Autoimmunity

  1. Therapeutic Strategies and Management
    1. Treatment Goals and Principles
      1. Disease Remission
        1. Clinical Remission
          1. Serologic Remission
            1. Histologic Remission
            2. Prevention of Organ Damage
              1. Early Intervention
                1. Damage Index Monitoring
                2. Quality of Life Improvement
                  1. Symptom Control
                    1. Functional Preservation
                      1. Psychosocial Support
                      2. Minimizing Treatment Toxicity
                        1. Risk-Benefit Assessment
                          1. Monitoring Protocols
                        2. Pharmacological Interventions
                          1. Anti-inflammatory Agents
                            1. Nonsteroidal Anti-inflammatory Drugs
                              1. Mechanism of Action
                                1. COX-1 Inhibition
                                  1. COX-2 Inhibition
                                  2. Indications
                                    1. Joint Pain
                                      1. Serositis
                                      2. Limitations and Side Effects
                                        1. Gastrointestinal Toxicity
                                          1. Cardiovascular Risk
                                            1. Renal Toxicity
                                          2. Corticosteroids
                                            1. Mechanism of Action
                                              1. Glucocorticoid Receptor Binding
                                                1. Anti-inflammatory Effects
                                                  1. Immunosuppressive Effects
                                                  2. Administration Routes
                                                    1. Oral
                                                      1. Intravenous
                                                        1. Intra-articular
                                                          1. Topical
                                                          2. Side Effects
                                                            1. Metabolic Effects
                                                              1. Cardiovascular Effects
                                                                1. Bone Effects
                                                                  1. Infectious Risk
                                                                    1. Psychiatric Effects
                                                                    2. Monitoring Requirements
                                                                      1. Bone Density
                                                                        1. Blood Glucose
                                                                          1. Blood Pressure
                                                                            1. Infection Screening
                                                                        2. Conventional Disease-Modifying Antirheumatic Drugs
                                                                          1. Methotrexate
                                                                            1. Mechanism of Action
                                                                              1. Folate Antagonism
                                                                                1. Adenosine Release
                                                                                  1. Anti-inflammatory Effects
                                                                                  2. Indications
                                                                                    1. Rheumatoid Arthritis
                                                                                      1. Psoriatic Arthritis
                                                                                        1. Inflammatory Myositis
                                                                                        2. Monitoring
                                                                                          1. Liver Function Tests
                                                                                            1. Complete Blood Count
                                                                                              1. Pulmonary Function
                                                                                              2. Side Effects
                                                                                                1. Hepatotoxicity
                                                                                                  1. Bone Marrow Suppression
                                                                                                    1. Pulmonary Toxicity
                                                                                                  2. Hydroxychloroquine
                                                                                                    1. Mechanism of Action
                                                                                                      1. Lysosomal pH Alteration
                                                                                                        1. TLR Inhibition
                                                                                                        2. Indications
                                                                                                          1. Systemic Lupus Erythematosus
                                                                                                            1. Sjögren's Syndrome
                                                                                                            2. Monitoring
                                                                                                              1. Ophthalmologic Examination
                                                                                                                1. Visual Field Testing
                                                                                                                2. Side Effects
                                                                                                                  1. Retinal Toxicity
                                                                                                                    1. Cardiac Conduction Abnormalities
                                                                                                                  2. Sulfasalazine
                                                                                                                    1. Mechanism of Action
                                                                                                                      1. Anti-inflammatory Effects
                                                                                                                        1. Immunomodulation
                                                                                                                        2. Indications
                                                                                                                          1. Rheumatoid Arthritis
                                                                                                                            1. Inflammatory Bowel Disease
                                                                                                                            2. Side Effects
                                                                                                                              1. Gastrointestinal Intolerance
                                                                                                                                1. Bone Marrow Suppression
                                                                                                                              2. Azathioprine
                                                                                                                                1. Mechanism of Action
                                                                                                                                  1. Purine Synthesis Inhibition
                                                                                                                                    1. T Cell Suppression
                                                                                                                                    2. Indications
                                                                                                                                      1. Systemic Lupus Erythematosus
                                                                                                                                        1. Inflammatory Myositis
                                                                                                                                          1. Vasculitis
                                                                                                                                          2. Monitoring
                                                                                                                                            1. TPMT Activity
                                                                                                                                              1. Complete Blood Count
                                                                                                                                                1. Liver Function Tests
                                                                                                                                                2. Side Effects
                                                                                                                                                  1. Bone Marrow Suppression
                                                                                                                                                    1. Hepatotoxicity
                                                                                                                                                      1. Malignancy Risk
                                                                                                                                                    2. Mycophenolate Mofetil
                                                                                                                                                      1. Mechanism of Action
                                                                                                                                                        1. IMPDH Inhibition
                                                                                                                                                          1. Lymphocyte Proliferation Suppression
                                                                                                                                                          2. Indications
                                                                                                                                                            1. Lupus Nephritis
                                                                                                                                                              1. Systemic Sclerosis
                                                                                                                                                              2. Side Effects
                                                                                                                                                                1. Gastrointestinal Effects
                                                                                                                                                                  1. Bone Marrow Suppression
                                                                                                                                                                    1. Infectious Risk
                                                                                                                                                                  2. Cyclophosphamide
                                                                                                                                                                    1. Mechanism of Action
                                                                                                                                                                      1. DNA Cross-linking
                                                                                                                                                                        1. Cell Cycle Arrest
                                                                                                                                                                        2. Indications
                                                                                                                                                                          1. Severe Lupus Nephritis
                                                                                                                                                                            1. ANCA-Associated Vasculitis
                                                                                                                                                                              1. Inflammatory Myositis
                                                                                                                                                                              2. Administration
                                                                                                                                                                                1. Oral
                                                                                                                                                                                  1. Intravenous Pulse
                                                                                                                                                                                  2. Side Effects
                                                                                                                                                                                    1. Bone Marrow Suppression
                                                                                                                                                                                      1. Hemorrhagic Cystitis
                                                                                                                                                                                        1. Gonadal Toxicity
                                                                                                                                                                                          1. Malignancy Risk
                                                                                                                                                                                          2. Monitoring
                                                                                                                                                                                            1. Complete Blood Count
                                                                                                                                                                                              1. Urinalysis
                                                                                                                                                                                                1. Fertility Assessment
                                                                                                                                                                                            2. Biologic Therapies
                                                                                                                                                                                              1. TNF-α Inhibitors
                                                                                                                                                                                                1. Mechanism of Action
                                                                                                                                                                                                  1. TNF-α Neutralization
                                                                                                                                                                                                    1. Inflammatory Cascade Interruption
                                                                                                                                                                                                    2. Agents
                                                                                                                                                                                                      1. Adalimumab
                                                                                                                                                                                                        1. Etanercept
                                                                                                                                                                                                          1. Infliximab
                                                                                                                                                                                                            1. Golimumab
                                                                                                                                                                                                              1. Certolizumab Pegol
                                                                                                                                                                                                              2. Indications
                                                                                                                                                                                                                1. Rheumatoid Arthritis
                                                                                                                                                                                                                  1. Psoriatic Arthritis
                                                                                                                                                                                                                    1. Ankylosing Spondylitis
                                                                                                                                                                                                                      1. Inflammatory Bowel Disease
                                                                                                                                                                                                                      2. Monitoring
                                                                                                                                                                                                                        1. Tuberculosis Screening
                                                                                                                                                                                                                          1. Hepatitis B Screening
                                                                                                                                                                                                                            1. Complete Blood Count
                                                                                                                                                                                                                            2. Side Effects
                                                                                                                                                                                                                              1. Infectious Risk
                                                                                                                                                                                                                                1. Malignancy Risk
                                                                                                                                                                                                                                  1. Injection Site Reactions
                                                                                                                                                                                                                                    1. Paradoxical Autoimmunity
                                                                                                                                                                                                                                  2. B Cell-Targeting Therapies
                                                                                                                                                                                                                                    1. Rituximab
                                                                                                                                                                                                                                      1. Mechanism of Action
                                                                                                                                                                                                                                        1. CD20 Targeting
                                                                                                                                                                                                                                          1. B Cell Depletion
                                                                                                                                                                                                                                          2. Indications
                                                                                                                                                                                                                                            1. Rheumatoid Arthritis
                                                                                                                                                                                                                                              1. ANCA-Associated Vasculitis
                                                                                                                                                                                                                                                1. Systemic Lupus Erythematosus
                                                                                                                                                                                                                                                2. Side Effects
                                                                                                                                                                                                                                                  1. Infusion Reactions
                                                                                                                                                                                                                                                    1. Infectious Risk
                                                                                                                                                                                                                                                      1. Progressive Multifocal Leukoencephalopathy
                                                                                                                                                                                                                                                    2. Belimumab
                                                                                                                                                                                                                                                      1. Mechanism of Action
                                                                                                                                                                                                                                                        1. BLyS/BAFF Inhibition
                                                                                                                                                                                                                                                          1. B Cell Survival Reduction
                                                                                                                                                                                                                                                          2. Indications
                                                                                                                                                                                                                                                            1. Systemic Lupus Erythematosus
                                                                                                                                                                                                                                                            2. Side Effects
                                                                                                                                                                                                                                                              1. Infectious Risk
                                                                                                                                                                                                                                                                1. Depression Risk
                                                                                                                                                                                                                                                            3. T Cell Costimulation Blockers
                                                                                                                                                                                                                                                              1. Abatacept
                                                                                                                                                                                                                                                                1. Mechanism of Action
                                                                                                                                                                                                                                                                  1. CD28-CD80/86 Blockade
                                                                                                                                                                                                                                                                    1. T Cell Activation Inhibition
                                                                                                                                                                                                                                                                    2. Indications
                                                                                                                                                                                                                                                                      1. Rheumatoid Arthritis
                                                                                                                                                                                                                                                                        1. Psoriatic Arthritis
                                                                                                                                                                                                                                                                        2. Side Effects
                                                                                                                                                                                                                                                                          1. Infectious Risk
                                                                                                                                                                                                                                                                            1. Malignancy Risk
                                                                                                                                                                                                                                                                        3. Interleukin Inhibitors
                                                                                                                                                                                                                                                                          1. IL-6 Receptor Antagonists
                                                                                                                                                                                                                                                                            1. Tocilizumab
                                                                                                                                                                                                                                                                              1. Mechanism of Action
                                                                                                                                                                                                                                                                                1. Indications
                                                                                                                                                                                                                                                                                  1. Side Effects
                                                                                                                                                                                                                                                                                  2. Sarilumab
                                                                                                                                                                                                                                                                                  3. IL-17 Inhibitors
                                                                                                                                                                                                                                                                                    1. Secukinumab
                                                                                                                                                                                                                                                                                      1. Ixekizumab
                                                                                                                                                                                                                                                                                        1. Brodalumab
                                                                                                                                                                                                                                                                                        2. IL-23 Inhibitors
                                                                                                                                                                                                                                                                                          1. Ustekinumab
                                                                                                                                                                                                                                                                                            1. Guselkumab
                                                                                                                                                                                                                                                                                              1. Risankizumab
                                                                                                                                                                                                                                                                                              2. IL-1 Inhibitors
                                                                                                                                                                                                                                                                                                1. Anakinra
                                                                                                                                                                                                                                                                                                  1. Canakinumab
                                                                                                                                                                                                                                                                                              3. Small Molecule Inhibitors
                                                                                                                                                                                                                                                                                                1. Janus Kinase Inhibitors
                                                                                                                                                                                                                                                                                                  1. Mechanism of Action
                                                                                                                                                                                                                                                                                                    1. JAK-STAT Pathway Inhibition
                                                                                                                                                                                                                                                                                                      1. Cytokine Signaling Blockade
                                                                                                                                                                                                                                                                                                      2. Agents
                                                                                                                                                                                                                                                                                                        1. Tofacitinib
                                                                                                                                                                                                                                                                                                          1. Baricitinib
                                                                                                                                                                                                                                                                                                            1. Upadacitinib
                                                                                                                                                                                                                                                                                                              1. Filgotinib
                                                                                                                                                                                                                                                                                                              2. Indications
                                                                                                                                                                                                                                                                                                                1. Rheumatoid Arthritis
                                                                                                                                                                                                                                                                                                                  1. Psoriatic Arthritis
                                                                                                                                                                                                                                                                                                                    1. Inflammatory Bowel Disease
                                                                                                                                                                                                                                                                                                                    2. Side Effects
                                                                                                                                                                                                                                                                                                                      1. Infectious Risk
                                                                                                                                                                                                                                                                                                                        1. Thrombotic Risk
                                                                                                                                                                                                                                                                                                                          1. Malignancy Risk
                                                                                                                                                                                                                                                                                                                            1. Laboratory Abnormalities
                                                                                                                                                                                                                                                                                                                          2. Phosphodiesterase 4 Inhibitors
                                                                                                                                                                                                                                                                                                                            1. Apremilast
                                                                                                                                                                                                                                                                                                                              1. Mechanism of Action
                                                                                                                                                                                                                                                                                                                                1. Indications
                                                                                                                                                                                                                                                                                                                                  1. Side Effects
                                                                                                                                                                                                                                                                                                                            2. Non-Pharmacological Interventions
                                                                                                                                                                                                                                                                                                                              1. Physical and Occupational Therapy
                                                                                                                                                                                                                                                                                                                                1. Exercise Programs
                                                                                                                                                                                                                                                                                                                                  1. Range of Motion Exercises
                                                                                                                                                                                                                                                                                                                                    1. Strengthening Exercises
                                                                                                                                                                                                                                                                                                                                      1. Aerobic Conditioning
                                                                                                                                                                                                                                                                                                                                        1. Aquatic Therapy
                                                                                                                                                                                                                                                                                                                                        2. Joint Protection Strategies
                                                                                                                                                                                                                                                                                                                                          1. Splinting
                                                                                                                                                                                                                                                                                                                                            1. Assistive Devices
                                                                                                                                                                                                                                                                                                                                              1. Activity Modification
                                                                                                                                                                                                                                                                                                                                              2. Functional Assessment
                                                                                                                                                                                                                                                                                                                                                1. Activities of Daily Living
                                                                                                                                                                                                                                                                                                                                                  1. Work Capacity Evaluation
                                                                                                                                                                                                                                                                                                                                                2. Lifestyle Modifications
                                                                                                                                                                                                                                                                                                                                                  1. Dietary Interventions
                                                                                                                                                                                                                                                                                                                                                    1. Anti-inflammatory Diets
                                                                                                                                                                                                                                                                                                                                                      1. Mediterranean Diet
                                                                                                                                                                                                                                                                                                                                                        1. Omega-3 Fatty Acids
                                                                                                                                                                                                                                                                                                                                                          1. Vitamin D Supplementation
                                                                                                                                                                                                                                                                                                                                                          2. Exercise and Physical Activity
                                                                                                                                                                                                                                                                                                                                                            1. Benefits in Autoimmunity
                                                                                                                                                                                                                                                                                                                                                              1. Exercise Prescription
                                                                                                                                                                                                                                                                                                                                                                1. Monitoring Guidelines
                                                                                                                                                                                                                                                                                                                                                                2. Smoking Cessation
                                                                                                                                                                                                                                                                                                                                                                  1. Impact on Disease Activity
                                                                                                                                                                                                                                                                                                                                                                    1. Cessation Strategies
                                                                                                                                                                                                                                                                                                                                                                    2. Stress Management
                                                                                                                                                                                                                                                                                                                                                                      1. Psychological Interventions
                                                                                                                                                                                                                                                                                                                                                                        1. Mindfulness-Based Therapies
                                                                                                                                                                                                                                                                                                                                                                          1. Cognitive Behavioral Therapy
                                                                                                                                                                                                                                                                                                                                                                          2. Sleep Hygiene
                                                                                                                                                                                                                                                                                                                                                                            1. Sleep Quality Assessment
                                                                                                                                                                                                                                                                                                                                                                              1. Sleep Disorder Management
                                                                                                                                                                                                                                                                                                                                                                            2. Patient Education and Self-Management
                                                                                                                                                                                                                                                                                                                                                                              1. Disease Understanding
                                                                                                                                                                                                                                                                                                                                                                                1. Pathophysiology Education
                                                                                                                                                                                                                                                                                                                                                                                  1. Prognosis Discussion
                                                                                                                                                                                                                                                                                                                                                                                    1. Treatment Rationale
                                                                                                                                                                                                                                                                                                                                                                                    2. Medication Adherence
                                                                                                                                                                                                                                                                                                                                                                                      1. Importance of Compliance
                                                                                                                                                                                                                                                                                                                                                                                        1. Side Effect Management
                                                                                                                                                                                                                                                                                                                                                                                          1. Monitoring Requirements
                                                                                                                                                                                                                                                                                                                                                                                          2. Symptom Monitoring
                                                                                                                                                                                                                                                                                                                                                                                            1. Disease Activity Recognition
                                                                                                                                                                                                                                                                                                                                                                                              1. Flare Identification
                                                                                                                                                                                                                                                                                                                                                                                                1. When to Seek Medical Care
                                                                                                                                                                                                                                                                                                                                                                                                2. Lifestyle Counseling
                                                                                                                                                                                                                                                                                                                                                                                                  1. Activity Pacing
                                                                                                                                                                                                                                                                                                                                                                                                    1. Energy Conservation
                                                                                                                                                                                                                                                                                                                                                                                                      1. Social Support
                                                                                                                                                                                                                                                                                                                                                                                                  2. Emerging and Experimental Therapies
                                                                                                                                                                                                                                                                                                                                                                                                    1. Cellular Therapies
                                                                                                                                                                                                                                                                                                                                                                                                      1. Mesenchymal Stem Cell Therapy
                                                                                                                                                                                                                                                                                                                                                                                                        1. Immunomodulatory Properties
                                                                                                                                                                                                                                                                                                                                                                                                          1. Clinical Applications
                                                                                                                                                                                                                                                                                                                                                                                                            1. Safety Considerations
                                                                                                                                                                                                                                                                                                                                                                                                            2. Regulatory T Cell Therapy
                                                                                                                                                                                                                                                                                                                                                                                                              1. Ex Vivo Expansion
                                                                                                                                                                                                                                                                                                                                                                                                                1. Adoptive Transfer
                                                                                                                                                                                                                                                                                                                                                                                                                  1. Clinical Trials
                                                                                                                                                                                                                                                                                                                                                                                                                  2. CAR-T Cell Therapy
                                                                                                                                                                                                                                                                                                                                                                                                                    1. Anti-CD19 CAR-T
                                                                                                                                                                                                                                                                                                                                                                                                                      1. Applications in Autoimmunity
                                                                                                                                                                                                                                                                                                                                                                                                                    2. Gene Therapy Approaches
                                                                                                                                                                                                                                                                                                                                                                                                                      1. Gene Editing Technologies
                                                                                                                                                                                                                                                                                                                                                                                                                        1. CRISPR-Cas9
                                                                                                                                                                                                                                                                                                                                                                                                                          1. Base Editing
                                                                                                                                                                                                                                                                                                                                                                                                                            1. Prime Editing
                                                                                                                                                                                                                                                                                                                                                                                                                            2. Viral Vector Delivery
                                                                                                                                                                                                                                                                                                                                                                                                                              1. Adeno-Associated Virus
                                                                                                                                                                                                                                                                                                                                                                                                                                1. Lentiviral Vectors
                                                                                                                                                                                                                                                                                                                                                                                                                              2. Antigen-Specific Immunotherapy
                                                                                                                                                                                                                                                                                                                                                                                                                                1. Peptide-Based Vaccines
                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Tolerogenic Peptides
                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Altered Peptide Ligands
                                                                                                                                                                                                                                                                                                                                                                                                                                    2. DNA Vaccines
                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Plasmid DNA Delivery
                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Immune Tolerance Induction
                                                                                                                                                                                                                                                                                                                                                                                                                                        2. Nanoparticle Delivery Systems
                                                                                                                                                                                                                                                                                                                                                                                                                                          1. Targeted Delivery
                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Controlled Release
                                                                                                                                                                                                                                                                                                                                                                                                                                          2. Microbiome-Based Therapies
                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Probiotic Interventions
                                                                                                                                                                                                                                                                                                                                                                                                                                              1. Specific Bacterial Strains
                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Mechanisms of Action
                                                                                                                                                                                                                                                                                                                                                                                                                                                2. Fecal Microbiota Transplantation
                                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Donor Selection
                                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Safety Protocols
                                                                                                                                                                                                                                                                                                                                                                                                                                                    2. Prebiotic Supplementation
                                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Fiber-Based Interventions
                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Short-Chain Fatty Acid Production

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                                                                                                                                                                                                                                                                                                                                                                                                                                                  5. Diagnosis and Clinical Evaluation

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                                                                                                                                                                                                                                                                                                                                                                                                                                                  Next

                                                                                                                                                                                                                                                                                                                                                                                                                                                  7. Research Frontiers and Future Directions