VIDEO: IgG4-related disease research focusing on therapeutic options

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So, we have made a very big advance recently, and that is with the MITIGATE trial, the demonstration that B-cell depletion is an effective therapy for remission maintenance in IgG4 related disease. We're at a wonderful point in the disease in that we understand a substantial amount about the basic immunology of the disease. B cells are clearly in the center of this.

A number of cells of the B lineage are likely important in IgG4 related disease. Another side of the equation is T-cells, and particularly a CD4 positive cytotoxic T-cell, we believe is very important in this condition, and it is this crosstalk between cells of the B lineage, and cells of the T lineage, CD4, likely CD8 positive T cells as well, that drive this disease. Thus far, most of the therapeutic efforts have been directed against the B cell lineage. It's quite possible that by tweaking T-cells, it may be possible to exert a favorable outcome on the disease as well.

At the moment, I anticipate for the next few years, most of the therapeutic options will be directed against B cells. But there are other possibilities as well. The contribution of the complement system to the disease is now beginning to be investigated more intensively. There have been some important papers along these lines recently, and I think this may be another area where there are therapeutic options that emerge.