Predictive Biomarkers May Support Potential for “Personalized Medicine Approach” in RA Patients, Study Reveals
A study published by researchers in Trinity College Dublin and St Vincent’s University Hospital proposes a better understanding of the site of inflammation in rheumatoid arthritis which will allow for the development of new treatment strategies or predictive biomarkers which could support the potential for a ‘personalised medicine’ approach. The study was published in the journal Science Advances. In India, the prevalence of rheumatoid arthritis is estimated to be 0.7% which is higher than the global prevalence of 0.46%
The team performed an in-depth investigation of a specific population of cells: ‘the macrophages’ that reside in the synovium of Rheumatoid arthritis patients, ‘individuals-at-risk’ of RA, and healthy controls. Researchers demonstrated for the first time, the presence of a dominant macrophage subtype (CD40-expressing CD206+CD163+) in the inflamed Rheumatoid arthritis synovium, which importantly was associated with disease activity and treatment response.
The team identified that these cells are resident in the joint which, in health plays a protective role, but in disease – for reasons we are unsure of – become pro-inflammatory, and release proteins called cytokines that induce inflammation, and also can activate the invasive fibroblast cell type which leads to cartilage and bone destruction.
Researchers identified that the pro-inflammatory status of these macrophages is maintained by specific signaling and metabolic pathways within the joint, the targeting of which may induce the resolution of inflammation. Importantly the team identified that these changes in the macrophage status occurred pre-disease onset.
Combined, these findings identify the presence of an early pathogenic macrophage cell/gene signature that shapes the Rheumatoid arthritis joint inflammatory environment and represents a unique opportunity for early diagnosis and therapeutic intervention.
Reference: Loss of synovial tissue macrophage homeostasis precedes rheumatoid arthritis clinical onset. https://www.science.org/doi/epdf/10.1126/sciadv.adj1252
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