Interferon is a beta biomarker of the effectiveness of rheumatoid arthritis therapy
Scientists from the New York Orthopedic Hospital Hospital for Special Surgery in collaboration with rheumatologists from the University of South Carolina have discovered that inerferon-beta can serve as a biomarker with which doctors can accurately determine which of those suffering from rheumatoid arthritis will be helped by the appointment of tumor necrosis factor blockers (TNF) – extracellular protein, a multifunctional proinflammatory cytokine formed mainly by monocytes and macrophages.
Rheumatoid arthritis is a chronic autoimmune disease in which the human immune system, designed to fight infectious and harmful agents entering the body from the outside, attacks the cells of its own body, causing inflammation and destruction of connective tissue, leading to damage to small joints. The disease often leads to disability as a result of impaired motor functions and constant pain.
In the development of rheumatoid arthritis, the tumor necrosis factor plays a noticeable negative role: it mediates a strong localized immune response, causing inflammation and subsequent destruction of connective tissue.
Tumor necrosis factor blockers, such as Enbrel, Humira and Remicade, have been used for about ten years and bring noticeable relief to patients with rheumatoid arthritis, but not all, but only 50-70%. One of the side effects of drugs in this group is an increased risk of developing infectious diseases and mycoses. Due to the very high cost (drugs cost patients $ 16,000 a year), as well as their potential toxicity, unjustified prescription of these drugs strikes the purse and health of patients.
Previously, several factors associated with the weak effectiveness of tumor necrosis factor blockers (the activity of some genes) were found, but not one of them was suitable for the role of a biomarker.
A group of researchers led by Mary Crow drew attention to type I interferons, in particular interferon-beta, because it was known that this suppressing cell growth protein is found in the joints of some patients with rheumatoid arthritis. Interferons are proteins produced in the human body in response to the invasion of viruses and bacteria and have a wide range of biological activity: antiviral, immunostimulating and anticancer.
Scientists have suggested that different levels of interferon-beta activity in the blood may be associated with the effectiveness of treatment with tumor necrosis factor blockers. Due to the fact that interferon-beta stimulates the production of another protein, an interleukin-1 receptor antagonist (interleukin-1 receptor antagonist, IL-1Ra), the researchers also determined the levels of this protein in the blood of RA patients.
The study was conducted on three groups of people: 1) rheumatoid arthritis patients taking TNF blockers (35 people), 2) patients not taking any medications (12 people) and 3) healthy volunteers (50 people). Scientists determined the activity of interferon-beta and the level of IL-1Ra in the blood of participants before the start of the experiment and in the interval from three to nine months after the end of treatment, for a more accurate diagnosis of the condition of the subjects. The assessment of the clinical condition of patients was carried out by testing on the Disease Progression Scale in 28 joints (the Disease Activity Score/28), traditionally used to determine the condition in rheumatoid arthritis, and patients were assigned to one of three groups according to the effectiveness of treatment: good, medium and no reaction.
It turned out that in patients with high interferon-beta activity in the blood, TNF-blocker therapy is most likely to be effective. Subjects with a good response to treatment also had high levels of IL-1Ra in the blood compared to patients with an average and no reaction.
Despite the fact that the study was conducted on a relatively small group of volunteers, the data obtained are reliable and clinically significant.
The introduction of interferon-beta as a biomarker for predicting the effectiveness of TNF-blockers will become possible after conducting more extensive studies.
The article by Clio P. Mavragani et al., “Association of the response to tumor necrosis factor antagonists with plasma type I interferon activity and interferon-β/α ratios in rheumatoid arthritis patients: A post hoc analysis of a predominantly Hispanic cohort" was published online on January 28, 2010 in the journal Arthritis & Rheumatism.
Daria Chervyakova
Portal "Eternal youth" http://vechnayamolodost.ru based on Hospital for Special Surgery: Biomarker Could Help Doctors Tailor Treatment for Rheumatoid Arthritis02.02.2010