Details

Autor(en) / Beteiligte

• Gao, Ying
• Zhang, Yunkai
• Liu, Xingguang

Titel

Rheumatoid arthritis: pathogenesis and therapeutic advances

Ist Teil von

• MedComm (2020), 2024-03, Vol.5 (3), p.e509-n/a

Ort / Verlag

China: John Wiley & Sons, Inc

Erscheinungsjahr

2024

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by the unresolved synovial inflammation for tissues‐destructive consequence, which remains one of significant causes of disability and labor loss, affecting about 0.2–1% global population. Although treatments with disease‐modifying antirheumatic drugs (DMARDs) are effective to control inflammation and decrease bone destruction, the overall remission rates of RA still stay at a low level. Therefore, uncovering the pathogenesis of RA and expediting clinical transformation are imminently in need. Here, we summarize the immunological basis, inflammatory pathways, genetic and epigenetic alterations, and metabolic disorders in RA, with highlights on the abnormality of immune cells atlas, epigenetics, and immunometabolism. Besides an overview of first‐line medications including conventional DMARDs, biologics, and small molecule agents, we discuss in depth promising targeted therapies under clinical or preclinical trials, especially epigenetic and metabolic regulators. Additionally, prospects on precision medicine based on synovial biopsy or RNA‐sequencing and cell therapies of mesenchymal stem cells or chimeric antigen receptor T‐cell are also looked forward. The advancements of pathogenesis and innovations of therapies in RA accelerates the progress of RA treatments. Rheumatoid arthritis (RA) is a chronic inflammatory and autoimmune disease with multisystem involvement, including genetic, epigenetic, metabolic, and immune factors. This review focuses on the importance of recently identified epigenetic and metabolic risk factors for immune dysfunction and pathogenic tissue‐remodeling programs in RA development. Moreover, this review depicts the therapeutic potential of these metabolite and epigenetic targets and their agents for clinical remission and treatment.