title: [Emergent therapies for rheumatoid arthritis].
abstract: The use of biological agents such as etanercept, infliximab, adalimumab and anakinra has been recently approved for the treatment of rheumatoid arthritis. All are effective controlling signs and symptoms and inhibiting disease progression. To overcome the problems generated by their high costs and possible participation in reactivating latent infections, other therapeutic tools are being developed. Gene therapy using expression vectors carrying genes coding for specific proteins, may interfere in key points involved in the pathogenesis of the disease. Intra-articular administration of cDNA coding for soluble TNF receptors, IL-1, or IL-1Ra decreases signs of the disease in animal models. Vectors, expressing inhibitors of signal transduction pathways involving to NF-kB and JAK-STAT-3, are effective in modulating joint inflammation in mice. The use of antigen-pulsed antigen presenting cells or dendritic cells (DC) bound to apoptosis-inducing molecules, specifically eliminates autoreactive T cells. Other novel approach attempts the development of T regulatory-inducing tolerogenic DC-based vaccines that inhibit autoreactive T cells, through the secretion of suppressing cytokines or by other mechanisms to be elucidated. Oral tolerance induction to auto-antigens is also a successful experimental strategy under study. Current research aims to control peripheral tolerance in rheumatoid arthritis patients.
authors.affiliation: Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile. jaguillo@med.uchile.cl
authors.forename: Juan C
authors.initials: JC
authors.lastname: Aguillón
authors.forename: Andrea
authors.initials: A
authors.lastname: Cruzat
authors.forename: Juan
authors.initials: J
authors.lastname: Contreras-Levicoy
authors.forename: Andrés
authors.initials: A
authors.lastname: Dotte
authors.forename: Bárbara
authors.initials: B
authors.lastname: Pesce
authors.forename: Octavio
authors.initials: O
authors.lastname: Aravena
authors.forename: Lorena
authors.initials: L
authors.lastname: Salazar
authors.forename: Diego
authors.initials: D
authors.lastname: Catalán
authors.forename: Paula
authors.initials: P
authors.lastname: Abello
authors.forename: Adam
authors.initials: A
authors.lastname: Aguirre
authors.forename: Carolina
authors.initials: C
authors.lastname: Llanos
authors.forename: Miguel
authors.initials: M
authors.lastname: Cuchacovich
mesh_terms: D000818:Animals; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology; D004359:Drug Therapy, Combination; D015316:Genetic Therapy; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*
chemical_list: D018501:Antirheumatic Agents; D007155:Immunologic Factors