scholarly journals Developing new therapeutic approaches for rheumatoid arthritis: the continuing challenges of clinical assessments

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2019 ◽  
Author(s):  
David L. Scott
Keyword(s):  
Rheumatoid Arthritis ◽  
Intensive Therapy ◽  
Treatment Intensity ◽  
Optimal Management ◽  
Therapeutic Approaches ◽  
Optimal Care ◽  
Clinical Assessments ◽  
New Therapeutic Approaches ◽  
Different Types ◽  
Key Driver

The management of rheumatoid arthritis has changed dramatically over the last three decades. Improvements in clinical assessment have been a key driver of these changes. However, in the last five years, three areas of unresolved uncertainty have dominated specialist thinking in the field. These challenges comprise identifying the optimal management target, determining how best to reach this target by using intensive treatments, and individualising management because not all patients need or respond to identical treatments. The key problem that links each of these areas is balancing different types of evidence and is most readily appreciated in relation to treatment intensity. Giving more intensive therapy improves outcomes but also increases risks and, with biologic treatments, substantially increases drug costs. Specialists and healthcare funders need to agree on how best to rationalise optimal care for patients with what is most effective and safe and what is affordable.

scholarly journals Pathogenesis of Ischemic Stroke: Role of Epigenetic Mechanisms

Genes ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 89 ◽  
Author(s):  
Rosita Stanzione ◽  
Maria Cotugno ◽  
Franca Bianchi ◽  
Simona Marchitti ◽  
Maurizio Forte ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Epigenetic Modifications ◽  
Review Article ◽  
Epigenetic Changes ◽  
Therapeutic Approaches ◽  
Nutritional Factors ◽  
New Therapeutic Approaches ◽  
Different Types ◽  
The Impact

Epigenetics is the branch of molecular biology that studies modifications able to change gene expression without altering the DNA sequence. Epigenetic modulations include DNA methylation, histone modifications, and noncoding RNAs. These gene modifications are heritable and modifiable and can be triggered by lifestyle and nutritional factors. In recent years, epigenetic changes have been associated with the pathogenesis of several diseases such as diabetes, obesity, renal pathology, and different types of cancer. They have also been related with the pathogenesis of cardiovascular diseases including ischemic stroke. Importantly, since epigenetic modifications are reversible processes they could assist with the development of new therapeutic approaches for the treatment of human diseases. In the present review article, we aim to collect the most recent evidence concerning the impact of epigenetic modifications on the pathogenesis of ischemic stroke in both animal models and humans.

scholarly journals New Therapeutic Approaches for the Treatment of Rheumatoid Arthritis may Rise from the Cholinergic Anti-Inflammatory Pathway and Antinociceptive Pathway

2010 ◽  
Vol 10 ◽  
pp. 2248-2253 ◽  
Author(s):  
Xiao Hua Pan ◽  
Jianxin Zhang ◽  
Xiaowei Yu ◽  
Ling Qin ◽  
Ligeng Kang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Therapeutic Approaches ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Drug Discovery And Development ◽  
New Therapeutic Approaches ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
Anti Inflammatory ◽  
Current Stage

Due to the complex etiology of rheumatoid arthritis (RA), it is difficult to be completely cured at the current stage although many approaches have been applied in clinics, especially the wide application of nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). New drug discovery and development via the recently discovered cholinergic anti-inflammatory and antinociceptive pathways should be promising. Based on the above, the nicotinic acetylcholine receptor agonists maintain the potential for the treatment of RA. Therefore, new therapeutic approaches may rise from these two newly discovered pathways. More preclinical experiments and clinical trials are required to confirm our viewpoint.

scholarly journals Photopheresis efficacy in the treatment of rheumatoid arthritis: a pre-clinical proof of concept

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Céline Coppard ◽  
Francis Bonnefoy ◽  
Dalil Hannani ◽  
Françoise Gabert ◽  
Olivier Manches ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Immune Cell ◽  
Unmet Need ◽  
Proof Of Concept ◽  
Therapeutic Approaches ◽  
Spleen Cells ◽  
New Therapeutic Approaches ◽  
Bovine Collagen ◽  
Treated Sample ◽  
Immune Cell Subsets

Abstract Background Despite major advances in rheumatoid arthritis outcome, not all patients achieve remission, and there is still an unmet need for new therapeutic approaches. This study aimed at evaluating in a pre-clinical murine model the efficacy of extracorporeal photopheresis (ECP) in the treatment of rheumatoid arthritis, and to provide a relevant study model for dissecting ECP mechanism of action in autoimmune diseases. Methods DBA/1 mice were immunized by subcutaneous injection of bovine collagen type II, in order to initiate the development of collagen-induced arthritis (CIA). Arthritic mice received 3 ECP treatments every other day, with psoralen + UVA-treated (PUVA) spleen cells obtained from arthritic mice. Arthritis score was measured, and immune cell subsets were monitored. Results ECP-treated mice recovered from arthritis as evidenced by a decreasing arthritic score over time. Significant decrease in the frequency of Th17 cells in the spleen of treated mice was observed. Interestingly, while PUVA-treated spleen cells from healthy mouse had no effect, PUVA-treated arthritic mouse derived-spleen cells were able to induce control of arthritis development. Conclusions Our results demonstrate that ECP can control arthritis in CIA-mice, and clarifies ECP mechanisms of action, showing ECP efficacy and Th17 decrease only when arthritogenic T cells are contained within the treated sample. These data represent a pre-clinical proof of concept supporting the use of ECP in the treatment of RA in Human.

scholarly journals Genetic View To Stroke Occurrence

2017 ◽  
pp. 75
Author(s):  
Sadegh Yoosefee ◽  
Seyyed Amir Hejazi ◽  
Ehsan Sharifipour ◽  
Tayyebeh Sabokbar
Keyword(s):  
Genetic Diversity ◽  
Personalized Medicine ◽  
The Other ◽  
Therapeutic Approaches ◽  
Genetic Studies ◽  
The Third ◽  
New Therapeutic Approaches ◽  
Different Types ◽  
Risk Of Disease

Stroke is the third leading cause of death. The role of genetics in the etiology and development of this disease is undeniable. As a result of inadequate previous research, more and more studies in the field of genetics are necessary to identify pathways involved in the pathogenesis of stroke, which in turn, may lead to new therapeutic approaches. However, due to the multifactorial nature of stroke and the few studies conducted in this field, genetic diversity is able to predict only a small fraction of the risk of disease. On the other hand, studies have shown genetically different architecture for different types of stroke, and finally pharmacogenomics as an important part of personalized medicine approach, is influenced by genetic studies, all of which confirm the need of addressing the topic by researchers.         

TFmiR2: constructing and analyzing disease-, tissue- and process-specific transcription factor and microRNA co-regulatory networks

2019 ◽  
Vol 36 (7) ◽  
pp. 2300-2302
Author(s):  
Maryam Nazarieh ◽  
Mohamed Hamed ◽  
Christian Spaniol ◽  
Thorsten Will ◽  
Volkhard Helms
Keyword(s):  
Transcription Factor ◽  
Regulatory Networks ◽  
Dominating Set ◽  
Web Server ◽  
Theoretical Concept ◽  
Supplementary Information ◽  
Therapeutic Approaches ◽  
Driver Genes ◽  
New Therapeutic Approaches ◽  
Key Driver

Abstract Summary TFmiR2 is a freely available web server for constructing and analyzing integrated transcription factor (TF) and microRNA (miRNA) co-regulatory networks for human and mouse. TFmiR2 generates tissue- and biological process-specific networks for the set of deregulated genes and miRNAs provided by the user. Furthermore, the service can now identify key driver genes and miRNAs in the constructed networks by utilizing the graph theoretical concept of a minimum connected dominating set. These putative key players as well as the newly implemented four-node TF-miRNA motifs yield novel insights that may assist in developing new therapeutic approaches. Availability and implementation The TFmiR2 web server is available at http://service.bioinformatik.uni-saarland.de/tfmir2. Supplementary information Supplementary data are available at Bioinformatics online.

scholarly journals Immunopathogenic Mechanisms and Novel Immune-Modulated Therapies in Rheumatoid Arthritis

2019 ◽  
Vol 20 (6) ◽  
pp. 1332 ◽  
Author(s):  
Shyi-Jou Chen ◽  
Gu-Jiun Lin ◽  
Jing-Wun Chen ◽  
Kai-Chen Wang ◽  
Chiung-Hsi Tien ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Unknown Etiology ◽  
Therapeutic Approaches ◽  
New Therapeutic Approaches ◽  
Disease Outcomes ◽  
Immune Mediated ◽  
Clinical Impairment ◽  
Inflammatory Autoimmune Disease ◽  
Near Future ◽  
Better Than

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disease of unknown etiology. It is characterized by the presence of rheumatoid factor and anticitrullinated peptide antibodies. The orchestra of the inflammatory process among various immune cells, cytokines, chemokines, proteases, matrix metalloproteinases (MMPs), and reactive oxidative stress play critical immunopathologic roles in the inflammatory cascade of the joint environment, leading to clinical impairment and RA. With the growing understanding of the immunopathogenic mechanisms, increasingly novel marked and potential biologic agents have merged for the treatment of RA in recent years. In this review, we focus on the current understanding of pathogenic mechanisms, highlight novel biologic disease-modifying antirheumatic drugs (DMRADs), targeted synthetic DMRADs, and immune-modulating agents, and identify the applicable immune-mediated therapeutic strategies of the near future. In conclusion, new therapeutic approaches are emerging through a better understanding of the immunopathophysiology of RA, which is improving disease outcomes better than ever.

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