新型靶向疗法和提高药物稳定性和传递的工具的出现显著改善了自身免疫性疾病（ADs）的治疗效果。最近开发的策略消耗特定的有害T和B细胞子集，中断受体-配体相互作用并/或抑制与组织损伤有关的炎症介质的分泌或活性。尽管通常有效，但这些干预措施有局限性，已有记录的药物耐药和不良副作用。它们也难以应用于非器官特异性ADs，这些情况下触发和效应抗原不知名，自身免疫活动广泛分布于全身。在ADs的情境下，通过遥远的细胞调节剂的可能性，通过脱离效应局部达到治疗效果，如在癌症放射治疗和免疫治疗中所描述的一样，可能特别有效。未来研究需要探索具有脱离效应的潜在药物的小分子和肽基治疗，以恢复受影响患者的生活质量并引出强效的免疫耐受和临床平静。 版权所有，2023年出版Elsevier B.V.

The emergence of novel targeted therapies and the tools that increase the stability and delivery of drugs have greatly improved treatment outcomes in autoimmune diseases (ADs). Recently-developed strategies deplete specific deleterious T- and B-cell subsets, interrupt receptor-ligand interactions, and/or inhibit the secretion or activity of inflammatory mediators linked to tissue damage. Although generally efficient, these lines of intervention have limitations, with documented cases of drug-resistance and undesired side effects. They are also difficult to apply to non-organ-specific ADs, where the trigger and effector antigens are unknown and in which autoimmune activity is widely spread throughout the body. The potential of cellular modulators that act at a distance from the affected site, by abscopal effect, as described in the case of cancer radio- and immuno-therapy might be especially efficient in the context of ADs. Future research to discover small molecule- and peptide-based treatments will need to explore potential drugs with abscopal effects that could elicit potent immune tolerance and clinical quiescence to restore quality of life of affected patients.Copyright © 2023. Published by Elsevier B.V.