Humans are well-protected from infection by pathogens such as bacteria, viruses, fungi and parasites thanks to our innate and adaptive immune systems. These protective systems are distinct from each other, but work together in our body.

Many autoimmune diseases, like rheumatoid arthritis, display aspects of both the innate and adaptive responses at different points in their progression. The common theme among all of these conditions is that they are immune-mediated, meaning the immune system is the main factor causing the inflammation. Collectively, these immune-mediated inflammatory conditions are the focus of research and development at AbbVie Immunology.

See our entire Immunology Pipeline.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, progressive, inflammatory disorder mainly characterized by inflammation of the lining of the joints. RA causes inflammation, joint pain, stiffness and swelling and may eventually cause permanent joint damage.

RA affects approximately 1% of the adult population in the industrialized world (around 1.5 million Americans)^[1][2] , with women approximately three times more likely to be affected by RA than men^[3].

RA is an immune-mediated disease in which the body mistakenly attacks healthy joints, resulting in loss of function over time^[1]. Long-term, RA can lead to a reduced ability to perform everyday tasks and activities, such as opening a jar or turning a doorknob.^[4]

Current treatments for RA focus on inhibiting specific components of the immune system, which reduces inflammation and helps slow down RA progression. More recently, researchers have observed that different signals in the immune system are active as disease progresses.

We are investigating different parts of the immune system associated with RA in the hope of finding additional ways to interrupt the disease process.

Juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is an immune-mediated disease that includes several forms of chronic arthritis that affect children ages 16 or younger^[5][6]. There are several subtypes of JIA, each with distinct symptoms: systemic arthritis, oligoarthritis, polyarthritis (rheumatoid factor positive or negative), psoriatic arthritis, enthesitis-related arthritis and undifferentiated arthritis.^[6]

Approximately 300,000 children^[7] in the United States and 59,000 in Europe^[8] are affected by JIA—a serious, painful and potentially disabling disease that can lead to permanent disability^[7]. While the exact prevalence is dependent on subtype, JIA occurs more often in girls than boys^[9]. Studies have found that over one-third of patients have ongoing active disease into adulthood.^[10]

Typical symptoms of JIA include stiffness when awakening, limping, joint tenderness, fatigue and joint swelling. Different joints in the body, including the knees, ankles and joints of the hands and feet, can be affected,^[5] and in some cases internal organs can be affected as well.^[6] Inflammation from the disease may limit the mobility of affected joints^[11] and, in more severe cases, cause problems with bone development and growth.^[7]

Early diagnosis and treatment of JIA are important for patients living with this condition.

Ankylosing spondylitis

Ankylosing spondylitis (AS), or arthritis of the spine, is a chronic, multisystem inflammatory disorder. It primarily affects the spine, sacroiliac joints (where the spine meets the pelvis) and axial skeleton (the skull, rib cage and vertebrae).^[12] The spine’s vertebrae begin to fuse together, causing spine rigidity, which leads to pain and stiffness from the neck down.^[13] Symptoms can range from mild to severe. Over time, AS can result in a permanent stooped-over position.^[13]

While the cause of AS is currently unknown, there is a strong genetic link.^[13] AS affects approximately 0.1% to 0.5% of the adult population and, while it can occur at any age, it most commonly occurs in males in their teens or 20s.^[13]

The most common symptom of AS is a gradual onset of lower back pain,^[14] which includes ligament and tendon inflammation, constant pain and stiffness around the buttocks and hips and abnormal fusion of the vertebrae.^[14] AS is a systemic disease, which can lead to more widespread symptoms such as fever, fatigue, loss of appetite and eye inflammation. In rare cases, lung and heart conditions may also arise.^[14]

There is currently no cure for AS, but early diagnosis and treatment is important for patients with this condition.

Osteoarthritis

Osteoarthritis (OA) is a disease of the entire joint—including the joint lining, cartilage, ligaments and bone.^[15]

Osteoarthritis is the most frequent chronic musculoskeletal disease. There are at least 27 million adults afflicted with OA in the United States.^[16] [17]Approximately 40 percent of adults over 70 are afflicted by OA of the knee and 25 percent are limited in their daily activities, making it the leading cause of disability in elderly persons.^[17]

Osteoarthritis occurs most frequently in the hands, knees, spine, hips and toes. Symptoms of OA can include joint pain, stiffness, swelling, bone-on-bone noises when moving and limited joint mobility.^[16] The cause of OA is not fully understood, although there are certain risk factors for the condition, including genetic predisposition, aging, obesity and joint malalignment.^[17]

Cartilage degeneration in OA has been linked to interleukin-1 (IL-1), which exists as IL-1alpha (IL-1α) and IL-1beta (IL-1β), two closely related versions of the same molecule.^[18] IL-1 is an inflammatory molecule, which may contribute to cartilage degradation.

Dermatology

We’re committed to finding answers for even more patients with unmet dermatology needs.

Find out more about the future of AbbVie Dermatology.

Plaque psoriasis

Plaque psoriasis is a chronic skin condition in which a person’s immune system sends faulty signals, resulting in skin cells that grow too rapidly. The body does not shed these excess skin cells, leading to a pile-up on the surface resulting in white, silvery or red patches of skin. The accumulation of these skin cells forms thick patches called “plaques” that typically appear on the knees, elbows, scalp, hands, feet and lower back.^[19]

There is strong evidence that plaque psoriasis may be genetically inherited, although it can be triggered by external environmental factors such as cold and dry climates, infections, stress, dry skin and certain medications. Additionally, physical injury to the skin can cause more patches to form.^[19] Most common in adults, plaque psoriasis is not contagious and cannot be spread by touch.^[19] Plaque psoriasis is a common disease, affecting approximately 2% of the global population^[20] (over 125 million people worldwide^[21] and 7.5 million people in the United States^[22]). Patients with plaque psoriasis sometimes develop psoriatic arthritis or similar conditions.^[21]

The extent and duration of symptoms in plaque psoriasis varies greatly from patient to patient. Symptoms tend to disappear, even without treatment, and can flare up without warning.^[19]

In more severe cases of plaque psoriasis, the skin becomes inflamed, itchy and tender. These patches can join together and cover large areas of skin such as the back.^[19] Patients with plaque psoriasis may become self-conscious and avoid activities that would expose their skin, such as swimming^[23].

Approximately 10 to 20% of patients with plaque psoriasis also experience psoriatic arthritis, inflammation of the joints that can progress to severe deformities.^[23]

Hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a painful, chronic inflammatory skin disease characterized by inflamed areas typically located around the armpits and groin, on the buttocks and under the breasts.^[29] Physical signs include painful abscesses and nodules, sinus tracts and scarring.^[30][31]

HS is often under recognized and misdiagnosed; average diagnosis time can be lengthy.^[32][33] Signs and symptoms of HS include deep-seated lesions consisting of painful nodules and abscesses, lesions localized to the armpit, groin, buttocks and breast regions of the body and recurrences over time.^[32]

The average onset of HS usually occurs after puberty, typically during the second or third decade of life.^[34] HS can be progressive and increase in severity over time. Early diagnosis and management is important.^[35]

Inflammatory Bowel Disease

Crohn’s disease

Crohn’s disease (CD) is a chronic, inflammatory bowel disease (IBD) that can affect anywhere along the digestive tract, from the mouth to the anus.^[36] In CD, mucosal lesions are caused by inflammation that penetrates the full thickness of the bowel wall. Common symptoms of the disease include diarrhea, cramps/abdominal pain, weight loss and fever.^[36]

CD affects approximately 565,000 people in the United States.^[37]Men and women are equally affected,^[38] with a higher prevalence seen in North America and Europe.^[39] People of all ages can suffer from CD, but it is most often diagnosed in adolescents and young adults between the ages of 15 and 35.^[39]

CD is characterized by periods in which the disease flares and periods of remission, during which symptoms decrease or disappear.^[40]Complications of CD can include fistulas (ulcers in the wall of the intestine that cause a tunnel to another part of the intestine, skin or another organ), stricture, which can lead to intestinal obstruction or an abscess.^[40]

Ulcerative colitis

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that causes ulcers in the colon and rectum.^[41] While Crohn’s disease can affect any part of the gastrointestinal tract, UC only affects the colon and rectum, resulting in diarrhea, rectal bleeding, abdominal cramping and weight loss.^[42] UC only affects the innermost lining of the intestinal wall.^[42]

Up to 700,000 Americans may be living with UC.^[42]  Typically, people are diagnosed with UC in their mid-30s, though the disease can occur at any age.^[42]  Patients may experience a range of symptoms based on the extent of the disease and severity of inflammation.^[42] The symptoms tend to come and go, with periods of clinical stability punctuated by episodic flares of disease activity.^[42] Severe flares of UC can necessitate hospitalization and may lead to life-threatening complications.^[43]

It is estimated that 25 to 33% of patients with UC may require surgery during their lifetimes. Over the long term, UC can increase the risk of colon cancer. In addition, some patients may experience symptoms in other parts of the body such as joint pain, eye problems and liver disease.^[44]

Systemic lupus erythematosus

Systemic lupus erythematosus (SLE), the most common type of lupus, is associated with inflammation of multiple organ systems throughout the body^[45]. Diagnosis of lupus is challenging due to a range of symptoms that can affect the kidneys, lungs, skin, nervous system and musculoskeletal system.

A report submitted by the National Arthritis Data Working Group estimated that SLE affects 250,000 Americans and is more common in females of childbearing age; however, it can affect men or women at any age. The highest prevalence occurs in women, African-Americans and persons between 20 and 40 years of age.^[45] Although the cause of SLE is not known, it can be triggered by exposure to sunlight and certain drugs. A potential genetic link has been identified, in which people who carry a specific form of the genes for both Bcl-2 and IL-10, an immune signaling molecule, are at significant risk of developing SLE.^[46] In many cases an autoimmune reaction, where the immune system attacks itself, may be present and detectable years before the symptoms are apparent. This increase in autoimmune activity is helpful in diagnosing the disease.^[47]

Although SLE is often associated with inflammatory arthritis and a butterfly-shaped facial rash, it is more common for individuals with SLE to have other symptoms. These can include fatigue, malaise (a general feeling that you aren’t well), oral ulcers, skin rashes that appear after exposure to sunlight, chest pains, headache, sensations of burning, tickling or itching on the skin, dry eyes and mouth, discoloration of toes and fingers in the cold and mild hair loss. There can also be a problem with any one of a patient’s major organs.^[47]

_{[1] National Institute of Arthritis and Musculoskeletal and Skin Diseases. Handout on Health: Rheumatoid Arthritis. 2014. http://www.niams.nih.gov/health_info/rheumatic_disease/. Accessed May 25, 2016.}

^{[2] Brennan FM, McInnes IB. Evidence that cytokines play a role in rheumatoid arthritis. J Clin Invest. 2008;118(11):3537-3545.}

^{[3] Van Vollenhoven RF. Sex differences in rheumatoid arthritis: more than meets the eye. BMC Med. 2009;7(1):12.}

^{[4] Srikesavan CS, Shay B, Szturm T. Test-retest reliability and convergent validity of a computer based hand function test protocol in people with arthritis. Open Orthop J. 2015;9:57-67.}

^{[5] Southwood T, Szer I. Juvenile Idiopathic Arthritis. In: ABC of Rheumatology. Vol Wiley; 2010:Chapter 15. https://books.google.com/books?id=ehnQn0VZZ3kC&pg=PT201&lpg=PT201&dq=abc+of+rheumatology+juvenile+idiopathic+arthritis&source=bl&ots=wKwH_awciB&sig=Hhc01Wt9Mmrd8QiqqTvgjhe4sxo&hl=en&sa=X&ved=0CDgQ6AEwAmoVChMI59j_tvu3xwIViReSCh1JOgjL#v=onepage&q=abc. Accessed May 25, 2016.}

^{[6] National Institute of Arthritis and Musculoskeletal and Skin Diseases. Questions and Answers About Juvenile Arthritis. 2015. http://www.niams.nih.gov/Health_Info/Juv_Arthritis/default.asp. Accessed May 25, 2016.}

^{[7] Chang HJ, Burke AE, Glass RM. Juvenile idiopathic arthritis. JAMA. 2010;303(13):1328.}

^{[8] Thierry S, Fautrel B, Lemelle I, Guillemin F. Prevalence and incidence of juvenile idiopathic arthritis: a systematic review. Joint Bone Spine. 2014;81(2):112-117.}

^{[9] Centers for Disease Control and Prevention. Childhood Arthritis. 2013. http://www.cdc.gov/arthritis/basics/childhood.htm. Accessed May 25, 2016.}

^{[10] Malviya A, Johnson-Lynn S, Avery P, Deehan D, Foster H. Juvenile idiopathic arthritis in adulthood and orthopaedic intervention. Clin Rheumatol. 2009;28(12):1411-1417.}

^{[11] Ding T, Hall A, Jacobs K, David J. Psychological functioning of children and adolescents with juvenile idiopathic arthritis is related to physical disability but not to disease status. Rheumatology. 2008;47(5):660-664.}

^{[12] Daikh DI, Chen PP. Advances in managing ankylosing spondylitis. F1000Prime Rep. 2014;6:78.}

^{[13] WebMD. Arthritis and Ankylosing Spondylitis. 2015. http://www.webmd.com/back-pain/guide/ankylosing-spondylitis. Accessed May 25, 2016.}

^{[14] Brent LH. Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy. Medscape. 2015. http://emedicine.medscape.com/article/332945-overview. Accessed May 25, 2016.}

^{[15] Srikulmontree T. Osteoarthritis. Am Coll Rheumatol. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Osteoarthritis/. Accessed May 25, 2016.}

^{[16] Lawrence R, Felson D. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum. 2008;58(1):26-35.}

^{[17] Oliviero F, Ramonda R, Punzi L. New horizons in osteoarthritis. Swiss Med Wkly. 2010;140:w13098.}

^{[18] Lee AS, Ellman MB, Yan D, et al. A current review of molecular mechanisms regarding osteoarthritis and pain. Gene. 2013;527(2):440-447.}

^{[19] WebMd. Psoriasis – Topic Overview. 2015. http://www.webmd.com/skin-problems-and-treatments/psoriasis/understanding-psoriasis-basics. Accessed May 26, 2016.}

^{[20] World Health Organization. Psoriasis.; 2013. http://apps.who.int/gb/ebwha/pdf_files/EB133/B133_5-en.pdf. Accessed May 26, 2016.}

^{[21] Langham S, Langham J, Goertz H-P, Ratcliffe M. Large-scale, prospective, observational studies in patients with psoriasis and psoriatic arthritis: A systematic and critical review. BMC Med Res Methodol. 2011;11(1):32. doi:10.1186/1471-2288-11-32.}

^{[22] American Academy of Dermatology. Psoriasis. 2015. https://www.aad.org/media-resources/stats-and-facts/conditions/psoriasis. Accessed May 26, 2016.}

^{[23] Lui H. Plaque Psoriasis. Medscape. 2015. http://emedicine.medscape.com/article/1108072-overview. Accessed May 26, 2016.}

^{[24] Gladman DD. Psoriatic arthritis. Dermatol Ther. 22(1):40-55.}

^{[25] Angelillo MP. Psoriatic Arthritis. In: All About Arthritis. Vol iUniverse; 2009:40-45. https://books.google.com/books?id=_Gch5mIlSsYC&pgis=1. Accessed May 25, 2016.}

^{[26] National Psoriasis Foundation. Tests to confirm diagnosis of psoriatic arthritis. 2015. https://www.psoriasis.org/psoriatic-arthritis/diagnosis/tests-to-confirm. Accessed May 15, 2016.}

^{[27] National Psoriasis Foundation. About Psoriatic Arthritis. 2015. https://www.psoriasis.org/about-psoriatic-arthritis. Accessed May 25, 2016.}

^{[28] Genetics Home Reference. U.S. National Library of Medicine. Psoriatic arthritis. August 2015. http://ghr.nlm.nih.gov/condition/psoriatic-arthritis. Accessed May 25, 2016.}

^{[29] Jemec GBE. Hidradenitis Suppurativa. N Engl J Med. 2012:366:158-164.}

^{[30] Dufour DN, Emtestam L, Jemec GB. Hidradenitis Suppurativa: A Common and Burdensome, Yet Under-Recognised, Inflammatory Skin Disease. Postgrad Med J. 2014; 90 (1062):216-21.}

^{[31] Esmann S, Jemec GB. Psychosocial impact of hidradenitis suppurativa: a qualitative study. Acta dermato-venereologica. 2011;91(3):328-332.}

^{[32] L.J. Margesson, F.W. Danby. Hidradenitis suppurativa. Best Pract Res Clin Obstet Gynaecol. 2014; 28: 1013-1027.}

^{[33] Dhaou BB, Boussema F, Aydi Z, Baili L, Rokbani L. Hidradenitis suppurativa (Verneuil’s disease). J Saudi Soc Dermatology & Dermatol Surg. 2013;17:1-5.}

^{[34] American Academy of Dermatology. Hidradenitis suppurativa. Available at: https://www.aad.org/public/diseases/painful-skin-joints/hidradenitis-suppurativa. Accessed May 25, 2016.}

^{[35] Collier F, Smith RC, Morton, CA. Diagnosis and management of hidradenitis suppurativa. BMJ. 2013;346.}

^{[36] U.S. National Library of Medicine. National Institutes of Health. Crohn’s Disease. 2015. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022801/. Accessed May 25, 2016.}

^{[37] Kappelman MD, Moore KR, Allen JK, Cook SF. Recent trends in the prevalence of Crohn’s disease and ulcerative colitis in a commercially insured US population. DigDis Sci. 2013;58:519-525.}

^{[38] Crohn’s & Colitis Foundation of America. What is Crohn’s Disease? 2015. http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/. Accessed May 25, 2016.}

^{[39] Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142(1):46-54.e42; quiz e30.}

^{[40] Crohn’s & Colitis Foundation of America. The Facts About Inflammatory Bowel Diseases. 2014. http://www.ccfa.org/assets/pdfs/updatedibdfactbook.pdf. Accessed May 25, 2016.}

^{[41] U.S. National Library of Medicine. National Institutes of Health. Ulcerative Colitis. 2015. http://www.nlm.nih.gov/medlineplus/ulcerativecolitis.html. Accessed May 26, 2016.}

^{[42] Crohn’s and Colitis Foundation of America. What is Ulcerative Colitis? 2015. http://www.ccfa.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/. Accessed May 26, 2016.}

^{[43] Mayo Clinic. Ulcerative colitis. 2015. http://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/basics/definition/con-20043763. Accessed May 26, 2016.}

^{[44] Crohn’s & Colitis Foundation of America. Living with Ulcerative Colitis. http://www.ccfa.org/assets/pdfs/living_with_uc_brochure_final.pdf. Accessed May 26, 2016.}

^{[45] Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. 2012;37:240-249.}

^{[46] Mehrian R, et al. Synergistic effect between IL-10 and bcl-2 genotypes in determining susceptibility to systemic lupus erythematosus. Arthritis Rheum. 1998 Apr;41(4):596-602}

^{[47] D’Cruz DP. Systemic lupus erythematosus. BMJ. 2006;332(7546):890-894.}