Rheumatoid arthritis from a student's perspective

Do antivirals have any utility in the treatment of arthritis?

Viruses have been linked to arthritides by several pathways. Apart from the ability of different viral pathogens to cause arthritic symptoms directly, only some circumstantial evidence for the involvement of (retro)viruses in the pathogenesis of rheumatoid arthritis has been presented in recent years. Therefore, the question of whether antiviral agents can be used to treat arthritis has become of interest. However, the mechanisms by which exogenous retroviral infection as well as activation of endogenous retroviral sequences may potentially lead to the induction of rheumatoid arthritis is just beginning to emerge. Moreover, the hypothesis that persistent viral infection may account for some hitherto unclassified, chronic arthritides, still needs to be confirmed. Therefore, the use of antiviral agents in the treatment of arthritides has been limited to viral complications of anti-arthritic therapy and to some experimental approaches. In this review, we will focus on current concepts of viral involvement in arthritis and point to future directions in the use of antiviral agents for arthritis.

Retroviral sequences in rheumatoid arthritis synovium

There are several relationships between retroviruses and cellular transformation, as well as retroviruses being involved in the development of autoimmune diseases. Retroviruses have been discussed as etiologic agents modulating or triggering certain pathways in the pathogenesis of rheumatoid arthritis (RA). However, none of the currently known retroviruses has been identified as specific for RA. Due to the unique properties of retroviruses, distinct experimental approaches can be used to detect retroviral activity in cells and tissues. Current research in RA using state-of-the-art molecular biology techniques includes both the search for exogenous and endogenous retroviral gene sequences in synovium of patients with RA.

Experimental spondyloarthropathy in HLA-B27 transgenic rats

Rats of the LEW, F344, and PVG strains bearing high copy numbers of transgenes for HLA-B27 and human beta 2-microglobulin develop a multisystem disorder, many features of which resemble aspects of the human spondyloarthropathies, most dramatically axial and peripheral arthropathy. The disease is not seen in rats with comparable expression of HLA-B7, and so is relatively specific for HLA-B27. It requires T cells and another bone marrow derived cell, as well as an intact gut flora. Characteristic cytokine profiles distinguish the inflammatory infiltrates in the gut and the joint, and the earliest T cell infiltrates at these sites are polyclonal. Polymorphism at the Tap-2 peptide transporter locus has no significant effect on disease, whereas the DA strain background abrogates disease. The molecular role of the B27 molecule in disease remains to be elucidated, but there is good reason to believe that it will eventually yield to continued investigation of this animal model.