Abstract
Within the past years, more and more attention has been devoted to the epigenetic dysregulation that provides an additional window for understanding the possible mechanisms involved in the pathogenesis of autoimmune rheumatic diseases. Rheumatoid arthritis (RA) is a heterogeneous disease where a specific immunologic and genetic/epigenetic background is responsible for disease manifestations and course. In this field, microRNAs (miRNA; miR) are being identified as key regulators of immune cell development and function. The identification of disease-associated miRNAs will introduce us to the post-genomic era, providing the real probability of manipulating the genetic impact of autoimmune diseases. Thereby, different miRNAs may be good candidates for biomarkers in disease diagnosis, prognosis, treatment and other clinical applications. Here, we outline not only the role of miRNAs in immune and inflammatory responses in RA, but also present miRNAs as diagnostic/prognostic biomarkers. Research into miRNAs is still in its infancy; however, investigation into these novel biomarkers could progress the use of personalized medicine in RA treatment. Finally, we discussed the possibility of miRNA-based therapy in RA patients, which holds promise, given major advances in the therapy of patients with inflammatory arthritis.
Highlights
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease that affects 1% of the population worldwide [1]
A new strategy of treatment for RA should consist of the co-stimulation of T cell blockers using abatacept, which is an anti-CD80/86 inhibitor, B cell depletion drugs, such as rituximab, which is a chimeric anti-CD20 mAb, and Janus kinase (JAK), using tofacitinib or baricitinib, which belong to the targeted synthetic DMARDS [22,23,24,25,26]
The effects of miRNAs on synovial hyperplasia are presented in Table 6. miR-126 overexpression in rheumatoid arthritis synovial fibroblast (RASF) leads to an increased rate of proliferation and, on the other hand, lower apoptosis
Summary
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease that affects 1% of the population worldwide [1]. Within the epigenetic factors participating in RA, micro-RNAs (miRNAs), playing an important role in many biological processes, are considered to be potential therapeutic targets for many autoimmune/inflammatory diseases, including RA [6,7]. Traditional treatments for RA involve suppressing the excessive immune and inflammatory responses, which may only help to relieve the symptoms of RA and delay the progression of the disease, not cure it These strategies lead to several systemic side effects. A new strategy of treatment for RA should consist of the co-stimulation of T cell blockers using abatacept, which is an anti-CD80/86 inhibitor, B cell depletion drugs, such as rituximab, which is a chimeric anti-CD20 mAb, and JAK, using tofacitinib or baricitinib, which belong to the targeted synthetic DMARDS (tsDMARDs) [22,23,24,25,26]. Researchers hope that miRNA will facilitate faster disease detection and better and more precise therapy
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