The hills are alive . . . and so are biologics! That song probably wouldn’t be as catchy, though.
Biologics are an ever-growing class of complex medications that harness the power of biological sources such as cells and tissues to carry out their mechanisms of action. They’re successfully being used against some of the most historically challenging diseases to treat, including autoimmune diseases and certain types of cancer.
In the fight against autoimmune disease, biologic agents are formulated to target and calm overactive inflammatory immune responses that are the hallmark of conditions such as:
- psoriatic arthritis and rheumatoid arthritis
- ankylosing spondylitis
- inflammatory bowel disease
- systemic lupus erythematosus
Perhaps you have an autoimmune disease and have been prescribed a biologic treatment. Or perhaps you’re just curious to know more about them and Googled, “How do biologics work?” Either way, read on to find out. This article covers it all — how biologics affect the immune system, the different kinds of biologic medications, advantages and disadvantages of treatment, and more! (Source)
How Do Biologics Work?
To answer the question, “How do biologics work to treat autoimmune diseases?” we first have to talk about how the immune system works.
When the immune system recognizes a threat — a virus, for example — it mounts a response by producing antibodies that “attack” that threat. In the case of autoimmune disease, the body mistakenly identifies its own healthy cells and tissues as a threat. This results in an excessive immune system activation and near constant barrage of inflammation.
The biologics used to treat autoimmune diseases are man-made antibodies that target specific proteins involved in the inflammation cascade, thereby decreasing inflammation throughout the body. This can alleviate symptoms and damage caused by the disease.
Because these unique drugs are made from biological sources — such as bacteria, viruses, proteins, carbohydrates, blood cells, genetic material, and tissues taken from humans and animals — they’re able to act on the body’s immune responses in different, more targeted ways than conventional medications. (Source, Source)
Types of Biologics
There are hundreds of biologic drugs on the market today that fall into many different categories, including:
- monoclonal antibodies
- blood factor derivatives
Biologic therapy used to treat autoimmune diseases are monoclonal antibodies. Monoclonal antibodies (mAbs) are man-made versions of antibodies produced by the immune system in response to threats. Depending on what the monoclonal antibody has been created to do, it may disrupt cellular signals, kill diseased cells, or keep immune responses in check.
Some of the most common mAbs used to treat autoimmune diseases include TNF alpha and interleukin inhibitors. TNF alpha and interleukins are cytokines, a type of protein produced by the immune system that — among other things — is responsible for regulating inflammation in the body. Both interleukins and TNF alpha are known as “immunomodulatory” proteins because they’re necessary to activate an immune response.
TNF alpha and interleukins are often dysregulated and/or overproduced in people with autoimmune disease. These inhibitors work by doing just what their name suggests — they inhibit, or block, the inflammatory action of the two proteins, which then reduces inflammation in the body.
TNF alpha inhibitors include:
- infliximab (Remicade®)
- certolizumab (Cimzia®)
- adalimumab (Humira®)
- golimumab (Simponi®)
- etanercept (Enbrel®)
Common examples of interleukin inhibitors include:
- anakinra (Kineret®)
- tocilizumab (Actemra®)
- ustekinumab (Stelara®)
- secukinumab (Cosentyx®)
Interestingly, the ending of these drugs’ names often indicate what kind of cell was used to make them. Drugs ending in –umab are derived entirely from mice; those ending in –ximab are partially mouse, partially human (chimeric); those ending in –zumab have small bits of mouse proteins added to human proteins (humanized); and those ending in –umab have fully human origins. (Source)
Biologics targeting B cells and T cells — immune system cells (lymphocytes) that work together to produce antibodies and destroy unhealthy cells — have also been successfully used to treat autoimmune diseases. Abatacept (Orencia®) and rituximab (Benlysta®) are two such medications. (Source)