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T Cell Types and Functions

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When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
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Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as  SH2...
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[Rheumatoid Arthritis].

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    Rheumatoid arthritis (RA) is an inflammatory disease impacting joints and potentially lungs. Early treatment with disease-modifying antirheumatic drugs (DMARDs), like methotrexate, is crucial for managing RA progression and improving patient outcomes.

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    Area of Science:

    • Rheumatology
    • Immunology
    • Internal Medicine

    Background:

    • Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease primarily affecting joints.
    • It can lead to extra-articular manifestations such as interstitial lung disease and vasculitis.
    • Untreated RA results in irreversible functional loss and increased mortality.

    Purpose of the Study:

    • To outline the recommended treatment strategies for rheumatoid arthritis.
    • To emphasize the importance of early diagnosis and targeted therapy.
    • To describe the treat-to-target principle for managing RA.

    Main Methods:

    • Administration of disease-modifying antirheumatic drugs (DMARDs) upon diagnosis, with methotrexate as the first choice.
    • Temporary use of glucocorticoids for 3-6 months.
    • Utilizing a treat-to-target approach with regular assessment of disease activity scores.

    Main Results:

    • Treatment response is defined by a minimum 50% reduction in disease activity scores, evaluated at 12 and 24 weeks.
    • If treatment targets are not met, adjustments are made, including switching to other conventional systemic (cs)DMARDs, biological (b)DMARDs, or targeted synthetic (ts)DMARDs.
    • Sequential re-evaluation guides further therapeutic adjustments.

    Conclusions:

    • Early and targeted treatment is essential for managing rheumatoid arthritis.
    • The treat-to-target strategy, guided by validated scores, optimizes therapeutic outcomes.
    • Personalized treatment adjustments are necessary to achieve remission and prevent disease progression.