Subject: Latest research into RA by the Garvin Institute

There is currently no cure for rheumatoid arthritis, although progression of the disease can be slowed, the symptoms can be treated, and a person can be helped to adjust to the condition. Early management is vital in order to optimise function and minimise pain and long-term disability.

Physiotherapy is recommended to relieve pain and stiffness, improve joint movements and strengthen muscles. Rest is important when the joint inflammation worsens. Occupational therapy, including training, provision of splints, and aids such as walking aids and specialised cooking utensils, helps people to do daily activities more easily and with less pain.

Medicines, often taken in combinations, play an important part in dampening the inflammatory and autoimmune process. They include non-steroidal anti-inflammatory drugs, corticosteroids, immunosuppressant drugs and disease-modifying anti-rheumatic drugs (DMARDs). Tumor necrosis factor (TNF) alpha blockers are a class of DMARDs and a relatively new form of treatment that is used in patients with moderate to severe rheumatoid arthritis.

Diet is a factor that may influence the severity of arthritic symptoms. Fish oils that contain omega-3 fatty acids have been found to help reduce disease-associated inflammation. In some cases, where a joint (such as the knee) has been badly damaged, joint replacement surgery is an option.

Researchers at the Garvin Institute are dissecting the immune cellsā signalling pathways, to find points of intervention that may help control inflammatory conditions, such as rheumatoid arthritis. Professor Charles Mackay and team recently developed an antibody that blocks the action of one of the most important inflammatory molecules, called C5a, from guiding inflammatory cells into tissue by binding to the cell surface receptor, called C5aR. It is anticipated that a therapy based around C5aR will be a significant improvement over current anti-inflammatory therapies, such as TNF-alpha blockers, because it acts at a different and earlier point in the inflammatory process. Garvanās C5aR antibody has already been used to completely reverse disease in mice with rheumatoid arthritis.

In another project, Garvin has discovered an enzyme that is part of the MAP kinase (MAPK) pathway and which is made only by immune cells. Investigating the role of this enzyme may deepen our understanding of numerous inflammatory conditions, including rheumatoid arthritis, asthma and multiple sclerosis. The MAPK pathway is one of the most important Īsensorsā found in our body cells. It transmits danger and environmental signals to cells, such as the presence of bacteria, and these signals are turned into actions.

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