Reshaping neuroimmunology: diagnosis and treatment in the era of precision medicine

Abstract

Precision medicine has revolutionized the field of neuroimmunology, with innovative approaches that characterize diseases based on their biology, deeper understanding of the factors leading to heterogeneity within the same disease, development of targeted therapies, and strategies to tailor therapies to each patient. This review explores the impact of precision medicine on various neuroimmunological conditions, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), optic neuritis, autoimmune encephalitis, and immune-mediated neuropathies. We discuss advances in disease subtyping, recognition of novel entities, promising biomarkers, and the development of more selective monoclonal antibodies and cutting-edge synthetic cell-based immunotherapies in neuroimmunological disorders. In addition, we analyze the challenges related to affordability and equity in the implementation of these emerging technologies, especially in situations with limited resources.

What is the role of microbial biotechnology and genetic engineering in medicine?

“…In contrast, monoclonal antibodies are composed of a single IgG against one epitope (i.e., made using identical immune cells) (Mitra & Tomar, 2021 ). Monoclonal antibodies allow for higher specificity to a single epitope, which is also reflected in low cross‐reactivity (Dos Passos et al, 2023 ). Although polyclonal antibodies were a component of the first successful immunosuppressive regimens in the 1960s, for clinical applications, monoclonal antibodies are a better solution.…”

“…In fact, by 2023, there were nearly 1200 monoclonal antibody therapeutics in clinical studies and around 175 in regulatory review or approval (Kaplon et al, 2023 ). This points to a shift toward precise and personalized medicine using these types of therapeutics (Dos Passos et al, 2023 ). The next generation of monoclonal antibodies has been represented by recombinant antibodies, which are very promising alternatives to the classical ones as they allow for multiple engineering possibilities that can be performed to alter and improve the properties of the monoclonal antibody.…”

“…, which is also reflected in low cross-reactivity(Dos Passos et al, 2023). Although polyclonal antibodies were a component of the first successful immunosuppressive regimens in the 1960s, for clinical applications, monoclonal antibodies are a better solution.…”