New areas for therapeutic intervention in the treatment of rheumatic disease.
Anti-rheumatic therapy has been targeted against the symptoms arising from chronic inflammation of the joint. This has resulted in the extensive use of non-steroidal anti-inflammatory drugs. It is now becoming apparent that these agents have no beneficial effect on disease progression. This mini review concentrates on the formation and maintenance of pannus, the granulomatous tissue responsible for cartilage and bone erosion. This reveals a number of possible therapeutic targets. Protease inhibitors could be used to interfere with the degradatory processes. The diverse functions of endothelial cells suggest oedema formation, cell accumulation and supply of nutrients to the granulomatous tissue could all be targeted by appropriate therapy. Alternatively the immune processes that control pannus formation and state of activation could be regulated by interfering with antigen presentation and the cytokine network.
Willoughby
D
D
William Harvey Research Institute, Department of Experimental Pathology, Saint Bartholomews Hospital Medical College, London, United Kingdom.
Seed
M
M
Moore
A
A
Colville-Nash
P
P
Chander
C
C
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D002908:Chronic Disease; D016207:Cytokines / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology; D011480:Protease Inhibitors / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000209:etiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016207:Cytokines; D011480:Protease Inhibitors; D001241:Aspirin