RESUMO
Both genetic and environmental factors affect susceptibility, severity and probably drugs' efficacy in patients with rheumatoid arthritis (RA). After initial completion of the Human Genome Project on the 16th February 2001, significant progress has been made in identifying other than HLA genome regions linked to the increased RA susceptibility. As an effect several new genes have been recognized as an HLA-independent genetic risk factors of RA. PTPN22 gene polymorphism, C5/TRAF1 genes region polymorphism and TNFAIP3-OLIG3 genes region polymorphism(s) are among newly identified and already confirmed genetic risk factors, whereas STAT 4, CTLA4, PADI4 and IRF5 genes polymorphisms are listed among probable RA development genetic risk factors.
Assuntos
Artrite Reumatoide/genética , Predisposição Genética para Doença/genética , Polimorfismo Genético , Antígenos CD/genética , Antígeno CTLA-4 , Proteínas de Ligação a DNA/genética , Humanos , Fatores Reguladores de Interferon/genética , Proteínas de Transporte de Cátions Orgânicos/genética , Proteína Tirosina Fosfatase não Receptora Tipo 22/genética , Fatores de Risco , Fator de Transcrição STAT4/genética , Fator 1 Associado a Receptor de TNF/genética , Fator 1 Associado a Receptor de TNF/metabolismoRESUMO
Cyclophosphamide has been used in the therapy of rheumatoid arthritis (RA) for nearly fifty years. An experience gathered throughout that time helped to identify indications, profits, restrictions and side effects related to its use. As a result of the progress in RA therapy in the recent years, including introduction of anti - TNF alpha therapy, the importance of cyclophosphamide significantly decreased. However, despite all restrictions related to its use, there are still RA patients for whom cyclophosphamide can be considered as a first choice drug. In this article we review the current knowledge on the issue.
Assuntos
Antirreumáticos/farmacologia , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Ciclofosfamida/farmacologia , Ciclofosfamida/uso terapêutico , Artrite Reumatoide/complicações , Humanos , Resultado do TratamentoRESUMO
Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disease leading to severe disability. A secondary amyloidosis (AA amyloidosis) affecting RA patient is a life threatening clinical complication of the illness. The most common symptoms of secondary amyloidosis include: proteinuria, erythrocyturia, abdominal pain and chronic diarrhoea. It is essential to carry out regular screening tests, especially abdominal fat tissue biopsy, to early diagnose and properly manage patients with the condition. Effective anti-inflammatory therapy of RA and eradication of coexisting infections seem to be the best way to decrease the risk of development and prevent progression of the secondary amyloidosis.
Assuntos
Amiloidose/complicações , Anti-Inflamatórios/uso terapêutico , Artrite Reumatoide/complicações , Gordura Abdominal/patologia , Amiloidose/diagnóstico , Amiloidose/tratamento farmacológico , Amiloidose/etiologia , Biópsia , Humanos , Resultado do TratamentoRESUMO
Numerous scientific investigations confirmed the occurrence of oxidative stress in rheumatoid arthritis patients. There is evidence demonstrating elevated levels of oxidative stress markers and oxidative damage caused by reactive oxygen species (ROS) to lipids, proteins, sugars, and DNA, as well as a significant decrease in total antioxidant capacity, which protects the organism against ROS activity. Extensive ROS production can significantly accelerate the process of articular cartilage damage. It is believed that many disease-modifying anti-rheumatic drugs (DMARDs) affect oxidative stress, although there has been insufficient research to confirm such a relationship.
