Understanding how treatments impact the response of our immune system and therefore how they fight the disease, is essential for optimizing and personalizing treatments. It was discussed today in Rome, on the occasion of a meeting between clinicians and researchers, organized by ‘Inrete’, with the collaboration of Becton Dickinson, a company in the medical devices sector. At the center of the debate the evidence of the consensus document “Application of immunological monitoring. Focus on autoimmune diseases and development prospects”, created – thanks to the unconditional contribution of Becton Dickinson with the scientific collaboration of Edra, with the patronage of Fadoi (Federation of associations of internist hospital managers), Sin (Italian Society of Neurology), Sin Reni (Italian Society of Nephrology), Iscca (Italian Society for cytometric cell analysis) and elaborated by a board of clinicians.
The concept of the immune system, as never before in this period of health emergency, is entering the vocabulary not only of patients but of citizens in general. More and more often, we talk about the “reaction of the immune system and biological drugs”. A winning combination that today has further weapons to combat oncohematological and autoimmune pathologies in neurology, rheumatology, nephrology. Therapeutic areas that correspond to diseases with a heavy impact on the quality of life of patients. Let’s think for example of multiple sclerosis or rheumatoid arthritis to name a few.
Great strides have been made in the development of therapies capable of combating these pathologies which are therefore less frightening now but which still require further and more specific treatments. Today, however – reports a note – there is an extra arrow in the arch of the clinicians. Immunological monitoring with flow cytometry: a technology already widely used in hospitals and which, thanks to a particular equipment, allows to quantify healthy cells compared to diseased ones through a specific biomarker of that particular pathology. In practice, through this technology the clinician is able to control the patient’s response by modifying the therapeutic approach in terms of frequency and doses of administration, even deciding to change therapy where appropriate. This strategy has a fundamental impact on the patient. In fact, thanks to this technique, the clinician can set up a personalized therapy which, taking into account the state of the patient’s immune system and by modulating the therapy, can prevent some side effects but above all improve its effectiveness. In practice, the immune system becomes the protagonist of the therapy whose choice passes through the monitoring of the patient’s immune system.
“The use of monoclonal antibodies in therapy, – comments Bruno Brando, Director of Immunohematology and Transfusion Center, West Milanese Hospital in Legnano – offers us the almost unique possibility of clearly identifying the cellular target and verifying the correct mechanism of action of the drug . Immunological laboratory monitoring allows a rational use of these powerful agents and allows the therapies to be calibrated in a reasoned way, maximizing their effectiveness and reducing the risk of unwanted effects “.
The immune system therefore – continues the note – thanks also to the new therapeutic strategies, is now more involved in the fight against the disease and this makes it even more essential for the clinician to be able to evaluate the effectiveness of immunological reconstitution or how the immune system of the patient, urged by new drugs, manages to fight the disease, in other words how he reacts. “Cell therapies – comments Martino Introna, head of the Center of Cellular Therapy ‘G. Lanzani ‘, Asst Papa Giovanni XXIII of Bergamo – are used above all in the field of transplants and their complications and cancer diseases. For each specific application there may be a role for the evaluation of the immunological set-up, but it is difficult to generalize “.
In particular, therefore, the monitoring of the immune system enables the clinician not only to prevent any side effects of the therapies but also to know in an early manner what the response to treatment will be. As Carlo Maria Guastoni, director of Uoc Nephrology and Dialysis, West Milanese Hospital, Legnano, comments, “the family of kidney diseases is varied and numerous and also includes autoimmune forms in which the damage is due to the production of antibodies against kidney components. In these forms, monoclonal antibodies are used which act to prevent the immune system from triggering the autoimmune response. This is a therapeutic option that in most cases achieves an improvement or cure of the disease without serious side effects. Furthermore – continues Guastoni – monitoring the patient’s immune structure during the therapeutic process is important because it helps the clinician both to understand the reasons for a possible lack of response, and to identify the best time to administer the therapy. Immunological monitoring can therefore be considered a very useful tool for personalizing therapy “.
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