This Research Topic is part of a series:
Autoimmune and Inflammatory Rheumatic Diseases: Identifying Biomarkers of Response to Therapy with BiologicsAutoimmune rheumatic diseases are a group of diseases characterized by abnormal immune responses against different tissues and organs of the body. Altered immune responses include dysregulation of cell death, complement cascade activation, inflammation, activation of self-reactive immune cells leading to uncontrolled release of cytokines and a variety of autoantibodies. Some of these diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjogren’s syndrome (SS), polymyositis (PM), dermatomyositis (DM), antiphospholipid syndrome (APS) and spondyloarthropathies (SpA), represent conditions ranking among the leading causes of mortality and disability.
Given the involvement of several organs, the mechanisms underlying these diseases are not always clearly identified and a great number of studies is aimed at their elucidation. Similarly, various are the pharmacological options for these diseases - medications used in these contexts include nonsteroidal anti-inflammatory drugs, corticosteroids, immunosuppressive agents, various biologic drugs consisting of monoclonal antibodies directed against cytokines or cell receptors, as well as therapies targeted to key elements and regulators of cellular responses. A challenge is also represented by tailoring therapy to specific patients’ needs.
In the last few years, conventional immunosuppressive therapies – characterized by an often-unspecific mechanism of action and complicated by frequent and serious side effects – are gradually but consistently being replaced with biologic agents and targeted therapies (e.g., jak-inhibitors), in autoimmune and inflammatory rheumatic diseases. In contrast to traditional immunosuppressive strategies, these drugs show selectivity of action towards specific targets and are currently employed to induce remission or treat specific organ involvements.
In some cases, these innovative drugs have unfortunately failed to meet their primary endpoints in randomized-controlled trials, especially in complex diseases such as SLE and SSc. This has led to changes to therapies currently used as well as development of new approaches and has at the same time revealed the need to urgently identify biomarkers able to either guide the treatment choice or predict the response to therapy. These biomarkers might be particularly relevant in identifying patients potentially susceptible to the effects of the therapy. This is an emerging issue in the field of personalized and precision medicine.
The scope of this Research Topic is to provide a forum for an updated overview on the progress and advances in the research of new biomarkers that guide the treatment choice in autoimmune and inflammatory rheumatic diseases and their potential role as indicators of personalized treatment options. In Rheumatology this is an emerging issue in the field of personalized and precision medicine.
We welcome manuscripts reporting Original Research clinical data, validity processes, methodological aspects on predictive biomarkers of treatment response. Reviews, Mini-Reviews, Perspectives and Opinions are also welcome to complete insight into current and new available biomarkers.