The early stages of rheumatoid arthritis: New targets for the development of combinational drug therapies

Abstract

Abstract Introduction The current methods of treating rheumatoid arthritis (RA) do not address the early phases of the disease progression and instead merely treat the symptoms. Whilst this approach may help to alleviate much of the pain and discomfort associated with RA, it does not stop the disease progression and the destruction of joint tissue still occurs. Furthermore, a number of serious side effects are associated with the current treatment modalities. A better strategy may be to eradicate the cause of the disease, thereby bypassing the later phase events. Until recently, this has not been possible due to a lack of understanding of the etiology of RA. However, recent advances have identified Proteus mirabilis as a trigger of the disease and have provided some understanding of the disease progression. An understanding of the early phases of the disease has identified a variety of new targets for anti-RA drug development which may allow for the development of new treatment regimes with increased efficacy and/or less serious side effects. Conclusion The current report examines the P. mirabilis bacterial trigger of RA and how it results in self-reactive antibody production. In so doing, the report highlights some targets for drug treatments aimed at blocking the early phases of RA before the more serious later phase events occur. Whilst it is unlikely that any single drug will be able to treat all aspects of this disease, resveratrol and other stilbenes are highlighted as a class of compounds which may have beneficial effects on several phases of RA disease progression.