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Combination Therapies
| Article
# : |
19270 |
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Section : |
NATURAL SCIENCE
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| Issue
Date : |
7 / 1991 |
1,826 Words |
| Author
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Charles S. Marwick
Charles S. Marwick is the East Coast editor of the medical
news and perspectives section of the Journal of the American
Medical Association. |
For at least two hundred years, since the English physician Edward Jenner used cowpox to protect people against smallpox, medical science has used the body's immune system to fight disease. Yet the process of vaccination initiated by Jenner treats the immune system as a black box, in that a foreign substance (an antigen) placed in the blood triggers the formation of appropriate molecules (antibodies) to fight the antigen.
With advances in medical research, the black box of the immune system is gradually being opened to expose a complex array of cells whose formation and interactions are mediated by a host of molecules circulating in the blood. Yet the body is a single fabric. The immune, endocrine, and nervous systems are integrated components of the larger system called the body. All body cells are regulated by peptide molecules called cytokines that circulate in body fluids and are produced by various cells in the body.
With the advent in the 1970s and 1980s of modern biotechnology and molecular engineering, cytokines could be produced in large enough quantities to permit testing in animals and humans.
"There has been a virtual explosion in the study of these cytokines and their potential for the treatment of human disease," says Dr. Gerald Quinnan, acting director of biological products at the Food and Drug Administration (FDA). "The science of molecular biology has advanced in such an extraordinary way that it is now possible not only to identify proteins and clone and express them, but also to modify them and to study their functions in ways which were not envisioned as little as ten years ago."
More than one hundred different cytokines have been identified so far. They are under intense study not just for their role in the treatment of disease, but also for their ability to maintain normal body functions. The first clinically significant benefit of the advances in molecular biology involved a class of cytokines called interferons. In 1987 the FDA licensed interferon alpha, a recombinant-produced cytokine, for the treatment of hairy cell leukemia.
In December 1990, a related but structurally different form of interferon, called interferon gamma, was licensed by the FDA for the treatment of chronic granulomatous, a rare, hereditary immune disorder in which the white blood cells do not function. Interferon gamma stimulates the white cells' effectiveness, resulting in fewer life-threatening bouts of bacterial and fungal
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