白小姐论坛

AIRDs affect millions globally and include rheumatoid arthritis, lupus and Sj枚gren鈥檚 syndrome 鈥� all with high rates of morbidity. They occur when the immune system mistakenly attacks and damages its own tissues, though the pathogenesis (the mechanism which triggers this) is still ill-defined and delivering targeted therapeutic strategies is challenging.

As a result, current treatments for AIRDs are primarily designed to supress the symptoms (inflammation), but are 鈥榣ow target鈥� meaning the drugs may also have unintended side-effects. 听In this regard, AIRDs drugs often cause changes to cell metabolism (such as lipid metabolism) and function, putting patients at greater risk of co-morbidities such as cardiovascular disease (CVD).

First听author, Dr George Robinson (Centre for Rheumatology Research, 白小姐论坛 Division of Medicine), said: 鈥淲hile the mechanisms that cause rheumatic diseases are ill-defined, some recent research indicates cell metabolism may play an important role in triggering or worsening their onset or affect.

鈥淚n this review we therefore sought to understand the effect of both conventional and emerging therapies on lipid metabolism in patients with AIRDs.鈥�

For the study, published in the听Journal of Clinical Investigation, researchers carried out a literature review听of more than 200 studies, to assess and interpret what is known regarding the on-target/off-target (adverse) effects and mechanisms of action of current AIRD therapies on lipid metabolism, immune cell function and CVD risk.

Explaining the findings, Dr Robinson said: 鈥淥ur review found that current AIRD therapies can both improve or worsen lipid metabolism, and either of these changes could cause inflammation and increased CVD risk.

鈥淢any conventional drugs also require cell metabolism for their conversion into therapeutically beneficial products; however drug metabolism often involves the additional formation of toxic by-products, and rates of drug metabolism can be different between patients.鈥�

The review noted that better control of inflammation using optimal combinations of immunosuppressive treatments, could lead to an improved metabolic/lipid profile in AIRDs.

However, it also revealed many studies have shown that lipid lowering drugs (such as statins) are not sufficient to reduce CVD risk in some AIRDs, potentially because they cannot completely restore the anti-inflammatory properties

Lead author,听Professor Liz Jury (Centre for Rheumatology Research, 白小姐论坛 Division of Medicine), added: 鈥淭he unfavourable off-target adverse effects of current therapies used to treat AIRDs provides an opportunity for optimal combination co-therapies targeting lipid metabolism that could reduce immune complications and potential increased CVD risk in patients.

鈥淣ew therapeutic technologies and research have also highlighted alternative metabolic pathways that can be more specifically targeted to reduce inflammation but also to prevent undesirable off-target metabolic consequences of conventional anti-inflammatory therapies.鈥�

Links

• 白小姐论坛 Centre for Rheumatology Research
• 白小姐论坛 Division of Medicine

Image

• 'Senior woman with rheumatoid arthritis visits a听doctor'', credit Suze777 on

Media contact

Henry Killworth

Tel: +44 (0) 7881 833274

贰:听h.killworth@ucl.ac.uk