Editorial

Immunocytokines: the long awaited therapeutic magic bullet in rheumatoid arthritis?

Fons A van de Loo and Wim B van den Berg^*

• * Corresponding author: Wim B van den Berg W.vandenBerg@reuma.umcn.nl

Author Affiliations

Rheumatology Research and Advanced Therapeutics, Department of Rheumatology, Radboud University Nijmegen Medical Centre, Nijmegen 6525 GA, The Netherlands

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Arthritis Research & Therapy 2009, 11:132 doi:10.1186/ar2835

Published: 6 November 2009

Abstract

Modulatory cytokines such as IL-4 and IL-10 looked promising biologicals, but suffered from poor exposure at the inflamed joints when administered via the patient-friendly subcutaneous route. Immunocytokines have now been engineered with tissue targeting potential and are a possible solution to this problem, although challenges still exist. Local inflammatory processes cause destruction of extracellular matrix (ECM) components, leading to neo-eptitopes, and/or elicit the synthesis of new ECM components. This makes ECM elements interesting targets for antibody-mediated recognition and retention, to achieve higher levels of immunocytokines at the site of therapeutic interference. The study presented by Schwager and colleagues shows that targeted delivery of IL-10 is more efficacious in experimental arthritis. Clinical studies are warranted to show whether this strategy works for all rheumatoid arthritis patients or is better for subgroups with a defined ECM phenotype. In principle, the scFv-targeting system is plastic enough to allow for personalized strategies.