The biology of chronic inflammation
Diseases like RA are a result of immune response activation causing inflammation resulting in tissue damage and disability. Inflammatory diseases include a huge gamut of illnesses from asthma and inflammatory bowel disease to psoriasis. However, RA is an excellent model system in which to unravel the shared biology. The 'Mechanisms to attack steering effectors of rheumatoid syndromes with innovated therapy choices' (MASTERSWITCH) project collected data from over 10 000 RA patients and over 30 000 healthy patients at risk of developing chronic arthritis. The goal was to identify mechanisms of onset, progression and resolution of inflammation leading to identification of therapeutic targets. Clinically, the team found that early diagnosis and treatment minimised joint damage and improved quality of life. However, about 78 % of patients sought help too late due to gradual onset of RA symptoms, believing that their symptoms would resolve spontaneously. To ensure early intervention in RA, 'early arthritis recognition clinics' were opened in Europe. These clinics provided insight into onset of RA symptoms through donated blood serum samples. Research into biological mechanisms demonstrated an auto-antibody response increasing in magnitude and complexity shortly before the onset of arthritis. Such an abnormality might serve as an early indicator of risk for RA-development, providing a window of opportunity to initiate early treatment and prevent disease onset. Numerous novel immune cells and related mechanisms were identified as potential targets for new drug therapies and treatments. MASTERSWITCH has already begun implementing findings through its early recognition clinics. Continued research could provide novel diagnostic and therapeutic options to halt RA in its tracks. Successful outcomes will provide better quality of life and reduce socioeconomic burdens for RA patients.
Keywords
Inflammatory diseases, rheumatoid arthritis, clinic, blood serum , auto-antibody, immune cells