It has been known for long that rheumatoid arthritis patients respond differently to the same treatment instituted. The mechanism however remained unclear. A new study now explains that it is due to diversity in immune mechanisms. The results have been identified following experiments conducted on animal models of mouse that mimics the disease condition.
The identification of such complex behaviors could enable physicians make an individualized diagnosis of RA patients, eventually paving way for effective therapies against specific forms of the disease. There has been a considerable improvement in the identification of new therapies and a universal acceptance of the same over the past 20 years.
Rheumatoid arthritis (RA) is a chronic and crippling inflammatory joint, bone and cartilage disease affecting more than 2.1 million Americans. It is an autoimmune disorder that is characterized by inflammation of the lining of the joints, called the synovium.
Researchers have identified three distinct types of the disease. In diffuse RA, T and B-lymphocytes seem to infiltrate tissue randomly, re-sulting in autoimmune inflammation. In aggregate synovitis, T and B cells meet each other in aggregates and inflame the joints. In germinal center synovitis, T cells, B cells, and other supporting cell populations go into the joints and acquire a highly complex and organized micro-architecture that resembles conditions in an inflamed lymph node.
Two proteins, known as APRIL (A proliferation inducing ligand) and BlyS (B-lymphocyte stimulator) that are hypothesized to help B-lymphocytes survive and differentiate are the targets of new experimental drugs currently in early phase clinical trials.
The researchers implanted human tissue from RA patients who had the three different types of disease into the mice and treated it with the proteins. It was found that in mice with germinal center synovitis, there was a halt of the inflammatory process while in the other two groups there was an aggravation of the condition.
In conclusion, the two proteins have been found to have multiple and complex effects in rheumatoid arthritis. The goal of current RA treatment is to suppress the immune system. The present research study has pointed out to the necessity of identification of natural anti-inflammatory pathways that can be exploited.