Abstract
Rheumatoid Arthritis (RA) is an autoimmune and inflammatory disease that affects the synovium (lining that surrounds the joints), causing the immune system to attack its own healthy tissues. Treatment options, to the current day, have serious limitations and merely offer short-term alleviation to the pain. Using a theoretical exercise based on literature, a new potentially viable therapy has been proposed. The new therapy focusses on a long-term treatment of RA based on gene therapy, which is only active when inflammation of the joint occurs. This treatment will prevent side effects of systemic application of drugs. Furthermore, the benefits of this treatment for the patient from a socio-economic perspective has been discussed, focusing on the quality of life of the patent and lower costs for the society.
Highlights
Rheumatoid arthritis (RA) is a long-term inflammatory and autoimmune disease that affects the synovium, causing the immune system to attack its own healthy tissues
The process starts with the release of pro-inflammatory cytokines, especially tumor necrosis factor-α (TNFα) and Interleukin (IL-6 and IL-1), followed by the production of inflammatory cytokines in the joint (TNFα, IL-6, -15, -16, -17, -18, Interferon-γ (IFN-γ))
Given the fact that the overproduction of inflammatory cytokines by fibroblast-like synoviocytes (FLSs) is believed to play a pivotal role in the development and progression of RA [8], we have proposed a therapy that would overall suppress inflammation, by expressing anti-inflammatory cytokines
Summary
Rheumatoid arthritis (RA) is a long-term inflammatory and autoimmune disease that affects the synovium (lining that surrounds the joints), causing the immune system to attack its own healthy tissues. In the plethora of cases, RA symptoms occur in the same joints on both sides of the body; a great number of patients with RA experience symptoms that do not involve the joints, such as weight loss, fatigue, and weakness It is not known why the immune system attacks healthy body tissue in RA, a genetic component appears likely [2] and can increase the susceptibility to environmental factors that may trigger the disease. Biological-based approaches have appeared as the most promising, using mainly monoclonal antibodies, recombinant forms of natural inhibitors, recombinant soluble TNF receptors, or anti-inflammatory cytokines, counteracting the released cytokines produced in the joint [3] These therapies have serious limitations, such as high expenses, side-effects (i.e., nausea, low blood pressure, skin reactions, trouble breathing), and the requirement for repeated systemic injections [6]. Ethical dilemmas that could arise when administering the proposed therapy have been pinpointed
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