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Medical Specialties / Rheumatology / Rheumatoid Arthritis


Vaccines and Autoimmune Diseases of the Adult

Abstract: Infectious agents contribute to the environmental factors involved in the development of autoimmune diseases possibly through molecular mimicry mechanisms. Hence, it is feasible that vaccinations may also contribute to the mosaic of autoimmunity. Evidence for the association of vaccinations and the development of these diseases is presented in this review. Infrequently reported post-vaccination autoimmune diseases include systemic lupus erythematosus, rheumatoid arthritis, inflammatory myopathies, multiple sclerosis, Guillain-Barré syndrome, and vasculitis. In addition, we will discuss macrophagic myofasciitis, aluminum containing vaccines, and the recent evidence for autoimmunity following human papilloma virus vaccine. ... Read more

Natural Autoantibodies to Apoptotic Cell Membranes Regulate Fundamental Innate Immune Functions and Suppress Inflammation

Abstract: The evolution of the immune system has provided a multilevel system that interconnects the innate and adaptive immune systems to serve at least three central purposes: the defense from microbial pathogens, the capacity for discrimination of self- from non-self necessary for the prevention of autoimmune disease, and essential effector roles in wound repair and tissue remodeling. In recent studies, we have elucidated an unsuspected role for a class of naturally occurring autoreactive antibodies from the most primitive tier of B lymphocytes, which regulates fundamental functions of the innate immune system. Our findings also throw light onto long unresolved mysteries regarding the origins of the earliest waves of B lymphocyte development. ... Read more

Interleukin-21 in T Cell-mediated Diseases

Abstract: Interleukin-21 (IL-21), a cytokine produced by activated CD4+ T cells, activated natural killer T cells, and T follicular cells, has been reported to play a crucial role in the tissue-damaging T cell response in various organs, such as gut, skin, pancreas, and joints. This pathogenic effect is strictly linked to the ability of IL-21 to enhance the functional activities of multiple immune and non-immune cells. Consistently, studies from various laboratories have shown that blockade of IL-21 limits the progression of T cell-mediated inflammatory diseases in mice. Here we review the present knowledge on the expression and role of IL-21 in T cell-mediated pathologies. ... Read more

Inflammation, Autoimmunity, and Atherosclerosis

Abstract: Historically atherosclerosis has been viewed as a disease associated with dyslipidemia because many studies (e.g., Framingham study) have demonstrated that dyslipidemia is clearly a risk factor for the disease and lipid-lowering statin therapies have proven to be highly effective in reducing the cardiovascular events and improving the quality of life for patients with coronary heart disease all over the world. Over the last decade, both preclinical and clinical research has provided multiple lines of unequivocal evidence that inflammation and immune response are integral components of the pathogenesis for atherosclerosis. In this article, both clinical and preclinical evidence in support of atherosclerosis as an inflammatory disease will be reviewed. Evidence in support of atherosclerosis as an autoimmune disease will also be presented. Furthermore, opportunities for translating the newly gained knowledge of atherosclerosis as an inflammatory/autoimmune disease into novel diagnostic and therapeutic modalities will be discussed along with challenges in developing these modalities. ... Read more

Immunological Tolerance in the Therapy of Rheumatoid Arthritis

Abstract: Dramatic progress in the treatment of Rheumatoid Arthritis (RA) has led to an early and aggressive treatment strategy, combining DMARDS with biological agents. Since these therapies are able to induce initial clinical control, attention has shifted toward the maintenance of this state. Tools to maintain long-term remission are still lacking but may be found in the ability to establish immunological tolerance. Tolerance can be induced in several specific and nonspecific ways, including manipulation of costimulatory signals, induction of regulatory T cells, and tolerization to heat shock proteins. Induction of disease control with the current combination therapies, followed by progressive withdrawal in parallel with re-establishing immunological tolerance, may be an attractive approach in the near future. ... Read more

Genetic Progress Towards the Molecular Basis of Common Autoimmunity

Abstract: Identification of the genetic determinants that underlie autoimmune diseases implicates new biochemical pathways in disease pathogenesis. The authors describe how recent advances in genetic knowledge of autoimmunity have pointed to aberrant negative regulation of autoreactive T-cells as a key step in autoimmunity. The tissue specificity of autoimmune attack is also under genetic control and variations in tissue-specific factors also appear to have a role. ... Read more

Malignancy Risk in Autoimmune Rheumatic Diseases

Abstract: Autoimmune diseases are chronic disorders and are highly prevalent in the population. It is thus logical to see whether patients with autoimmune rheumatic diseases are more prone to cancer. Studies show that most autoimmune diseases are not linked to cancer. However, patients with rheumatic arthritis or systemic lupus erythematosus do have an increased risk for lymphoma. ... Read more

HMGB1: An Immune Odyssey

Abstract: HMGB1, the high mobility group box 1 protein, is a busy molecule. In the nucleus, it bends DNA and regulates various biochemical transactions. Outside cells, it is a potent signal of inflammation that sets the innate immune system on a fast-track response to injury and inflammation. ... Read more

Crypticity of Self Antigenic Determinants Is the Cornerstone of a Theory of Autoimmunity

Abstract: Self antigens can have dominant and cryptic (hidden) antigenic determinants. T cells that can see the dominant antigenic determinants are tolerized and "disarmed." T cells that may still see the cryptic determinants are active and become a part of the T cell repertoire. Under certain circumstances when these T cells are more capable of "seeing" the cryptic antigenic determinants or the cryptic determinants unveil themselves, autoimmunity ensues. ... Read more

Can Infections Prevent or Cure Allergy and Autoimmunity?

Abstract: Empirical and scientific data support the phenomenon that infections can prevent and alleviate certain allergy and autoimmune diseases. The author discusses the mechanism behind it and how to maximize the benefits without revoking the deadly consequences of infections. ... Read more

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