Emerging patterns of genetic overlap across autoimmune disorders

Most of the recently identified autoimmunity loci are shared among multiple autoimmune diseases. The pattern of genetic association with autoimmune phenotypes varies, suggesting that certain subgroups of autoimmune diseases are likely to share etiological similarities and underlying mechanisms of disease. In this review, we summarize the major findings from recent studies that have sought to refine genotype-phenotype associations in autoimmune disease by identifying both shared and distinct autoimmunity loci. More specifically, we focus on information from recent genome-wide association studies of rheumatoid arthritis, ankylosing spondylitis, celiac disease, multiple sclerosis, systemic lupus erythematosus, type 1 diabetes and inflammatory bowel disease. Additional work in this area is warranted given both the opportunity it provides to elucidate pathogenic mechanisms in autoimmunity and its potential to inform the development of improved diagnostic and therapeutic tools for this group on complex human disorders.

Tumour necrosis factor-alpha blockers in rheumatoid arthritis: review of the clinical experience

Tumour necrosis factor (TNF)-alpha has been found to play a central role in the pathogenesis of rheumatoid arthritis, leading to development of novel drug therapies that neutralise the deleterious effects of this cytokine. This new concept of immunobiological treatment of rheumatoid arthritis has yielded successful results. Although the 2 currently available TNFalpha blockers, infliximab and etanercept, differ in structure, mechanism of action and pharmacokinetics, they have provided similar benefits both in clinical improvement and in slowing and even arresting the progression of radiographic damage. This therapeutic response seems to be unequalled by "conventional" treatments in rheumatoid arthritis, and is incontestably a turning point in the therapeutic management of this disease.

[Late cerebral radionecrosis of cystic aspect]

Two cases of delayed cerebral radionecrosis with cystic presentation are reported. The patients had received radiation therapy for a cutaneous tumor 16 and 12 years before. Surgical extirpation of the cerebral lesion permitted to confirm the diagnosis and to treat the patients with success. A cystic aspect has been reported rarely in the neuroradiologic descriptions of the cerebral radionecrosis in the literature. Its mechanism is discussed. The treatment of the delayed cerebral radionecrosis is not clearly established, but a cystic presentation is an argument for surgery.