Rheumatism Therapy


"A peace offer for the immune system ?"


About one in every hundred people suffer from arthritis. A perfidious disease - body defense attacks one's own joints. A new therapeutic approach is to bring the immune system to stop the long-term attack.


By Nina Weber


Rheumatoid arthritis: Constant inflammation in the joints


Multiple joints swell, are stiff, warm and painful: these are typical symptoms of rheumatoid arthritis. Often it hits the finger joints on both hands, but almost all joints can cause discomfort in the colloquially referred to as rheumatism disease - from the shoulder to the toes.


Due to the ongoing inflammation, the joints can deform and stiffen over time, in addition, the power can disappear. Movements requiring dexterity become difficult or even impossible. In addition, many suffer from flu-like symptoms, they are tired and exhausted.


It is estimated that around 800,000 people in Germany have rheumatoid arthritis, women are more likely to have it than men, and the risk of the disease increases with age.  (Numbers in the UK reprted at aprox 400,000 increasing by 20% per annum - Website Editor)


Although there are several medications that can stop the disease from progressing, they need to be taken permanently.


An international team of researchers has now introduced a different approach that aims to bring the unbalanced immune system back into balance. Whether the method, which has now been tested for the first time in a small study with 34 patients, fulfills this great hope, has yet to be seen in larger studies.

The typical rheumatism complaints arise because the immune system permanently attacks the body's own cells. "In the body, such autoimmune attacks are constantly taking place," explains Hendrik Schulze-Koops, Head of the Rheumatism Unit at the LMU Munich Hospital. "Usually this is not a problem because controls are in place to stop such attacks quickly." However, this control does not work for autoimmune diseases such as rheumatoid arthritis. The attacks, which are otherwise contained in time, then find no end: Own tissue is destroyed so gradually.


The immune system should “re-learn”

In order to pacify the body's defense, the team around Ranjeny Thomas from the University of Queensland, Australia, wants to use the immune cells of the affected patients. After all, there is also in your body that cell type that could stop the permanent attack. Specifically, they took blood from patients and isolated dendritic cells from it. These play an important role in the immune system because they can detect harmful invaders and initiate an attack.


The researchers then added to the extracted cells that some of the body's own structures, which are proven to be targets of the immune system in arthritis, are considered harmless. Then they injected the patients back into the blood. The hope was then that the cells spread their laboratory knowledge into the body.


18 patients received their manipulated cells, 16 served as a control group, as the researchers report in the journal "Science Translational Medicine" . Serious side effects did not occur - for exact information on possible side effects, the study is too small, they could only show that the method is basically safe.

The researchers also say little about the possible benefits of the therapy. The participating patients did not suffer from acute, severe inflammation due to their arthritis. And the observation that the subjects treated with the new method after one month was a little better than the control group is to be treated with caution in the small number of participants.

But: "It is a highly interesting and intelligent approach," says the Munich physician Schulze-Koops. "So far, we can only suppress the inflammatory response, and if the method actually works, it could actually cure the disease."


Until then, however, there are a few questions: is it actually sufficient to drain some prominent targets from the immune system - or is the imbalance much deeper?And if the method works, how long does it last? What side effects can the treatment bring?


Especially important is an early diagnosis

Until all this has been clarified, the already established therapies remain. Most importantly, it is important for arthritis patients to get the right diagnosis as soon as possible so they can take medicines that control the inflammation. Only in this way can damage to the joints be delayed for a long time or completely avoided.


"There are offers from rheumatologists all over Germany to ensure that patients with suspected rheumatoid arthritis get a specialist appointment very quickly," says Schulze-Koops.

With today's methods it is possible to reach a state in which the disease does not progress in 30 to 50 percent of the patients.   


But they would have to take medication permanently.