Arthritis

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How Your Body Clock Shapes Inflammation

Understanding the link between the body clock and inflammation could revolutionize treatment for conditions like arthritis.
Understanding the link between the body clock and inflammation could revolutionize treatment for arthritis.

New research from RCSI University of Medicine and Health Sciences has uncovered how the body’s internal clock, or circadian rhythm, regulates inflammation in the immune system. The findings reveal that immune cells called macrophages behave differently depending on the time of day, paving the way for treatments that work harmoniously with the body’s natural rhythms.

Macrophages are immune cells that act as first responders, detecting harmful substances and triggering inflammation when needed. They assemble large protein complexes called inflammasomes, which function like “smoke detectors” to alert the immune system to potential danger.

The study, published in The FASEB Journal, showed that activating a specific inflammasome called NLRP3 fluctuates based on the 24-hour circadian clock. This rhythm determines when macrophages are most effective at detecting threats and have the energy to respond. A critical driver of this process is the mitochondria, often referred to as the cell’s “powerhouses,” which fuel these immune responses.

Inflammation and the Time of Day

“When macrophages ‘think’ it’s morning, their inflammasome activation is faster and stronger,” explained Professor Annie Curtis, the study’s principal investigator from RCSI’s School of Pharmacy and Biomolecular Sciences. “This heightened immune response aligns with the early part of the day, when we are awake and more likely to face injuries or infections.”

This discovery helps explain why symptoms of inflammatory conditions, such as arthritis, tend to worsen in the morning.

“Overactive inflammasomes are a key factor in diseases like arthritis,” said Dr. James O’Siorain, lead author of the study. “Our findings suggest that therapies targeting these inflammasomes could be more effective when timed to the body’s natural immune rhythms.”

Implications for Treatment

The research opens up possibilities for tailoring treatments for inflammatory diseases based on the time of day. For example, medications designed to regulate inflammasome activity might be most effective when administered during peak macrophage activity in the morning.

The study highlights how an improved understanding of the connection between circadian rhythms and immune function could lead to more precise and effective therapies for inflammation-induced conditions.

Supported by funding from Taighde Éireann – Research Ireland, this study underscores the importance of timing in medicine, offering a new perspective on managing diseases where inflammation plays a central role.

Posted on Arthritis

How new therapies are revolutionizing the treatment of juvenile idiopathic arthritis

A groundbreaking study has found that children who exhibit neurodivergent traits, such as those associated with autism and ADHD, are twice as likely to experience chronic disabling fatigue by age 18.

The use of biologic and targeted therapies for children with juvenile idiopathic arthritis (JIA) surpassed more typical therapies in recent years, according to Rutgers Health researchers.

Their study examined more than 20 years of data from nearly 14,000 children with JIA throughout the nation.

Juvenile idiopathic arthritis (JIA) affects approximately 16 to 150 children per 100,000 in North America, according to the National Institutes of Health and prior research. This condition leads to chronic inflammation, resulting in persistent joint pain, swelling, and stiffness. The primary goals of JIA treatment are to alleviate symptoms, restore normal physical movement and growth, prevent long-term damage and vision loss, and enhance the overall quality of life. Researchers note that many studies on the use of antirheumatic drugs have focused more on adults with arthritis than on children with JIA.

“Juvenile Idiopathic Arthritis (JIA) can significantly impact the lives of affected children and their families,” stated Daniel Horton, a faculty member at the Rutgers Center for Pharmacoepidemiology and Treatment Science (PETS) and a senior author of the study. “Fortunately, the treatment options have greatly improved in recent years, offering people with JIA more potentially effective therapies.”

Researchers used data from privately insured people spanning the past two decades to describe trends throughout the significant expansion in the available treatments for JIA. Newer disease-modifying antirheumatic drugs, while often more expensive, are frequently more effective and better tolerated by patients than older conventional agents.

“Our study provides insight into the evolving real-world treatment practices for children with JIA,” said Priyanka Yalamanchili, lead author of the study, PETS trainee and a recent graduate of Rutgers School of Public Health’s master’s degree program in epidemiology with a pharmacoepidemiology concentration.

Initiations of conventional therapies declined by more than 45%, increasingly eclipsed by the use of newer biologic or targeted therapies. The use of adalimumab, one of the most popular biologics on the market today, has risen steadily since its initial approval for rheumatoid arthritis in 2002, representing nearly 80% of first-line biologic or targeted therapies started for JIA by 2022.

“This research sets the stage for future studies that will compare the effectiveness and safety of different therapies used to treat JIA,” said Horton, an associate professor at Rutgers Robert Wood Johnson Medical School and Rutgers School of Public Health and the faculty director of the Rutgers Institute for Health Survey/Data Core, which provided access to the data studied.

Posted on Arthritis, Exercise, Fibromyalgia, Pain Management

Some Exercises for Chronic Pain – Stretch, Strengthen and Feel Relief

Ease stiffness and feel relief from chronic conditions causing your pain, such as arthritis and fibromyalgia. In this gentle joint video, I will walk you through exercises that gently strengthen and stretch common troublesome areas. This workout begins with a warm-up in a standing position, and then halfway through, we move to a seated position in a chair. If you are only able to complete the seated portion, then just fast forward to that section (about the 15-minute mark), please make sure that you are in a warm environment. This will make sure that your muscles relax and don’t cramp up. It is also essential to stay hydrated. Drinking water will help lubricate your joints.

Posted on Arthritis

A new safety checklist aims to prevent side effects in patients with arthritis.

The researchers

The safety checklist, developed by Associate Professor Tue Wenzel Kragstrup and Dr. Lykke Skaarup from Aarhus University, aims to provide safer and more effective treatment for arthritis patients. Credit Aarhus University.

An inappropriate prescription of an antirheumatic drug for an unsuitable patient can lead to severe side effects, such as intestinal perforations, blood clots, heart failure, or liver damage.

“In order to tackle this problem, researchers from the Department of Biomedicine at Aarhus University and the Rheumatology Department at the University Clinic for Innovative Patient Pathways in Silkeborg have created a thorough safety checklist for the latest medications used in the treatment of rheumatic diseases.”

“With the increasing number of medications on the market, it is becoming more challenging for healthcare professionals to make prescriptions without risking serious side effects,” explained Associate Professor Tue Wenzel Kragstrup, one of the researchers behind the study and article recently published in the medical journal Drug Safety.

The article outlines a checklist to prevent patients from receiving medications they cannot tolerate.

“With over 20 antirheumatic drugs, each with up to 10 specific contraindications or precautions, there is an urgent need for advanced support tools to assist doctors and pharmacists in navigating the medical landscape,” adds Tue Kragstrup.

The checklist allows doctors to rapidly assess if a patient has comorbidities that restrict the use of certain medications.

“The principles can be applied to other disease areas.”

This checklist is the first of its kind. It was created by analyzing all available patient information leaflets and international treatment guidelines in Europe and the USA. It is based on data from both the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) in the USA.

Primarily intended for doctors prescribing medications to patients with rheumatic diseases, the study is also relevant to other doctors and patients as it highlights the risks associated with medical treatments and the need for tools to improve prescription safety in general. Dr. Lykke Skaarup, one of the researchers behind the data extraction in the study, explains.

“The principles behind the checklist can be applied across other disease areas because we have documented a method to systematically identify contraindications and precautions for a group of medications,” she says.

For example, similar checklists could be created for antihypertensive drugs, migraine medications, or cholesterol-lowering drugs using the same approach.

The study has made a wide range of medication information clear, accessible, and user-friendly, enabling doctors to make more informed decisions. Consequently, they can reduce the risk of side effects and enhance patient safety for those treated for inflammatory rheumatic diseases, both now and in the future.

Tue Wenzel Kragstrup notes that the results align with previous studies highlighting the need for better medication safety.

“We hope our work can contribute to safer and more effective treatment of rheumatic diseases,” he says.

Of course, the checklist will need to be continuously updated with new research and the latest reported side effects. The researchers are already working on implementing AI-driven support tools to handle much of this task.