....Thank goodness for the research concerning B-cell therapy. I'm very grateful!Lynn492008-06-09 12:34:00I think its great we have 'therapies' but we've lost site of the ultimate goal - the cure. If they don't think it's possible then they aren't looking for it. Why should they? Those therapies brought 7 Billion in revenue alone to Pfizer last year. Add all the Pharma cos. together and we see, what, 250 Billion??? reasons to not search for the cure.

MY Opinion,

Pip

Suzanne - loved the quote and captures the disconnect perfectly.

[QUOTE=CathyMN]

I would not want to be treated as those with RA were in the past. I prefer to have a better outcome and am thankful for those companies that continue to fund research.

[/QUOTE]

I think the decade old biologics have shown a better short term outcome, but isn't it still an unknown as to what the longterm outcome is?

I'm told by our ped rheum that in children, if they do get remission, the longest they can go on no meds is about two years; when it comes back, it is harder to control. I very much appreciate this frank honesty, and it certainly mirrors exactly what I see on the boards day in and day out. It doesn't impress me as a good outcome, though.

Agreed - the longterm outcome is unknown since biologics have only been around 10 years. I hope the short term outcome turns into a longterm as more time passes. I may be feeling optimistic about the new medications due to watching my uncle with RA progress to a wheelchair back in the 70's - so I'm thankful that for me that may not happen.

I've also heard that if you go off your meds, when it comes back it's back harder, so I'm not expecting to find med-free remission. Do very many actually come off their meds? I guess I always thought when people talked remission, it just meant that they are symptom free, but still have to continue their meds.

I'm aiming for a med free remission. Have to hit clinical remission first....

Pip

Is that what the call remission when you're still on meds - clinical remission? I need to get all my lingo down. Good attitude Pip. I hope it happens for you, but if not, clinicial remission sounds okay as well.

I believe I'm heading toward a clinical remission with Rituxan and that is just fine with me....It has been a long wait.Lynn492008-06-10 17:58:43Thanks Cathy -

Yep, they have different versions of remission as far as I can tell. To me that translates to everything normal lab-wise and NO (I MEAN NO) pain, not even a smidge. No stiffness etc. Then I'm going to ride that 'remission' for a year or two working on all the other things that contributed to this, then...when I'm sure...really really really sure - I'm going med free. And, not being stupid, I'm going to get regular blood work every 3 months for 5 years being careful to jump if I see something starting. I'm lucky in that I'm strongly RF positive so I figure anything over 60 and it's starting again. (My problem is I felt great at RF200+ and didn't even start 'dying' until it got over 400 and kept rising.

Hugs,

Pip

Remission is pain free, inflammation free, normal RA markers, negative physical exam, negative MRI of prior inflammed joints. This is the standards for clinical remission. Clinical remission can last from just days to years.

I would love to think that I could come off meds after a certain amount of time but with RA and PsA I'm not sure that's realistic for me. If I just had RA then I would start tapering MXT after 6 months of clinical remission and continue tapering until I could stop. If all markers remained negative then I would start Humira bi weekly instead of weekly and then keep stretching the time between injections.

Like Pip, I would continue with labs and if they started to rise then I would add MXT and see if that would be enough to stop the increase in numbers. No matter if you have active disease or are in clinical remission you have to be vigilent with labs. Lindy

Lin - you have to have MRIs to prove clinical remission? I thought x-rays were the standard.

I'm hopeful that clinical remission will happen for me... but w/ normal labs always.. those won't be my markers... it has to be based upon my "feeling" the RA or not and the RD's exams of my joints. I have achieved a 23% improvement since enbrel... I am very positive about that!!

I have a friend who is a scientist for one of the large pharma co's.. she says they are always looking for "solutions" but that cures are not always an option... so they do focus on relieving discomfort and returning people to their life without whatever disease... she also said that many meds that work are discovered accidently to work for something other than their original design.