多阻性类风湿性关节炎:一种罕见的难以治疗的疾病子集,具有明显的炎症和非炎症表征
相关实验视频
Updated: Jul 9, 2025

07:37
An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
Published on: June 6, 2025
133
Paula David1,2, Andrea Di Matteo1,3, Or Hen1,2
1Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, United Kingdom.
Arthritis & rheumatology (Hoboken, N.J.)
|December 7, 2023
概括
只有2.7%的难以治疗的类风湿性关节炎 (RA) 患者失败了所有生物/向合成疾病修饰药物 (DMARDs). 在这些患者中,不到60%的患者表现出客观性炎症,表明需要新的治疗策略.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 类风湿性关节炎 (RA) 管理包括生物 (b) 和有针对性的合成 (ts) 疾病修饰药物 (DMARDs).
- 难以治疗的RA (D2T-RA) 包括对治疗反应不足的患者.
- 多重耐火性RA是由所有b/tsDMARD类的失败定义的.
研究的目的:
- 为了确定D2T-RA患者中多重耐药性RA的患病率.
- 使用超声波 (US) 突炎来区分持久性炎症耐药RA (PIRRA) 和非炎症耐药RA (NIRRA) 之间的临床表型.
- 为了确定与这些耐火性RA表型相关的因素.
主要方法:
- 一项横截面研究包括1,591名接受b/tsDMARD治疗的RA患者.
- 根据D2T-RA标准对患者进行评估,并根据治疗失败将患者分类为多重耐药.
- 持久性炎症耐药性RA (PIRRA) 被定义为美国鼻膜炎,而非炎症耐药性RA (NIRRA) 则没有鼻膜炎.
主要成果:
- 16.8%的患者符合D2T-RA标准,只有2.7%被归类为多抗性RA.
- 多重耐药性RA患者表现出更高的疾病活性,C反应性蛋白 (CRP) 水平和吸烟率.
- 与PIRRA患者相比,NIRRA患者的BMI,纤维肌痛患病率较高,胀关节数量和CRP水平较低.
结论:
- 一小部分 (2.7%) 的D2T-RA患者是真正的多重耐药,未能完成所有b/tsDMARD课程.
- 很大一部分D2T-RA患者缺乏客观的炎症征兆 (US突炎),这表明非炎症机制.
- 这些发现凸显了针对不同耐火性RA表型的有针对性,创新的治疗策略的需要.
相关概念视频
T Cell Types and Functions
1.0K
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.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
1.0K
Chronic Bowel Disorders: Introduction
456
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
456
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
143
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
143
Inflammatory Bowel Disease II: Crohn's Disease
255
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
255
The JAK-STAT Signaling Pathway
8.9K
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...
8.9K
Genome-wide Association Studies-GWAS
13.5K
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
13.5K

