Novel immunotherapies for rheumatoid arthritis

摘要

Rheumatoid arthritis (RA) is a chronic inflammatory condition affecting 1% of adults in the developed world. In addition to joint inflammation and damage, the systemic effects of RA include an enhanced risk of cardiovascular disease, similar to that seen in diabetes. A greater understanding of RA pathogenesis has enabled the development of targeted biological therapies that modulate inflammation and the immune system.Joint damage in RA is caused by inflammation of the synovium (synovitis), which becomes hyperplastic and irreversibly destroys the articular cartilage and underlying subchondral bone. Synovitis is ultimately driven by a number of pro-inflammatory cytokines, such as tumour necrosis factor (TNF), interleukin 6 (IL-6) and inter-leukin 1 (IL-1). Environmental factors, such as smoking, can cause immune tolerance to fail in genetically predisposed individuals, which leads to an autoimmune attack on the joint