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Thinking About Immune-Based Therapy. . . ?

April 2000

In HIV disease, even though the immune system generally weakens over time, it is also in some ways over-boosted. When it comes to the immune system, "more" is not always better. For example, a whole range of diseases are called "autoimmune" illnesses in which the immune system is overactive and attacks the body itself. In some ways, HIV causes the immune system to overreact and damage cells and tissues. Still other illnesses, like the opportunistic infections associated with AIDS, result from diminished immune function. In HIV disease, it is more accurate to think of the immune response as abnormal or disrupted, rather than just in need of a "boost."

Creating drugs or strategies that suppress the reproduction of HIV is a very complex task by itself, which is why such drugs are far from perfect. The same, or worse, may be true for immune-based therapy, however "natural" the idea sounds. The immune system is perhaps the most complex product of human evolution. The immune system carries on a daily war against invading enemies, both known and unknown. It does this through an almost unthinkably complex interaction of dozens of different cells and tissue sites, which communicate with each other and invading agents through hundreds or even thousands of chemical messages made by cells.

The goal of immune-based therapy in HIV disease is to first understand how the immune system reacts against HIV, why it fails to "cure" the infection the way it does with most diseases, and finally, to figure out how to change or manipulate the immune response to improve its activity against HIV. This task is inherently more complex than merely building chemical toxins that slow the production of new virus.

Despite this complexity, many researchers have dedicated their lives to the study of the immune system because they believe it ultimately holds the keys for conquering all human illness.


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