Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis

被引:685
作者
Lin, Yen-Ju [1 ]
Anzaghe, Martina [2 ]
Schuelke, Stefan [1 ]
机构
[1] Paul Ehrlich Inst, Vice Presidents Res Grp 1 Mol Allergol, D-63225 Langen, Hesse, Germany
[2] Paul Ehrlich Inst, Prod Testing Immunol Biomed, D-63225 Langen, Hesse, Germany
关键词
rheumatoid arthritis; autoimmunity; TNF; IL-6; C-REACTIVE PROTEIN; ANTITUMOR NECROSIS FACTOR; ERYTHROCYTE SEDIMENTATION-RATE; FIBROBLAST-LIKE SYNOVIOCYTES; MESENCHYMAL STEM-CELLS; CITRULLINATED PEPTIDE ANTIBODY; RADIOGRAPHIC JOINT DAMAGE; ALPHA MONOCLONAL-ANTIBODY; COLONY-STIMULATING FACTOR; NONMELANOMA SKIN-CANCER;
D O I
10.3390/cells9040880
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
Rheumatoid arthritis (RA) is an autoimmune disease that involves multiple joints bilaterally. It is characterized by an inflammation of the tendon (tenosynovitis) resulting in both cartilage destruction and bone erosion. While until the 1990s RA frequently resulted in disability, inability to work, and increased mortality, newer treatment options have made RA a manageable disease. Here, great progress has been made in the development of disease-modifying anti-rheumatic drugs (DMARDs) which target inflammation and thereby prevent further joint damage. The available DMARDs are subdivided into (1) conventional synthetic DMARDs (methotrexate, hydrochloroquine, and sulfadiazine), (2) targeted synthetic DMARDs (pan-JAK- and JAK1/2-inhibitors), and (3) biologic DMARDs (tumor necrosis factor (TNF)-alpha inhibitors, TNF-receptor (R) inhibitors, IL-6 inhibitors, IL-6R inhibitors, B cell depleting antibodies, and inhibitors of co-stimulatory molecules). While DMARDs have repeatedly demonstrated the potential to greatly improve disease symptoms and prevent disease progression in RA patients, they are associated with considerable side-effects and high financial costs. This review summarizes our current understanding of the underlying pathomechanism, diagnosis of RA, as well as the mode of action, clinical benefits, and side-effects of the currently available DMARDs.
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