Currently, there are no cures for rheumatoid arthritis (RA), which affects 40,000 people in Ireland. The disease costs an estimated $22,000 per patient, per year with an overall cost to the health system of ~$608 million. Only 1 in 4 patients achieve remission and a significant proportion of patients have suboptimal responses or no response at all to current available therapies.
As it is impossible to predict who will develop severe, erosive disease and who will respond to treatment, a trial-and-error approach prevails, leading to potential irreversible joint damage before the patient has received the correct treatment. Now, a study by researchers at Trinity College Dublin and St Vincent's University Hospital proposes a better understanding of the site of inflammation in RA that will allow for the development of new treatment strategies or predictive biomarkers which could support the potential for a personalized medicine approach. The study is published in the journal Science Advances .
This work was led by Professor Ursula Fearon and Dr. Megan Hanlon from the Molecular Rheumatology Group in Trinity, and by Professor Douglas Veale, from St Vincent's University Hospital. The team performed an in-depth investigation of a specific population of cells: the macrophages that reside in the synovium of RA patients, individuals-at-risk of RA, and healthy controls.
Researchers demonstrated, for the first time, the presence of a dominant macrophage subtype (CD40-expressing CD206+CD163+.