[Emergent therapies for rheumatoid arthritis].
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.
Aguillón
Juan C
JC
Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile. jaguillo@med.uchile.cl
Cruzat
Andrea
A
Contreras-Levicoy
Juan
J
Dotte
Andrés
A
Pesce
Bárbara
B
Aravena
Octavio
O
Salazar
Lorena
L
Catalán
Diego
D
Abello
Paula
P
Aguirre
Adam
A
Llanos
Carolina
C
Cuchacovich
Miguel
M
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*
D018501:Antirheumatic Agents; D007155:Immunologic Factors