--by Betty Diamond, M.D., Chair, AARDA Scientific Advisory Board
What an amazing turnaround in biomedical research! After years of an essentially flat budget at the NIH, there is a large infusion of money to the NIH as part of the economic stimulus effort, as well as a greater than 3 percent increase in the 2009 NIH budget. These resources will allow investigators to accelerate studies of autoimmune disease. In particular, we can look forward to studies of the functional properties of the autoimmune susceptibility genes which have been identified over the past few years. These studies are the link between genetics and novel therapeutic strategies. Investigators are poised to perform these studies.
Studies of T cells continue to surprise. We now know that regulatory T cells can change their character and become T effector cells. This new information will lead to a reconsideration of the potential of regulatory T cells as a therapeutic modality.
AARDA's conference this year is focusing on the immunodeficiency present in individuals with autoimmune disease. The recognition of this connection really reverses a long-held model in which autoreactivity represented an over-exuberant immune response; and immunodeficiency, an impoverished immune response. It is now clear that autoimmunity and immunodeficiency often coexist. This recognition implies that we should be able to devise therapies that both improve immunocompetence and decrease autoreactivity.
Clinical trials in autoimmune disease continue. While some have been disappointing, they continue to teach us about disease pathogenesis. These studies are routinely being conducted in sites worldwide. This provides an enhanced opportunity to determine whether different ethnic or racial groups display a different response to therapy.
The era of pharmacogenomics has arrived. There is intense interest in identifying the genetic basis for response to therapy. Interest in identifying biomarkers that predict response to therapy is also intense. These studies represent the first forays into customized medicine for patients with autoimmune disease. Overall, our understanding of autoimmune diseases continues to advance. The increased availability of resources should help sustain the progress that has been made.
