Cytokines Approach: Treatment of Rheumatoid Arthritis, One of the serious cause physical disability in North zone of India

Lubna Azmi, Ila Shukla, Ambreen Shoiab, Padam Kant, Ch. V. Rao


Introduction: Cytokine expression and regulation may yield effective therapeutic targets in rheumatoid arthritis. Pathogenesis reveals (arguably) the most inclusive study of pathologic cytokine function in a chronic inflammatory disease in recent years. Presence of IL-1, IL-6, TNF alpha, chemokines (e.g., IL-8) and GM-CSF has been reported in patients with rheumatoid arthritis irrespective of curative therapy. They must be produced de novo in response to an immune stimulus. Generally act over short distances and short time spans and at very low concentration. India does not have a national rheumatoid arthritis surveillance system creation, it is very difficult to methodically access and determine burden of hospital-acquired rheumatoid arthritis. This review reports cytokine approach for the treatment of rheumatoid arthritis in north zone of India.

Methods: Methodical review of the peer-reviewed works reporting the incidence of cytokine expression and regulation may yield effective therapeutic targets in rheumatoid arthritis and approach of cytokines for the treatment of RA in North Indian hospitals was identified using MEDLINE and CINAHL records.

Results: Data of the 934 research papers recognized in the search, 30 articles were included in this review, these studies suggest that cytokines  act by binding to specific membrane receptors, which then signal the cell via second messengers, often tyrosine kinases, to alter its behavior (gene expression).Subsequently, other proinflammatory cytokines were also suppressed if TNF alpha was neutralized, paving way for the novel idea that the proinflammatory cytokines were linked in a network with TNF alpha at its apex. It shows that TNF alpha was of major importance in rheumatoid arthritis and was a therapeutic target. Numerous clinical trials using a chimeric anti-TNF alpha antibody have revealed marked clinical advantage, verifying the hypothesis that TNF alpha is of major importance in rheumatoid arthritis. Retreatment studies have also shown benefit in repeated relapses, indicating that the disease remains TNF alpha dependent.

Conclusion: Overall, these studies demonstrate that analysis of cytokine expression and regulation may yield effective therapeutic targets in Rheumatoid arthritis.


Rheumatoid arthritis; Cytokines; Chemokines

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