Expert opinion on biological therapy
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Expert Opin Biol Ther · May 2009
ReviewRe-targeting T-cells against cancer by gene-transfer of tumor-reactive receptors.
Adoptive transfer of T-lymphocytes is a promising treatment for a variety of malignancies, but is often not feasible due to difficulties in generating T-cells reactive with the targeted antigen from patients. To facilitate rapid generation of cells for therapy, T-cells can be programmed with genes encoding for an antigen-specific T-cell receptor (TCR) or chimeric receptors. ⋯ Clinical trials report so far only limited efficacy of adoptively transferred genetically modified T-cells. However, the recent progress in engineering tumor-reactive T cells is providing a promising basis to further explore this treatment modality.
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Expert Opin Biol Ther · Apr 2009
ReviewRilonacept for the treatment of cryopyrin-associated periodic syndromes (CAPS).
Cryopyrin-associated periodic syndromes (CAPS) encompass a group of rare inherited, autoinflammatory disorders that represent a spectrum of one disease with varying degrees of severity. Until recently, there was no effective treatment for CAPS, but identification of the genetic basis of CAPS highlighted the pathogenic role of IL-1beta. ⋯ Rilonacept, the only IL-1 Trap, is the first of many novel IL-1-targeted therapies being developed. In a very short time it has changed the lives of CAPS patients.
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Yellow fever is a re-emerging infectious disease, as vector control and routine immunisation have dwindled in endemic areas in the last few decades. There is a constant threat of outbreaks in the large susceptible non-immune population of the megacities in tropical countries with an ongoing virus life cycle in the rainforests. For this population and for travellers to endemic areas, vaccination is the only effective protective measure against the disease and the spread of the virus. ⋯ Vaccination with the live attenuated yellow fever-17D vaccine (YF-17D) induces low-grade viraemia in half of the vaccinees and elicits protective neutralising antibody levels in 99%. Reports of serious adverse events in the elderly and immunocompromised, and the inability to produce large quantities of yellow fever vaccine at short notice in combination with limited vaccine stockpiles highlight the need for further study of this highly effective and safe vaccine.
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Expert Opin Biol Ther · Oct 2008
ReviewCardiovascular complications associated with biological therapies for breast cancer.
With increasing number of breast cancer survivors, treatment-associated toxicities are gaining importance because they may decrease quality of life and shorten expected survival. Biological treatment strategies are less toxic than conventional chemotherapy. However, practically all biological therapies for breast cancer induce cardiovascular complications. In the case of targeted therapies mechanisms of cardiotoxicity and strategies to manage cardiovascular disorders have not been completely defined. ⋯ Introduction of biological therapies has resulted in reduction of morbidity and mortality of breast cancer patients in recent years. However, all biological strategies bring a risk of cardiotoxicity and despite progress in the knowledge and management of cardiovascular complications there are still many unaswered questions.
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Expert Opin Biol Ther · Aug 2008
ReviewNew therapeutic applications for the anticoagulant, activated protein C.
Activated protein C (APC) is derived from its precursor, protein C (PC). Originally thought to be synthesised exclusively by the liver, recent reports have shown that PC is also produced by endothelial cells, smooth muscle cells, keratinocytes and some leukocytes. ⋯ APC functions as an anticoagulant with cytoprotective, anti-inflammatory and antiapoptotic properties. In vitro and preclinical data have revealed that APC exerts its protective effects via an intriguing mechanism requiring endothelial protein C receptor and protease activated receptor-1. Approved as a therapeutic agent for severe sepsis, APC is emerging as a potential treatment for a number of autoimmune and inflammatory diseases including spinal cord injury, asthma, chronic wounds and possibly rheumatoid arthritis. The future therapeutic uses of APC look very promising.