Predicting rheumatoid arthritis

RA is a chronic inflammatory disease caused by an immune system-mediated destruction of joints. Patients experience significant pain and discomfort, while reduced mobility negatively impacts their quality of life. Inflammation can also extend to areas outside the joints, thereby affecting other tissues and organs.

Although there is no cure for RA, if it is diagnosed early it is easier to control and the outcome is less severe. To provide further insight into RA development and improve prediction, scientists on the EU-funded project 'Towards early diagnosis and biomarker validation in arthritis management' (EURO-TEAM propose to identify disease-related biomarkers. The ultimate goal is to identify individuals at risk of developing RA and to promptly administer preventative treatments.

For this purpose, they have performed genomic, metabolomic and antibody analyses of samples taken from cohorts of asymptomatic individuals with genetic risk factors, environmental risk factors or systemic autoimmunity. Their profiles will be compared with data from RA patients or from individuals with joint-related symptoms. The idea is to identify signatures predictive of the development of RA and to develop predictive tests.

So far, researchers have observed the presence of anti-carbamylated protein antibodies in patients with established RA and in individuals at risk. Additional autoantibodies have been associated with RA development, and the predictive power of metabolites is currently being evaluated.

In another part of the study, partners are examining synovial and lymph node tissue from individuals at risk for potential cellular alterations. Preliminary observations indicate an increase in pro-inflammatory cell content and activity at very early stages of the disease.

The work of the EURO-TEAM project is set to provide fundamental knowledge on the early events that drive RA development. Equally important is to support patients in their decision-making process and interpretation of the risk information. Significant study efforts are thus also devoted to this area.