scholarly journals Role of Biological Response Modifiers in the Treatment of Rheumatoid Arthritis - A Review

1970 ◽  
Vol 18 (1) ◽  
pp. 60-65
Author(s):  
Md Azizul Haque ◽  
ARM Saifuddin Ekram ◽  
Quazi Tarikul Islam
Keyword(s):  
Rheumatoid Arthritis ◽  
Monoclonal Antibody ◽  
Chronic Disease ◽  
Receptor Antagonist ◽  
Disease Progression ◽  
Joint Damage ◽  
Biological Response ◽  
The Past ◽  
Conventional Dmards

Rheumatoid arthritis is a chronic disease with the potential to cause substantial joint damage and disability. During the past 10 years, improved understanding of the pathophysiology of rheumatoid arthritis has led to several key changes in the approach to therapy. Most important of that is the development of some biological agents interfering with the activity of several important cytokines. Infliximab, etanarcept, and adalimumab are TNF blockers, anakinra is IL-1 receptor antagonist, and rituximab is anti CD-20 monoclonal antibody. These newer agents proved to be useful for alleviating symptoms and slowing the disease progression in the patients with RA who have failed to respond to conventional DMARDs.   doi: 10.3329/taj.v18i1.3309 TAJ 2005; 18(1): 60-65

scholarly journals Role of Biological Response Modifiers in the Treatment of Rheumatoid Arthritis-A Review

1970 ◽  
Vol 17 (1) ◽  
pp. 71-76
Author(s):  
M Azizul Haque ◽  
ARM Saifuddin Ekram ◽  
Quazi Tarikul Islam
Keyword(s):  
Rheumatoid Arthritis ◽  
Monoclonal Antibody ◽  
Chronic Disease ◽  
Receptor Antagonist ◽  
Disease Progression ◽  
Joint Damage ◽  
Biological Response ◽  
The Past ◽  
Conventional Dmards

Rheumatoid arthritis is a chronic disease with the potential to cause substantial joint damage and disability. During the past 10 years, improved understanding of the pathophysiology of rheumatoid arthritis has led to several key changes in the approach to therapy. Most important of that is the development of some biological agents interfering with the activity of several important cytokines. Infliximab, etanarcept, and adalimumab are TNF blockers, anakinra is IL-1 receptor antagonist, and rituximab is anti CD-20 monoclonal antibody. These newer agents proved to be useful for alleviating symptoms and slowing the disease progression in the patients with RA who have failed to respond to conventional DMARDs.   doi: 10.3329/taj.v17i1.3494 TAJ 2004; 17(1) : 71-76

scholarly journals AB0308 NO SIGNS OF CONGESTIVE HEART DISEASE PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS ON IL-6 RECEPTOR ANTAGONIST AFTER 12 MONTHS TREATMENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1452.3-1453
Author(s):  
A. Martynova ◽  
T. Popkova ◽  
H. Gerasimova
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Disease ◽  
Receptor Antagonist ◽  
Disease Progression ◽  
European Heart Journal ◽  
Heart Function ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Ultrasound Evaluation ◽  
Congestive Heart Disease

Background:N-terminal pro-brain natriuretic peptide (NT-proBNP) is a known marker of heart dysfunction, mainly described in patients with high activity of rheumatoid arthritis (RA). Further knowledge of the influence of the IL-6 receptor antagonist, tocilizumab (TCZ), on NT-proBNP levels and systolic heart function is yet to be obtained.Objectives:Access the effect of 12 months TCZ therapy on NT-proBNP levels, transthoracal ehocardiography results and analyze the association between congestive heart disease progression and RA activity.Methods:37 RA patients (pts) (31F/6M); median age 56,5 [48; 63,5] years; disease duration 48 [6; 348] months; DAS28 score 6,15 [5,44; 6,45]; rheumatoid factor (RF)+100%; anti–citrullinated protein antibody (ACPA) + 79,6% were treated in an open-label study with TCZ (8 mg/kg every 4 weeks). Identification of NT-pro-BNT in blood serum, transthoracal ultrasound evaluation of left ventriculum ejection fraction (LVEF), E/A ratio performed at baseline and 12 months.Results:11 (29,7%) pts had congestive heart disease (CHD) (II functional class of NYHA), 7 (18,9%) pts having signs of mild left ventricular dysfunction (LVD) as dyspnea, shortness of breath, cardiotropic treatment remained the same in the course of the study. After 12 month TCZ treatment as RA activity lowered (DAS28 2.32 [1,75; 3,15], р<0,05), NT-proBNP levels decreased (100,95 [57.9; 117.6] pg/ml to 90,46 [33.62; 106.6] pg/ml), along with elevation of LVEF (60,75 [60; 70]% to 67,68 [62.5; 73.5], p = 0,001). Increase of E/A (0,97 [0.8; 1.17] to 1,04 [0.7; 1.42] correlated with decrease of NT-proBNP level (r = -0,63, p=0,036). Raise of LVEF over 12 months correlated with decrease of RA activity according to SDAI scale (r= -0,670, p<0,05). No significant relationship between NT-proBNP levels, LVEF, E/A and other scales measuring RA activity was found. Clinically all patients had improvement in evaluation of their health and no signs of CHD or RVD progression were found.Conclusion:Use of TCZ in patients with active RA showed none to positive influence on heart condition, specifically, lowering NT-proBNP levels, improving LVEF and reducing clinical signs of LVD.References:[1]Pan Y, Li D, Ma J, Shan L, Wei M. NT-proBNP test with improved accuracy for the diagnosis of chronic heart failure. Medicine (Baltimore). 2017 Dec;96(51):e9181.[2]D Novikova, I Kirillova, E Markelova et al. The first report of significantly improvement of NT-proBNP level in rheumatoid arthritis patients treated with tofacitinib during 12-month follow-up, European Heart Journal, Volume 40, Issue Supplement_1, October 2019, ehz745.0836.[3]Pappas DA, Nyberg F, Kremer JM et al. Clin Rheumatol. 2018 Sep;37(9):2331-2340.Disclosure of Interests:None declared

Role of Cytokines in the Pathogenesis of Anemia of Chronic Disease in Rheumatoid Arthritis

1999 ◽  
Vol 92 (2) ◽  
pp. 153-160 ◽  
Author(s):  
P.V. Voulgari ◽  
G. Kolios ◽  
G.K. Papadopoulos ◽  
A. Katsaraki ◽  
K. Seferiadis ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Disease ◽  
Anemia Of Chronic Disease

scholarly journals Peptides Bearing Multiple Post-Translational Modifications as Antigenic Targets for Severe Rheumatoid Arthritis Patients

2021 ◽  
Vol 22 (24) ◽  
pp. 13290
Author(s):  
Cristina García-Moreno ◽  
María J. Gómara ◽  
Raúl Castellanos-Moreira ◽  
Raimon Sanmartí ◽  
Isabel Haro
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Serum Antibody ◽  
Joint Damage ◽  
Erosive Disease ◽  
Post Translational Modifications ◽  
Diagnosis And Prognosis ◽  
Modified Peptides ◽  
Chimeric Peptides

Rheumatoid arthritis (RA) is characterized by the presence of autoantibodies that are of paramount importance for the diagnosis and prognosis of the disease and have been implicated in its pathogenesis. Proteins resulting from post-translational modifications (PTMs) are capable of triggering autoimmune responses important for the development of RA. In this work, we investigate serum antibody reactivity in patients with an established RA against a panel of chimeric peptides derived from fibrin and filaggrin proteins and bearing from one to three PTMs (citrullination, carbamylation and acetylation) by home-designed ELISA tests (anti-AMPA autoantibodies). The role of anti-AMPAs as biomarkers linked to the presence of a more severe RA phenotype (erosive disease with radiological structural damage) and to the presence of interstitial lung disease (ILD), a severe extra-articular manifestation in RA patients entailing a high mortality, was also analyzed. In general, the association with the clinical phenotype of RA was confirmed with the different autoantibodies, and especially for IgA and IgM isotypes. The prevalence of severe joint damage was only statistically significant for the IgG isotype when working with the peptide bearing three PTMs. Furthermore, the median titers were significantly higher in patients with RA-ILD, a finding not observed for the IgG isotype when working with the single- and double-modified peptides.

Role of joint damage, malalignment and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis and osteoarthritis

2021 ◽  
pp. annrheumdis-2020-218744
Author(s):  
Irina Gessl ◽  
Mihaela Popescu ◽  
Victoria Schimpl ◽  
Gabriela Supp ◽  
Thomas Deimel ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Power Doppler ◽  
Joint Damage ◽  
Joint Space ◽  
Early Arthritis ◽  
Damage Score ◽  
Established Disease ◽  
Active Inflammation

ObjectivesTo determine whether clinical tenderness can be considered a sign of inflammatory joint activity in patients with rheumatoid arthritis (RA), osteoarthritis (OA) or psoriatic arthritis (PsA) and to assess other possible factors associated with tenderness.MethodsPatients diagnosed with RA, PsA and OA underwent clinical and ultrasound examination of wrists and finger joints. Radiographs of the hands were scored for erosions, joint space narrowing (JSN), osteophytes and malalignment. A binary damage score (positive if ≥1 erosion, JSN and/or presence of malalignment) was calculated. Differences in grey scale signs of synovitis and power Doppler (PD) between tender non-swollen (TNS) versus non-tender non-swollen (NTNS) joints were calculated. Disease duration was assessed,<2 years was regarded as early and >5 years as long-standing arthritis.ResultsIn total, 34 patients (9 early and 14 long-standing) from patients with RA, 31 patients (7 early and 15 long-standing) with PsA and 30 with OA were included. We found equal frequencies of PD signal between TNS and NTNS joints in RA (p=0.18), PsA (p=0.59) or OA (p=0.96). However, PD had a significant association with tenderness in early arthritis both in RA (p=0.02) and in PsA (p=0.02). The radiographic damage score showed significant association with tenderness in RA (p<0.01), PsA (p<0.01) and OA (p=0.04).ConclusionTenderness might not always be a sign of active inflammation in RA, PsA and OA. While tenderness in early arthritis may be more related to inflammation, established disease is better explained by joint damage and malalignment.

The Role of Rituximab in the Treatment of Myasthenia Gravis

2010 ◽  
Vol 5 (2) ◽  
pp. 95 ◽  
Author(s):  
Olivier Benveniste ◽  
David Hilton-Jones ◽  
◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Monoclonal Antibody ◽  
B Cells ◽  
Myasthenia Gravis ◽  
B Cell ◽  
Predictive Factors ◽  
Crucial Role ◽  
Efficacy And Safety ◽  
Off Label

Rituximab, a chimaeric monoclonal antibody against CD20, depletes B cells. It was initially approved for the treatment of B-cell lymphomas, but more recently has been approved for use in rheumatoid arthritis. It has been used extensively ‘off-label’ for the treatment of other autoimmune diseases with some evidence of efficacy, but there remain some as yet unanswered concerns about safety. Myasthenia gravis is the paradigm of an antibody-mediated disorder, and B cells are believed to play a crucial role. This article reviews experience of the efficacy and safety of rituximab in myasthenia gravis and considers predictive factors for the success and failure of rituximab in this disease.

scholarly journals The Pivotal Role of TBK1 in Inflammatory Responses Mediated by Macrophages

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Tao Yu ◽  
Young-Su Yi ◽  
Yanyan Yang ◽  
Jueun Oh ◽  
Deok Jeong ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Responses ◽  
Inflammatory Diseases ◽  
Cell Damage ◽  
Critical Role ◽  
Biological Response ◽  
Antiviral Defense ◽  
Functional Roles ◽  
Virus Interaction

Inflammation is a complex biological response of tissues to harmful stimuli such as pathogens, cell damage, or irritants. Inflammation is considered to be a major cause of most chronic diseases, especially in more than 100 types of inflammatory diseases which include Alzheimer's disease, rheumatoid arthritis, asthma, atherosclerosis, Crohn's disease, colitis, dermatitis, hepatitis, and Parkinson's disease. Recently, an increasing number of studies have focused on inflammatory diseases. TBK1 is a serine/threonine-protein kinase which regulates antiviral defense, host-virus interaction, and immunity. It is ubiquitously expressed in mouse stomach, colon, thymus, and liver. Interestingly, high levels of active TBK1 have also been found to be associated with inflammatory diseases, indicating that TBK1 is closely related to inflammatory responses. Even though relatively few studies have addressed the functional roles of TBK1 relating to inflammation, this paper discusses some recent findings that support the critical role of TBK1 in inflammatory diseases and underlie the necessity of trials to develop useful remedies or therapeutics that target TBK1 for the treatment of inflammatory diseases.

scholarly journals Vaccine Prevention of Paediatric Chronic Lung Disease: Targeting Haemophilus

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Parkes ◽  
KA O Grady
Keyword(s):  
Chronic Disease ◽  
High Risk ◽  
Lung Disease ◽  
Disease Progression ◽  
Respiratory Disease ◽  
Pneumococcal Vaccination ◽  
Future Research ◽  
High Risk Population ◽  
Early Results

Abstract Background Chronic Suppurative Lung Disease (CSLD) is an emerging term encompassing a spectrum of chronic childhood respiratory disease. Characterised by early and severe infections and recurrent exacerbations, it is associated with progressive deterioration in lung function and quality of life. CSLD is highly unequally distributed and largely preventable, and is a major contributor to the global burden of chronic paediatric respiratory disease. Relatively few pathogens comprise the main culprit organisms identified in the aetiology of CSLD, over which Non-Typeable Haemophilus influenzae (NTHi) predominates. Methods We review developments that establish the role of NTHi in disease progression, focusing on high-risk population subgroups with an established CSLD burden. We consider current studies examining the role of prenatal NTHi and pneumococcal vaccination in preventing CSLD through reducing infections in high-risk populations, and discuss current directions in future research, including the need for precise identification of the pulmonary microbiome in CSLD. Results Early, repeated NTHi infections are clearly implicated in the aetiology of CLSD. Early results of current studies indicate NTHi vaccination may reduce the frequency of causal infections in high-risk groups. Clinical and immunological data show vaccination also reduces frequency of exacerbations and antibiotic usage in CSLD. Conclusions We provide the first clinical and immunological data for H. influenzae vaccination in children with CSLD. Targeted vaccination strategies may prevent CSLD establishment, slow progression, and potentially reduce morbidity, healthcare presentations and antibiotic consumption. This implicates vaccination as a potential aid in both antimicrobial stewardship and prevention of chronic disease. In the face of threats posed to health systems by antimicrobial resistance and the growing burden of chronic disease, vaccination is again emerging as a uniquely powerful public health tool. Key messages Hi vaccination can reduce infective exacerbations and antibiotic use in children with CSL. Vaccines may have a role in preventing chronic disease progression and reducing antibiotic reliance.

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