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2014 ; 53
(9
): 1560-9
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Rheumatoid arthritis pathophysiology: update on emerging cytokine and
cytokine-associated cell targets
#MMPMID24402580
Furst DE
; Emery P
Rheumatology (Oxford)
2014[Sep]; 53
(9
): 1560-9
PMID24402580
show ga
Biologic therapies that target pathogenic cytokines such as TNF, IL-1? or IL-6
have greatly improved the treatment of RA. Unfortunately, not all RA patients
respond to current biologic therapies and responses are not always maintained,
suggesting that there are alternative drivers of RA pathogenesis that might serve
as promising therapeutic targets. Discovery of the new Th17 subset of Th cells,
and their role in autoimmune disease development, has implicated the
proinflammatory IL-12 and IL-17 families of cytokines in RA disease pathogenesis.
Members of these cytokine families are elevated in the blood and joints of RA
patients and have been shown to remain elevated in patients who do not respond to
current biologics. In addition, these cytokines have been shown to play roles in
joint destruction and erosion. A new subclass of biologics that target the IL-12
and/or IL-17 signalling pathways are under development. Here we review evidence
for a role of Th17 cells as well as IL-12 and IL-17 cytokines in RA pathogenesis
as the rationale for a subsequent discussion of the ongoing and completed
clinical trials of newly emerging biologic therapies directed at IL-12 or IL-17
pathway inhibition.