Arthritis in space and time – to boldly go!

Benson, R.A. , Patakas, A., McQueenie, R., Ross, K., McInnes, I.B. , Brewer, J.M. and Garside, P. (2011) Arthritis in space and time – to boldly go! FEBS Letters, 585(23), pp. 2640-3648. (doi: 10.1016/j.febslet.2011.04.069) (PMID:21570969)

Abstract

We focus on the importance of the spatiotemporal context of immune cell interactions in the pathogenesis of rheumatoid arthritis. We highlight gaps in our understanding of the disease process in rheumatoid arthritis. We outline potential approaches to address these gaps in our knowledge. We suggest the potential therapeutic impact of improved understanding. Despite the profound impact of biologics on the treatment of rheumatoid arthritis (RA), long lasting disease remission remains elusive. We propose that this is a consequence of failing to target the right molecular pathway in the most relevant patient group at the appropriate time and place in disease progression. A limitation to testing this approach is the availability of disease models representing the discrete steps in autoimmune pathogenesis. A particular example is the paucity of models to dissect the conditions permissive for the breach of self-tolerance, which would subsequently allow identification and testing of therapeutics for re-establishment of self-tolerance. We conclude that a detailed understanding of the location and timing of events leading to the systemic breach of self-tolerance and subsequent progression to tissue specific pathology are required if rational application of existing drugs and identification of novel targets is to be achieved. This will take the personalised medicine revolution into the realms of contextualised medicine, whereby the right drug is targeted to the right tissue, in the right patient, at the right time.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McInnes, Professor Iain and Garside, Professor Paul and Brewer, Professor James and Patakas, Dr Agapitos and Benson, Dr Robert and Ross, Dr Kirsty
• Authors: Benson, R.A., Patakas, A., McQueenie, R., Ross, K., McInnes, I.B., Brewer, J.M., and Garside, P.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: FEBS Letters
• Publisher: Elsevier BV
• ISSN: 0014-5793
• ISSN (Online): 1873-3468
• Published Online: 09 May 2011
• Copyright Holders: Copyright © 2012 Elsevier
• First Published: First published in FEBS Letters 585(23):2640-3648
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher.