Novel/future therapies

Question 1

What are the limitations of current RA therapies?

Answer 1

Only treat symptoms
Disease is progressive
Patients often don't respond
Serious SEs with long term use
Expensive

Question 2

What do matrix metalloproteinases do?

Answer 2

Degrade bone and cartilage and promote angiogenesis.

Increase circulating TNF.

Question 3

Name 2 immunosuppressants

Answer 3

Cyclosporin

Tacrolimus

Question 4

Immunosuppressants have selective effects on what?

Answer 4

T lymphocytes

Question 5

What do Type IV PDEIs do?

Answer 5

Increase cAMP and suppress TNF translation

Question 6

What produces IL-17?

Answer 6

Th17

Question 7

What does IL-17 do?

Answer 7

Synergises with and enhances effects of TNF

Question 8

What can IL-17 upregulate?

Answer 8

NFkB, MAPK, IL-6, COX2 and NO

Question 9

What do Regulatory T cells do?

Answer 9

Dampen down immune cell activation

Question 10

What do regulator T cells secrete ?

Answer 10

Anti-inflammatory cytokines e.g. IL-10, TGF-B

Question 11

B cells in RA patients show what?

Answer 11

increased B7-2 and decreased FcR

Question 12

What does a-TNF therapy decrease?

Answer 12

B7-2 expression

Question 13

Rituximab is given when?

Answer 13

In combination with methotrexate to patients failing to respond to other treatments including anti TNF