Artículo de revista
Terapias emergentes en artritis reumatoide
Fecha
2005Registro en:
Rev Méd Chile 2005; 133: 969-976
0034-9887
Autor
Aguillón Gutiérrez, Juan Carlos
Cruzat C., Andrea
Contreras Levicoy, Juan
Dotte G., Andrés
Pesce Reyes, Bárbara
Aravena M., Octavio
Salazar A., Lorena
Catalán Martina, Diego
Abello Cáceres, Paula
Aguirre D., Adam
Llanos M., Carolina
Cuchacovich Turteltaub, Miguel
Institución
Resumen
The use of biological agents such as etanercept, infliximab,
adalimumab and anakinra has been recently approved for the treatment of rheumatoid arthritis. All
are effective controlling signs and symptoms and inhibiting disease progression. To overcome the
problems generated by their high costs and possible participation in reactivating latent infections, other
therapeutic tools are being developed. Gene therapy using expression vectors carrying genes coding for
specific proteins, may interfere in key points involved in the pathogenesis of the disease. Intra-articular
administration of cDNA coding for soluble TNF receptors, IL-1, or IL-1Ra decreases signs of the disease
in animal models. Vectors, expressing inhibitors of signal transduction pathways involving to NF-κB
and JAK-STAT-3, are effective in modulating joint inflammation in mice. The use of antigen-pulsed
antigen presenting cells or dendritic cells (DC) bound to apoptosis-inducing molecules, specifically
eliminates autoreactive T cells. Other novel approach attempts the development of T regulatoryinducing
tolerogenic DC-based vaccines that inhibit autoreactive T cells, through the secretion of
suppressing cytokines or by other mechanisms to be elucidated. Oral tolerance induction to autoantigens
is also a successful experimental strategy under study. Current research aims to control
peripheral tolerance in rheumatoid arthritis patients