L3   TREATMENT OF AUTOIMMUNITY: FUTURE PERSPECTIVES

Luger T.A. Dept. of Dermatology, University of Münster, Germany

In the last years there has been an enormous increase in the understanding of the pathogenesis of immune mediated skin diseases that led to the development and introduction of new therapeutic regimes. Accordingly, non-specific immunosuppressive drugs such as cyclosporin A, mycophenolate mofetil, tacrolimus, ascomycins a.o. proved to be beneficial for a variety of skin diseases. Specific immunomodulating strategies involve for example DAB 398 IL-2, an IL-2 receptor-specific fusion protein, CTLA4-Ig, which functions as a CD28/CTL4 antagonist, and LFA3 TIP, which by blocking the binding of LFA3 to CD2 inhibits T-lymphocyte functions. Another interesting approach is to target the appropriate T-cell-receptor on autoreactive T-cells. Transfection with cytokine genes may represent a useful approach to generate immunedeviation and, thereby, treat immune mediated diseases. First promising results have been obtained by targeting the function of antigen-presenting cells such as dendritic cells (DC). Accordingly, tumor antigen pulsed DC with some success were used for the treatment of tumors. On the other hand, DC transfected with CD95L causing apoptosis in CD95 expressing target cells may be a useful approach to treat allergic and autoimmune mediated diseases. Although, the rapid development of research in autoimmune diseases has led to the development of several new and more effective therapeutic strategies, in most cases cure is still not possible until genetics of these diseases are unrevealed which ultimately may result in gene therapy.