Foreword

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A little over a year ago, the March 2006 issue of CPPAH focused on pediatric rheumatology – Jim Jarvis said then about children with rheumatoid diseases that “The future’s so bright, I gotta wear shades!” Much of that bright future can be attributed to a new class of medicines: monoclonal antibodies. In this month’s issue, we delve more deeply into the topic of monoclonal antibodies with an article put together by Richard Stiehm and colleagues. This month’s issue will stretch some of us who prefer the big picture – this is very basic science. Personally, I do well with pictures: check out the cartoon animation at http://www.maxanim.com/immunology/Monoclonal%20Antibodies/Monoclonal%20Antibodies.htm for a simplistic but helpful visual aid. But what exciting basic science it is! Barely a quarter-century ago, this was just an idea – its realization won the Nobel Prize in 1984, and now, there are children whose lives are changed by these new therapeutic agents. Like all miracle drugs, these also have their dark sides – both expected and unexpected side effects. The latter reminds us once again that our understanding of the human organism remains woefully deficient. And commercially available monoclonal antibodies are not cheap, a challenge to both individuals and health care systems struggling to make ends meet. With sections on how they are named (what a clever scheme!), how they are made, and how they are used not only in juvenile idiopathic arthritis but also in other autoimmune diseases, and known adverse effects, readers will be well-informed about these exciting agents. Now, if only there were a monoclonal antibody against poverty… “endopovumab”?