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30 - Animal Models of Rheumatoid Arthritis

from PART VI - ANIMAL MODELS OF INFLAMMATION

Published online by Cambridge University Press:  05 April 2014

By
H.B. Patel ,
B. Dawson ,
F. Humby ,
M. Blades ,
C. Pitzalis ,
M. Burnet  and
M. Seed
Edited by
Charles N. Serhan ,
Peter A. Ward  and
Derek W. Gilroy
With contributions by
Samir S. Ayoub
H.B. Patel
Affiliation:
Queen Mary College University of London
F. Humby
Affiliation:
Queen Mary College University of London
M. Blades
Affiliation:
University of London
C. Pitzalis
Affiliation:
Queen Mary College University of London
M. Seed
Affiliation:
University of London
Charles N. Serhan
Affiliation:
Harvard Medical School
Peter A. Ward
Affiliation:
University of Michigan, Ann Arbor
Derek W. Gilroy
Affiliation:
University College London
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Summary

RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is an extremely painful, debilitating, and destructive inflammatory disease of diarthrodial joints. It affects between 0.5% and 1% of the world's population, with women having a threefold prevalence. Using traditional therapy, the majority will develop moderate disability at 2 years, with 40% being unable to work at 5 years. The disease has a high cost in pain, disability, and deformity. Morbidity is high, with a reduced lifespan. The advent of new treatment paradigms has meant that disability has been reduced, orthopedic surgeries have a much reduced rheumatoid joint replacement case-load, and whilst still severe, the aim of therapy is to preserve normal lifestyle and work patterns.

This is achieved by the use of low-dose methotrexate, leflunomide, or sulphasalazine, followed by biologic therapies, mainly anti-tumor necrosis factor (anti-TNF-α), anti-B cell (anti-CD20), recombinant human IL-1 receptor antagonist (rhIL-1ra), or anti-interleukin-6 (anti-IL-6). There remains a severe problem that despite these regimes a significant proportion (up to 40% for anti-TNF-α) do not respond. In addition, these treatments are expensive in their own right, and heavy on clinical resources for administration and monitoring. There is thus a continuing requirement for the development of improved therapeutics through drug discovery and further development of current therapeutics and their targets. A detailed understanding of the pathogenic mechanisms of RA are also required to fulfill these aims. Animal models of rheumatic disease continue to play a significant role in this process.

Type
Chapter
Information
Fundamentals of Inflammation , pp. 385 - 412
Publisher: Cambridge University Press
Print publication year: 2010

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