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The Journal of Bone and Joint Surgery 81:152-157 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Arthritis: Is the Cure in Your Genes?*{dagger}

JAMES H. HERNDON, M.D.{ddagger}, BOSTON, MASSACHUSETTS, PAUL D. ROBBINS, PH.D.§ and CHRISTOPHER H. EVANS, PH.D., D.SC.§, PITTSBURGH, PENNSYLVANIA

*One or more of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. In addition, benefits have been or will be directed to a research fund, foundation, educational institution, or other nonprofit organization with which one or more of the authors is associated. Funds were received in total or partial support of the research or clinical study presented in this article. The funding sources were National Institutes of Health Grants PO1 DK44935 and RO1 AR43623.


   Introduction
 
Rheumatoid arthritis is incurable and difficult to treat with traditional pharmacological approaches. Because conventional drug therapy has clearly failed to conquer this distressing condition, novel therapeutic strategies are required. We are not referring to the numerous dubious alternative methods touted by the tabloid press but to new possibilities arising from the results of serious laboratory investigation. Recent research into the biology of rheumatoid arthritis has identified a number of proteins with promising antiarthritic properties22, but their application to human disease is limited by difficulties in delivering them in a targeted, sustained fashion for extended periods of time.

Most investigators would agree, in general terms, that the natural history of rheumatoid arthritis is as follows. In genetically susceptible individuals, an unknown environmental agent triggers an autoimmune response, which leads to the production of mediators, particularly cytokines, that drive the pathophysiological processes leading to the clinical manifestations of rheumatoid arthritis. Therapeutic . . . [Full Text of this Article]


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