Immunotherapy for Infectious Diseases, Cancer, and Autoimmunity

Abstract

Immunotherapy uses advances from the field of immunology to exploit the immune system in clinical practice. The goal is the use of directed immunotherapy with minimal side effects to combat infection, cancer, and autoimmunity. Although immunotherapy was first used as passive transfer of serum containing polyclonal antibodies, the development of monoclonal antibodies has provided reagents that are targeted, specific, and completely uniform. Monoclonal antibodies are used against several infectious organisms, including respiratory syncytial virus. Monoclonal antibodies in cancer immunotherapy were first directed against tumor cells. Later they targeted immune molecules that modulate immune response against cancer cells. For instance, starting in 2011, checkpoint inhibitors were developed that block inhibitory receptors on immune cells involved in immune regulation. This had a dramatic impact on survival in a subset of patients with cancers such as melanoma and lung cancer. Checkpoint inhibition is associated with risks in a subset of patients that develop neurological, respiratory, musculoskeletal, cardiac, ocular, and/or autoimmune side effects. Management of autoimmune diseases with cytokines and cytokine inhibitors has revolutionized the field, although treatment failure is not uncommon. This may be due to an initial unresponsiveness to the agent, a later tolerance to that agent, or adverse events such as activation of latent infections.