Rheumatoid Arthritis patients at increased cardiovascular risk are identified

‘Usual suspect’ lesions appear not to cause most severe disability in Multiple Sclerosis patients

Rheumatoid Arthritis is an autoimmune disease of unknown origin that affects around 18 million people worldwide, according to World Health Organization data. It produces chronic inflammation that mainly affects the joints. In addition, it can increase the possibility of suffering heart disease by 50%, among other consequences. 


A new study led by the University of Córdoba (UCO), the Maimonides Institute for Biomedical Research (IMIBIC) and the Rheumatology Department at the Reina Sofía University Hospital in Córdoba (HURS) has managed to establish, for the first time, the molecular profile of those patients with rheumatoid arthritis who have a higher risk of suffering cardiovascular events. 


To this end the work carried out a detailed analysis of blood serum samples in more than 300 people suffering from this disease, in which more than 30 different molecules related mainly to oxidative stress, the alteration of immune cells, and other inflammatory ones, such as cytokines, were studied. 


In this way, based on computational tools and bioinformatic techniques that compared more than ten thousand different pieces of data, the system managed to establish three different groups of patients sharing similar patterns based on all the molecular characteristics previously analyzed. 


“Once we studied the clinical characteristics of each of these three groups, we came to the conclusion that, specifically, one of them was more likely to develop cardiovascular diseases,” explained Chary López-Pedrera, Principal Investigator with the “Chronic systemic-inflammatory autoimmune diseases of the musculoskeletal system and connective tissue” group. To this end, the research team analyzed different parameters associated with an increased risk of heart problems, such as hypertension, obesity amd thickening of the carotid intima-media, the two innermost layers of the artery responsible for blood supply to the brain. 


In search of high-precision medicine


“We have been able to demonstrate that molecular analyses are able to stratify patients who have a particular clinical behavior, such as an increased cardiovascular risk,” explained Carlos Pérez-Sánchez, Ramón y Cajal researcher and member of the Department of Cell Biology, Physiology and Immunology at the University of Córdoba. “That we have been able to characterize this is an important result which, if validated, will allow the analysis of certain molecules to yield information about the likelihood of suffering a heart problem,” he added. 


The study represents an advance towards more specific and personalized medical treatments, a result that may be possible in the future through blood tests to identify patients who, despite suffering from the same disease, have different characteristics that can be addressed therapeutically in differential ways. 

New insights into T and B cells offer hope for Rheumatoid Arthritis sufferers

According to a new study from the University of Surrey, scientists should focus on the interactions between T and B cells to find better treatments for autoimmune disorders, such as rheumatoid arthritis.

Systems Biology researchers have found that our metabolism could be outsized in the delicate balancing act between T and B cells, leading to autoimmune diseases. The study also found evidence that changes in metabolism caused by ageing add further risks.  

Dr Matteo Barberis, lead author of the study from the School of Biosciences, said: 

“We have proposed a new way to treat autoimmune diseases by focusing on the metabolism of immune cells, like T and B cells. We can find more effective treatments by understanding how these cells interact to change their behaviour due to shifts in our body’s energy processing. 

“This approach brings together different areas, such as inflammation and immunometabolism, how our immune system uses energy and the effects of ageing.” 

T and B cells are specialised white blood cells that play crucial roles in our immune system. T cells help identify and attack infected cells, while B cells create antibodies to neutralise harmful invaders like viruses and bacteria. Through mutual regulation, T and B cells can meet the metabolic demand required in each stage of their development. 

The team conducted a thorough critical analysis of the current literature in different areas, such as inflammation and immunometabolism, to comprehensively understand the processes involved, where metabolic, signalling and epigenetic routes integrate.  

“This approach envisions therapeutic treatments of autoimmune disorders through a strategy of repurposing drugs capable of simultaneously targeting the immune system and the metabolism. It’s a promising direction that could lead to better ways to manage conditions such as lupus or multiple sclerosis.” 

Why are women at greater risk of autoimmune diseases?

Somewhere between 24 and 50 million Americans have an autoimmune disease, a condition in which the immune system attacks our own tissues. As many as 4 out of 5 of those people are women. Rheumatoid arthritis, multiple sclerosis and scleroderma are examples of autoimmune disorders marked by lopsided female-to-male ratios. The ratio for lupus is 9 to 1; for Sjogren’s syndrome, it’s 19 to 1. Stanford Medicine scientists and their colleagues have traced this disparity to the most fundamental feature differentiating biological female mammals from males, possibly fostering a better way to predict autoimmune disorders before they develop.

RA and lupus – targets were discovered on RNA to short-circuit inflammation.

A new study details the high-throughput process for rapid screening and identification of mysterious long non-coding RNA.

New target for inflammation regulation discovered

UC Santa Cruz researchers have discovered that LOUP is a multifunctional gene in immune cells called monocytes. LOUP can work inside the nucleus to control its neighbour SPI1. They also discovered that LOUP RNA can leave the nucleus and produce a small peptide in the cytoplasm leading to an increase in the protein SPI1 and causing downregulation of NF-kB, the master controller of inflammation. CREDIT Carpenter Lab, UC Santa Cruz

UC Santa Cruz researchers have discovered a peptide in human RNA that regulates inflammation and may provide a new path for treating diseases such as arthritis and lupus. The team used a screening process based on the powerful gene-editing tool CRISPR to illuminate one of the biggest mysteries about our RNA–the molecule responsible for carrying out genetic information in our DNA.

This peptide originates within a long non-coding RNA (lncRNA) called LOUP. According to the researchers, the human genome encodes over 20,000 lncRNAs, making it the largest group of genes produced from the genome. But despite this abundance, scientists know little about why lncRNAs exist or what they do. This is why lncRNA is sometimes called the “dark matter of the genome.”

The study, published May 23 in the Proceedings of the National Academy of Sciences (PNAS), is one of the few in the existing literature to chip away at the mysteries of lncRNA. It also presents a new strategy for conducting high-throughput screening to rapidly identify functional lncRNAs in immune cells. The pooled-screen approach allows researchers to target thousands of genes in a single experiment, which is a much more efficient way to study uncharacterized portions of the genome than traditional experiments focusing on one gene at a time.

The research was led by immunologist Susan Carpenter, a professor and Sinsheimer Chair of UC Santa Cruz’s Molecular, Cell, and Developmental Biology Department. She studies the molecular mechanisms involved in protection against infection. Specifically, she focuses on the processes that lead to inflammation to determine lncRNAs’ role in these pathways.

“Inflammation is a central feature of just about every disease,” she said. “In this study, my lab focused on determining which lncRNA genes regulate inflammation.”

This meant studying lncRNAs in a type of white blood cell known as a monocyte. They used a modification of the CRISPR/Cas9 technology, called CRISPR inhibition (CRISPRi), to repress gene transcription and find out which of a monocyte’s lncRNA plays a role in whether it differentiates into a macrophage—another type of white blood cell that’s critical to a well-functioning immune response.

In addition, the researchers used CRISPRi to screen macrophage lncRNA for involvement in inflammation. Unexpectedly, they located a multifunctional region that can work as an RNA and contain an undiscovered peptide that regulates inflammation.

Ms Carpenter said that understanding that this specific peptide regulates inflammation gives drugmakers a target to block the molecular interaction behind that response to suppress it. “In an ideal world, you would design a small molecule to disrupt that specific interaction instead of targeting a protein that might be expressed throughout the body,” she explained. “We’re still far from targeting these pathways with that level of precision, but that’s definitely the goal. There’s a lot of interest in RNA therapeutics right now.”

What are some of the side effects of taking RA medications?

Dr. Glen Hazlewood speaks about the various side effects of rheumatoid arthritis medications and how discussing them with your rheumatologist is important. He explains how your rheumatologist can have ideas on managing these side effects, like taking folic acid or taking a medication differently.