THERAPY DIRECTED AT INFLAMMATORY PATHWAYS
The pace of changes in the field of autoimmunity is rapid. Recent advances in understanding the importance of key inflammatory pathways involved in specific diseases, such as the TNF-α pathway in RA, inflammatory bowel disease, and other disorders, but have been quickly followed by new biological therapies designated to interfere with these pathways. With recent data increasingly underscoring the importance of type I interferon pathways in the pathogenesis of lupus, it seems reasonable to expect that therapies directed at preventing the excessive production of IFN-α/-β will be tested in the near future. As always, a major challenge in immune therapy will be to treat the key immunological defects selectively, leaving the remainder pf the immune system intact to deal with infections. As the important immunological pathways become better defined, it may be feasible to selectively target one part of the pathway while leaving other intact. For instance, type I interferon is produced through several interrelated pathways. If only one of them is found to be abnormal in SLE, it may be feasible to selectively blockade that pathway, leaving the others intact to deal with viral and other infections.