Hungarian Immunology

[Biological therapy of arthritis and systemic autoimmune diseases - 2007]


JANUARY 20, 2007

Hungarian Immunology - 2007;6(01-02)

[Biological therapy acts at a specific point of inflammation. Today, rheumatoid arthritis is the prototype disease in this context due to the relatively high number of accessible patients and wellstandardized follow-up tools. However, apart from this disease, biological therapy has been introduced to the treatment of other diseases including various forms of arthritis, such as ankylosing spondylitis and psoriatic arthritis, as well as systemic autoimmune disorders, such as lupus, scleroderma, inflammatory myopathies and Sjogren’s syndrome. Anti-tumor necrosis factor-α (TNF-α) agents play a central role in biological therapy as these agents have been successfully tried in most of these diseases. However, when seeking for specific targets for biologicals, specific pathogenic factors of the given disease should be determined. For example, while anti-TNF agents seem to be most effective in various types of arthritis, anti-B cell therapy may be the first choice in other autoimmune conditions, such as lupus, Sjogren’s syndrome or dermatomyositis. It is important to consider the specific characteristics of the administered agents as there may be differences regarding side-effects.]



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Hungarian Immunology

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[1,25 dihydroxyvitamin D3, the biologically active metabolite of vitamin D3 plays an important role not only in bone and calcium metabolism but in differentiation of many cells and in the immunomodulation. It exerts its biological effects via vitamin D receptor (VDR) expressed in antigen-presenting cells and activated T cells. VDR is a member of the superfamily of nuclear hormone receptors. The receptor- ligand interaction activates nuclear transcription factors or the receptor binds directly to vitamin D responsive elements in the promoter regions of cytokine genes. Dendritic cells (DC) are the primary targets of vitamin D3; it inhibits the differentiation and maturation of DCs, and hereby DC-dependent T cell activation. These immunomodulatory activities have been demonstrated in vitro and in different models of autoimmune diseases and transplantation in vivo. In this report we review the regulatory effects of active vitamin D3 on the immune system and the latest results emphasizing the immunomodulatory role of 1,25 dihydroxyvitamin D3 which might be utilized more in therapy.]

Hungarian Immunology

[Autoimmunity as a result of escape from RNA surveillance]


[The pathomechanisms of autoimmune diseases are still unknown. Numerous factors are thought to play a role in the formation of the diseases (genetic arrangement, hormonal factors, exogen and endogen viruses, etc.) and many hypotheses have been formulated to explain the role of these factors. Most of the theories suspect that disturbance of the immune system is the clue but according to other researchers the immune system performs properly and one has to find other alterations that could be blamed for the formation of the autoimmune diseases. The aim of our present work is to show that certain genetic alterations together with the mistake of the RNA surveillance system could lead to autoimmune reactions. Results of immune research conducted in the past two decades revealed that there are mutations in the hot spot region of exon 7 of the La gene in the peripheral lymphocytes of patients suffering from certain autoimmune diseases (Sjögren's syndrome, SLE). RNAs originated from the mutant gene contain premature termination codon and therefore the RNA surveillance mechanism should get rid of these RNAs in order to prevent the formation of mutant proteins. However, because of the mistake of the surveillance system mutant proteins are formed that could finally lead to the autoimmune reactions.]

Hungarian Immunology

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Hungarian Immunology

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Lege Artis Medicinae

[Combination of leflunomide and biologic agents in the treatment of rheumatoid arthritis]

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