TiPS - May 1993 [Vol. 141
Much of the credit L - the incredible speed with which new advances in basic biology are turned to medical advantage can be attributed to immunopharmacology. It sits at the interface between the relatively young and expanding science of immunology and an established giant of the medical sciences, pharmacology. If it performs to expectations, immunopharmacology will add a range of exciting therapeutic possibilities to clinical medicine in the next decade. To date, this promise has not been fully realized; indeed there has been some disappointment for those craving immediate success. However, in pharmacological terms, the field is at a very early stage of development and a level-headed assessment is required. This joint issue from Trends in Pharmacological Sciences and immunology Today aims to provide just such a balanced appraisal of past achievements and a realistic survey of the prospects. Although immunologists and pharmacologists have not traditionally shared the same experimental approach, the goals of immunology and pharmacology are highly interconnected. Pharmacological science aims to identify agents (generally exogenous) with the capacity to modify biological responses. The goal of immunologists is to define the interactions of the cells and molecules (many of which are natural response modifiers) of the immune system. As understanding of these molecules has increased, so has the realization that they can be used therapeutically in cancer, infectious diseases and autoimmune diseases. In addition to endogenof therapeutic ous molecules value, the immune system also presents severai targets for pharmacological intervention. The development of synthetic agents that can modulate the immune response is the second major area of immunopharmacology; it is already of great value in the
control of transplant rejection and is of potential benefit in the treatment of autoimmune disease. The opening set of articles in this joint issue describes the development and use of antibodies as specific pharmacological reagents. This area was one of the first common aims of immunology and pharmacology. The range of specificities with which immunoglobulins are endowed makes them promising pharmacological probes with the capacity to target a virtually limitless range of structures to induce a wide array of biological effects. A range of current and future uses is described, illustrating that antibody-based immunotherapy is already firmly on the clinical agenda. The second section deals with the principles of cytokine therapy. Cytokines mediate communication within the immune system, and between immune and other cell types. In contrast to antibody therapy, where a single agent can have a single, defined effect, cytokine therapy relies on the subtle manipulation of the complex cytokine network, therefore presenting a major research challenge. In the third section, the current status of exogenous immunomodulation is reviewed. Immunopharmacology has its roots in natural adjuvants, which have
been a component of vaccine strategy for many decades. Today, a new era of synthetic adjuvant development, for use with a new generation of subunit vaccines, is now under way. Exogenous immunomodulation also encompasses the most successful application of immunotherapy; the use of microbe-derived agents, such as ciclosporin and FK506, to suppress immune responses. Some of the most successful drugs currently used in immunological and inflammatory pathologies were developed for other purposes. Now, a rational approach to drug design is being applied to yield increasingly efficacious therapies with fewer side-effects. In the final series of articles, the emphasis shifts from the laboratory to the clinic. Key contributions from leading figures in cancer allergy, transplantation, and autoimmune disease discuss established immunotherapies and ongoing clinical trials, providing a preview of future direction. The current status of immunopharmacology is, arguably, one of unrealized potential. However, as thic “pecial Issue reveals, there is a good deal of optimism at present and this is clearly an exciting period for the field. We are confident that a similar s-lrvey conducted a decade from now will reveal numerous success stories. RICHARD BRINES, DEBBIE
Today AND GIRDLESTONE, Trends in Pharmacological Sciences. *~resenf address: Science, Europe Office. Thomas House, 14 George IV Street.
Cambridge, UK CB2 IHH.
This joint issue between TiPS and IT was produced in collaboration with the IT Editorial staff Editor Robert Brines Subeditor Clare Thompson Editorial Secretary Clare Kirk 0
0165 - 6137/93/$06.00