Common therapeutic approaches for different autoimmune diseases

Autoimmune diseases occur when the immune system mistakenly attacks the body's own tissue. Although the organ systems affected can vary significantly—such as the intestines in chronic inflammatory bowel diseases or the joints and soft tissue in rheumatoid diseases—many of these diseases share common immunological mechanisms. This is precisely what gives rise to overarching therapeutic strategies that can be effective in treating various autoimmune diseases. Translated with DeepL.com (free version)

Common causes of the diseases

Many autoimmune diseases share key characteristics:

• Chronic inflammatory processes that progress without treatment
• Dysregulation of certain immune cells such as T cells, B cells, or macrophages
• Overproduction of pro-inflammatory cytokines, such as TNF-α, IL-6, IL-17, or interferons
• Phases of flare-ups and remissions

These similarities mean that therapeutic principles and medications are often suitable for several diseases at the same time.

Conventional forms of therapy

1. Corticosteroids

Fast-acting anti-inflammatory drugs used to treat flare-ups in many autoimmune diseases. They are not suitable for long-term therapy, but remain an indispensable emergency tool.

2. Classic immunosuppressants

Several substances are used in various indications:

• Azathioprine
• methotrexate
• sulfasalazine
• leflunomide
• mycophenolate mofetil
• cyclosporine / tacrolimus

They slow down the excessive immune response and can be used to treat some autoimmune diseases.

Biologics – targeted therapy across disease boundaries

The greatest advance in recent decades has been in the field of biologics, which block precisely defined inflammatory pathways. Many of these substances have a cross-sectional effect, meaning they are equally effective in treating several autoimmune diseases.

TNF-α blocker

• adalimumab
• infliximab
• golimumab
• certolizumab
• etanercept

Used for Crohn's disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, spondyloarthritis, etc.

IL-12/23 or IL-23 blockers

• ustekinumab
• risankizumab
• guselkumab

Effective in chronic inflammatory bowel diseases and psoriatic diseases.

IL-17 blocker

• secukinumab
• ixekizumab
• bimekizumab

Used primarily for psoriasis-related conditions and spondylarthritis.

IL-6 blocker

• tocilizumab
• sarilumab

Established therapy for rheumatoid arthritis and increasingly for other systemic inflammatory processes.

JAK inhibitors (small molecules)

• tofacitinib
• baracitinib
• upadacitinib
• filgotinib

Act intracellularly on central signaling pathways and are used in both rheumatology and gastroenterology.

Holistic strategies relevant to all autoimmune diseases

1. Lifestyle and dietary factors

An anti-inflammatory diet, sufficient exercise, stress reduction, and nicotine cessation support any immunotherapy.

2. Microbiome modulation

The gut microbiome plays a role in many autoimmune processes—not just in the gastrointestinal tract. Measures may include:

• tailored diet
• probiotic strategies
• avoiding unnecessary antibiotics
• potential future approaches such as microbiome transplants

3. Psychoimmunological support

Chronic autoimmune diseases affect mental resilience, sleep, and stress management. Methods such as behavioral therapy approaches, relaxation techniques, or mindfulness-based practices can have a positive impact on the overall course of the disease.

4. Sports

Targeted training and muscle building can probably have a positive effect on autoimmune diseases. Among other things, messenger substances (known as “myokines”) are produced in the muscles, which can have a positive effect on the inflammatory process.

Why joint therapies are beneficial

Economical: One drug can treat several diseases.

• Practical: Patients with more than one autoimmune disease benefit from standardized treatment pathways.
• Medizinisch: Durch das einheitliche „Targeting“ zentraler Entzündungswege lassen sich Symptome verschiedener Organsysteme gleichzeitig stabilisieren.
• Research-oriented: Findings from one disease can quickly be applied to other areas.

Conclusion

The treatment of autoimmune diseases is increasingly moving toward common, targeted therapeutic strategies. Chronic inflammatory bowel diseases and rheumatoid diseases are just two examples of conditions that can benefit from the same modern immunomodulators. With a growing understanding of immunological mechanisms, it is becoming increasingly possible to successfully control different autoimmune processes with similar, highly precise treatment approaches.

Thanks to our many years of experience, we can also support and advise you in the treatment of autoimmune diseases using modern therapeutic agents. In addition to our own expertise, we are in close contact with a network of colleagues from various disciplines (rheumatology, dermatology, infectious diseases) that we have built up over several years, with whom we can exchange ideas on interdisciplinary cases.