Immunology
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We are a disruptor in Immunology
Our goal is to reshape the future of immunology by harnessing innovative science and new technologies. We are developing medicines with the potential to move beyond symptom control to disease modification, remission and, one day, cure.
We intend to show the world what science can do, as we strive to transform outcomes for those living with immune-mediated diseases.
What are immune-mediated diseases?
Immune-mediated diseases encompass a broad spectrum of conditions that develop when the normal function of immune cells, which are responsible for protecting the body from bacteria and other threats, malfunction.
This loss of immune regulation – or homeostasis – leads to the immune system mistakenly ‘protecting’ itself, normally by attacking the body’s own healthy tissues, leading to chronic inflammation.1
This chronic inflammation can occur throughout the body, affecting different organs, and is responsible for the symptoms of immune-mediated diseases (some of which are otherwise known as “autoimmune” or “autoinflammatory” diseases), including systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), type 1 diabetes (T1D), rheumatoid arthritis (RA), multiple sclerosis (MS) and many others.1,2
The burden of immune-mediated diseases
1 in 10 people live with an immune-mediated disease, and evidence suggests these conditions are becoming increasingly common.3
This rising prevalence has far-reaching consequences, not only for the >40 million people who experience the debilitating symptoms, but also their families, healthcare systems, and society as a whole.4
If not controlled, chronic immune dysregulation can result in tissue injury, inflammation and long-term organ damage.1 As a result, patients can suffer from chronic pain, fatigue, and disabilities that can be life-limiting and are detrimental to their quality of life.2,5 For those with chronic immune-mediated diseases, such as a person with lupus struggling to manage a myriad of symptoms during a flare-up, anything that provides relief can feel life-changing.
Though we understand the severe implications of chronic immune diseases, they remain challenging to diagnose and treat effectively.
For years, many patients with immune-mediated diseases were treated with high doses of traditional immunosuppressants, such as oral corticosteroids (OCS). While OCS can improve symptoms, their long-term use can be associated with serious side effects and poor quality of life.6,7,8
Newer therapies, such as biologics and small molecules, have enabled many patients to achieve remission or maintain low disease activity, but for some this remains a challenge with treatment responses varying from person to person and certain patients not responding at all.6,9,10Despite the introduction of more advanced therapies, the use of OCS also remains concerningly high. There is therefore a significant need for new treatments that robustly address underlying immune dysfunction for the long term to reduce the impact of these diseases.
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Our ambition: making remission, and one day cure, a reality
Remission is a treatment goal in guidelines for several immune-mediated diseases.22,23,24 However, through a combination of suboptimal adherence to guidelines and the critical need for new treatment options, only a minority of patients actually achieve it.
We are accelerating our innovation to identify and target the biological drivers that lower disease activity, and pioneering new mechanisms and advanced modalities that address the underlying immune response. By doing this, we aim to disrupt immunology, redefine treatment paradigms in areas of high unmet need, and make remission, and eventually cure, a reality.
Our immunology focus areas include:
- Leading in lupus and related diseases by targeting underlying disease drivers.
- Exceeding current efficacy expectations in established diseases such as IBD and RA and making remission a reality for more patients.
- Accelerating next-generation technologies such as T-cell engagers and cell therapies, with the goal to rebalance and even “reset” immune cell function, aiming to address the cause of disease and not the effect as we aim to move towards cure.
We want to disrupt immunology by achieving increased rates of remission in under-served diseases like lupus, IBD, and RA. We are bringing in a new generation of therapeutics, that aim to regulate or reset the immune system, treat patients earlier, modify the course of disease, and one day offer a cure.
Unlocking the science of immune-mediated diseases
Key inflammatory mediators and pathways
The underlying drivers of immune-mediated diseases are diverse and complex. Inflammatory cytokines, chemokines and immune cell survival mediators, such as type 1 interferons (IFN-1), C-C chemokine receptor 9 (CCR9), IL-23, IL-6 and tumour necrosis factor alpha (TNF-α) are involved in the disease activity of a wide range of conditions.25,26,27
B-cell biology represents another critical therapeutic frontier: B-cell activating factor (BAFF) and other signalling proteins support autoreactive B-cells, which produce antibodies that drive multiple immune-mediated diseases.25 Proteins found on the surface of B-cells, such as CD19, CD20 and BCMA, therefore represent targeting opportunities for therapeutic intervention.
At the cellular level, dysregulation in cells that usually suppress immune system overactivity, such as regulatory T-cells (Tregs), can drive progression in some immune-mediated diseases.25
Therapeutic approaches
By deeply understanding the drivers of the inflammatory cascade, we can begin to further unlock the complex nature of these challenging diseases and design therapies that could potentially regulate or even reset the immune system.
Scientists at AstraZeneca are building on existing disease knowledge and emerging biology to build a toolbox of next-generation therapies for patients across the natural history of immune-mediated diseases.
Our pipeline includes novel biologics and small molecules that target key underlying drivers in moderate to severe disease, right through to cutting-edge advanced modalities, such as T-cell engagers and cell therapies, that aim to reset the immune system in refractory disease.
The biological mechanisms behind immune-mediated diseases. Dysregulation in the innate immune system and adaptive immune responses result in chronic autoimmune conditions and disease progression.
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References
1. Yasmeen F, et al. Understanding Autoimmunity: Mechanisms, Predisposing Factors, and Cytokine Therapies. Int J Mol Sci. 2024;25(14):7666.
2. Monteleone G, et al. Immune-mediated inflammatory diseases: Common and different pathogenic and clinical features. Autoimmun Rev. 2023;22(10)L:103410.
3. Conrad N, et al. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet. 2023;401:1878-1890.
4. AstraZeneca. Data on File 2025. Chronic Respiratory and Immune Mediated disease figure and burden. REF-249709.
5. Lupus Foundation of America. Lupus Facts and Statistics. Available at: https://www.lupus.org/resources/lupus-facts-and-statistics. Accessed September 2025.
6. Kostopoulou M, et al. Management of systemic lupus erythematosus: a systematic literature review informing the 2023 update of the EULAR recommendations. Ann Rheum Dis. 2024;0:1-13.
7. Bruce N, et al. Factors associated with damage accrual in patients with systemic lupus erythematosus: results from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort. Ann Rheum Dis. 2014;74(9):1706-1713.
8. Chung LP, et al. Rational oral corticosteroid use in adult severe asthma: A narrative review. Respirology. 2019;25(2):161-172.
9. Barberio B, et al. Maintenance of clinical remission with biologics and small molecules in inflammatory bowel disease according to trial design: Meta-analysis. Dig Liver Dis. 2024;56(1):7-14.
10. Kayal M, et al. Net Remission Rates with Biologic Treatment in Crohn’s Disease: A Reappraisal of the Clinical Trial Data. Clin Gastroenterol Hepatol. 2023;21(5):1348-1350.
11. Lee YH, Choi SJ and Song GG. Overall and cause-specific mortality in systemic lupus erythematosus: an updated meta-analysis. Lupus. 2016;25:727–734.
12. Zen M, et al. Mortality and causes of death in systemic lupus erythematosus over the last decade: Data from a large population-based study. Eur J Int Med. 2023:45-51.
13. Frances Rees, et al. Mortality in systemic lupus erythematosus in the United Kingdom 1999–2012, Rheumatology, 2016;55:854-860
14. Chunhuan Lao, et al, Mortality and causes of death in systemic lupus erythematosus in New Zealand: a population-based study, Rheumatology, 2023;, kead427.
15. Lundberg IE, et al. Diagnosis and classification of Idiopathic Inflammatory Myopathies. J Intern Med. 2016;280(1):39-51.
16. Adigun R, et al. Systemic Sclerosis (Scleroderma) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430875/. Accessed September 2025.
17. Arthritis Foundation. What is arthritis? Available at: https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis. Accessed September 2025.
18. Arthritis Foundation. Inflammatory Bowel Disease. Available at: https://www.arthritis.org/diseases/inflammatory-bowel-disease. Accessed September 2025.
19. Johns Hopkins Medicine. Inflammatory Bowel Disease (IBD). Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/inflammatory-bowel-disease
20. American Partnership for Eosinophilic Disorders. EOE. Available at: https://apfed.org/about-ead/egids/eoe/. Accessed September 2025.
21. American Partnership for Eosinophilic Disorders. Eosinophilic Granulomatosis with Polyangiitis. Available at: https://apfed.org/about-ead/eosinophilic-granulomatosis-with-polyangiitis/. Accessed September 2025.
22. Fanouriakis A, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2024;83(1):15-29.
23. Gordon H, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis. 2024;18:1531-1555.
24. Raine T, et al. ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment. J Crohns Colitis. 2022;16(1):2-17.
25. Ameer MA, et al. An Overview of Systemic Lupus Erythematosus (SLE) Pathogenesis, Classification, and Management. Cureus. 2022;14(10):e30330.
26. Sewell GW, et al. Interleukin-23 in the Pathogenesis of Inflammatory Bowel Disease and Implications for Therapeutic Intervention. 2022;16(2):ii3-ii19.
27. Wendt E, et al. CCR9 antagonism: potential in the treatment of Inflammatory Bowel Disease. Clin Exp Gastroenterol. 2015;8:119-30.
Veeva ID: Z4-77715
Date of preparation: October 2025