Writen by: Mike Mass, MD
Rheumatoid arthritis (RA) is an autoimmune disease that is localized in the joints but may also result in serious systemic symptoms. In the joints, RA begins in the lining tissue known as synovium. In RA inflammatory cells are stimulated in the synovium and release substances that will both activate other inflammatory cells and cause direct breakdown in the adjacent bone. If this inflammatory process is not interrupted it will immediately cause severe damage to the joint and, on occasion, other organs in the body.
Until recently, the only treatments available helped the symptoms of inflammation, such as pain and tenderness, but did little to stop the destructive process. The first drug that had some limited benefit was gold salts, but it was toxic and had to be monitored carefully. Low doses of a cancer drug (Methotrexate) were tried and proved effective in treating the symptoms of inflammation and also slowed down the destructive process in many patients and was a mainstay of therapy until the last decade.
As the understanding of the autoimmune abnormality increased, various substances released from inflammatory cells were identified. Initially, the most promising of these was known as tumor necrosis factor (TNF). While in other studies it had affected some tumor growth, it was also found to be a major cause of damage in RA. A group of anti-TNF monoclonal antibodies is on the market and has proven to be quite effective in a large number of patients. The search has continued for other substances that will either modify the autoimmune response or inactivate substances that cause damaging inflammation. Recently another protein has been identified that is present in the synovium and when activated will initiate a whole range of responses that result in a proliferation of synovial cells which then go on to damage the joint. This particular substance is part of a larger group of proteins known as “Integrins.” It is hoped that by giving a monoclonal antibody directed against the particular integrin a major portion of damaging inflammation will be shut down. A clinical trial of this antibody just opened at Jacksonville Center for Clinical Research University Blvd. Office and we are currently seeking volunteers. Call today to see if you qualify! 904-730-0166
