Chapters authored
Immunotherapeutic Approaches of Rheumatoid Arthritis and the Implication on Novel Interventions for Refractoriness
Rheumatoid arthritis is an autoimmune disorder involving the chronic inflammation of affected joints which lead to the distortion and eventually destruction of the articular tissues. Clinically, many therapeutic methods are being used for RA treatment. Non-steroidal anti-inflammatory drugs (NSAIDs), steroid, and disease-modifying anti-rheumatic drugs (DMARDs) are the three main categories of intervention approaches. Among which DMARDs, targeting mainly the release of pro-inflammatory cytokines, demonstrated high efficacy because of its direct drug action that alter the underlying disease mechanisms rather than simply to mediate symptoms relieve. However, the use of DMARDs also accompanying some unwanted adverse side effects, in particular, the development of refractoriness, which hampers the successful rate of treatment. In this chapter, the conventional RA drugs will be reviewed, focusing on the currently used and latest development of DMARDs. Novel methods that could improve RA pathogenesis will also be introduced. Because of the critical role of refractory RA, the progress of the disease to develop resistance to standard drug treatment will also be described. Finally, innovative RA therapeutic methods inspired by researches concerning the pathogenesis and contemporary treatments of RA will be discussed.
Part of the book: Immunoregulatory Aspects of Immunotherapy
Pathogenic Role of microRNA in Rheumatoid Arthritis
Rheumatoid arthritis (RA) being a chronic inflammatory disease can be affected by both genetic and environmental factors. Abnormal functioning of immune response is the main underlying cause of RA. A growing number of studies on related diseases uncovered that microRNA (miRNA) may influence the pathogenesis of RA, such as the promotion of proliferation of fibroblast-like synoviocytes and secretion of cytokines by highly expressed miRNAs. A large number of studies have reported the aberrant expressions of miRNAs during the entire phase of RA, from the preclinical to terminal stages. These dynamic changes can be potentially developed as a bio-marker for predicting the risk, diagnosis and clinical management of RA. This chapter aims to summarize and discuss miRNAs’ roles and mechanisms in the process of RA development, differential diagnosis from other diseases, clinical management and refractory RA. Therefore, miRNA demonstrates future perspectives of diagnosis and treatment of clinical RA under the support of newly discovered theoretical basis.
Part of the book: Rheumatoid Arthritis