How Will the New Drugs Be Different?
These new drugs will be unique in that they target fibroblast-like synoviocytes (FLS), which are the specialized cells in the synovial joint lining. They line the joints to provide lubrication and cushioning, preventing against and repairing injuries.
However, once activated, like during the autoimmune process of RA patients, the cells can actually attack the healthy cartilage and tissue surrounding the joint. In patients with RA, the synoviocytes are what cause the most joint and cartilage destruction, yet, until now, no drug approach has targeted them directly.
Taking it a step further, even if biologics or immunosuppressants have an RA patient’s immune activity under control, synoviocytes can still cause structural, skeletal damage to the patient’s joints. This may explain why some patients still experience pain and disability while inflammation rates and swelling are relatively under control.
The novel drug target that these researchers have identified will work on altering the enzyme receptor response that triggers the destructive activity of synoviocytes, using a sort of molecular decoy. Scientists envision this new method of treatment being used either in lieu of, or in addition to, existing RA therapies.
According to Dr. Bottini, “The ultimate goal is to use biologics that target synoviocytes in combination with treatments that suppress the immune system, such as methotrexate or anti-TNF, to address all three aspects of rheumatoid arthritis: swollen joints as a result of inflammation, cartilage damage, and bone damage.”