NEJM: Newly discovered cell types help predict and treat rheumatoid arthritis.

!--:page title" -- When Dana Orange's patient suddenly developed rheumatoid arthritis (RA), the consequences were catastrophica woman who was so sore that she couldn't even bend her elbow and brush her teethanother one couldn't support the weight of her purseonce, it takes 30 minutes to get up and 90 minutes to get dressedbut rheumatologist at Rockefeller University, Orange says the worst part is that these attacks are completely unpredictablea new study may change thatOrange and her colleagues found that in the weeks before the onset of rheumatoid arthritis, a newly discovered cell accumulates in the blood, which can trigger arthritisif researchers were able to diagnose or treat these cells, they could predict or even prevent SADirk Elewaut, a rheumatologist at the University ofGhent who was not involved in the study, said the new findings are "interesting" because they can help clinicians and patients control the ups and downs of the disease more effectivelyPhoto Source: Science Rheumatoid Arthritis is an autoimmune disease that causes debilitating pain and irreversible joint damage, among other symptomsestimates that 1.3 million people in the United States are suffering from the disease, with women more than twice as likely as men to develop the diseaseanti-inflammatory and immunosuppressive drugs can help control the condition, but the effects of these drugs may diminish over time, with up to a third of patients taking them developing a rashto better understand how this situation changes day by day, Orange and his colleagues decided to track the blood of five patients with uncontrolled rheumatoid arthritisthey wanted to know if there was a consistent change in the type of RNA circulating in the blood before the virus broke outbut the team believes that the ideal tracking requires patients to go to the lab at least weekly to draw bloodit's not realistic for patients, so they asked five volunteers to collect their own blood at home once a week (and if their blood suddenly swells, they do it several times) - similar to the way some diabetics monitor their conditionresearchers have also developed a new buffer solution that, when mixed with blood samples, can hold RNA for at least 24 hours, allowing patients to mail their blood samples to the team's labOverall, blood pumping lasted more than 200 weeks, a time of "blood, sweat, tears," said Robert Darnell, a neurooncologer at Rockefeller University inand senior author of the studywhen the team finally examined the samples, the researchers analyzed which RNA was rich before, during, and after each patient reported an outbreak, they then matched the data with the known characteristics of the cells that cause inflammation to reproduce patterns of immune activitythat's when they found a "significant, unexpected RNA signal."its source is interstitial cells, which develop into connective tissue in the body and fill the space between jointsthis interstitial cell RNA continued to appear in the weeks before each patient's outbreak, with inflammatory-related RNA appearing simultaneouslythis led the team to call these special cells pre-inflammatory hyperlipidrecells (PRIME)to verify their findings, the researchers then took samples from 19 other patients with rheumatoid arthritis and found that THE LEVELS OF PRIME WERE much higher than those of the health control group, which recently reported in The New England Journal of MedicineDarnell said that while the findings do not mean that PRIME cells cause attacks, these patterns suggest that they are part of the arthritis attackresearchers also found RNA signatures associated with immature white blood cells, which peaked in the days before PRIME cells became activewhite blood cells are responsible for initiating the cascade response of immune activity -- recruiting other inflammatory cells to complete -- and the dysfunctional white blood cells are associated with a variety of autoimmune diseases'Taken together, this finding suggests that PRIME cells can be mobilized by abnormal immune system activity,' said Darnell,Picture Source: Previous research by NEJM has found that similar inflammatory connective tissue cells cause joint disease in mice, but this is the first time such cells have been found in human blood, said Robert Winchester, a rheumatologist at Columbia University, that this makes the study "important" because it can lead researchers to the manipulation of these cells to control disease however, Elewaut warned that the study was only a first step to know exactly how PRIME cells affect the outbreak, there will be a "massive" number of experiments other experts excited about the new buffer solution Stanley Cohen, a rheumatologist at the University of Texas Southwestern Medical Center who wasn't involved in the study, said the study could help researchers monitor the activity of patients with other autoimmune diseases, including lupus and aggressive spina bifida "It's easy to imagine copying and pasting the whole method into" other diseases, says Darnell include COVID-19, because severe cases are characterized by large numbers of immune cells, clotting factors, and other inflammatory signals in the blood Darnell has begun to adjust the way COVID-19 is monitored in isolated patients at home Darnell said the findings could help researchers "take the Benjamin Franklin approach to fire prevention: one point of prevention, not one-point treatment." " Orange sees more specific benefits for her patients If PRIME cells help with diagnosis and treatment, "you can at least plan your life and even stop the onset of inflammation." " () References: Newly ed cell may-help-drisque oed, treat rheumatoid arthritis-!--/ewebeditor: page-!---e-webeditor: page-title"----RNA-Image of THE RNA-Gear-Cells-Cells-Rheumatoids Flares The Journal Of England A.P., Campos, J., Jansen, K Et al Distinct fibroblast subsets drive and damage in arthritis Nature 570, 246-251 (2019) https://doi.org/10.1038/s41586-019-1263-7Long-Term Effectiveness of Adalimumab in Patients with Rheumatoid Arthritis: An Observation Analysis from the Corrona Rheumat arthritis Rhoitod Arthritis Registry do scoronavirus kill? Clinicians trace a rampage a body, from brain to toes !--/ewebeditor: page.