期刊
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
卷 20, 期 6, 页码 -出版社
MDPI
DOI: 10.3390/ijms20061332
关键词
anticitrullinated peptide antibodies; antirheumatic drug; autoimmune; disease-modifying; immunology; pathology; rheumatoid factor
资金
- Ministry of Science and Technology, Taiwan [MOST102-2314-B-016 -019 -MY3, MOST106-2314-B-016 -041 -MY3]
- Tri-Service GeneralHospital, Taiwan [TSGH-C101-009-S03, TSGH-C107-008-S03]
- Penghu Branch of Tri-Service GeneralHospital, Taiwan [TSGH-C104-PH-1, TSGH-PH-105-1, TSGH-PH-106-1, TSGH-PH-107-7]
- Cheng Hsin General Hospital, Taiwan [CH-NDMC-107-05]
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan
Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disease of unknown etiology. It is characterized by the presence of rheumatoid factor and anticitrullinated peptide antibodies. The orchestra of the inflammatory process among various immune cells, cytokines, chemokines, proteases, matrix metalloproteinases (MMPs), and reactive oxidative stress play critical immunopathologic roles in the inflammatory cascade of the joint environment, leading to clinical impairment and RA. With the growing understanding of the immunopathogenic mechanisms, increasingly novel marked and potential biologic agents have merged for the treatment of RA in recent years. In this review, we focus on the current understanding of pathogenic mechanisms, highlight novel biologic disease-modifying antirheumatic drugs (DMRADs), targeted synthetic DMRADs, and immune-modulating agents, and identify the applicable immune-mediated therapeutic strategies of the near future. In conclusion, new therapeutic approaches are emerging through a better understanding of the immunopathophysiology of RA, which is improving disease outcomes better than ever.
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