How can studying the immune system help arthritis treatments in the future?

29 July 2020
Debs holding a pile of tablets in her hand, signifying how many she needs to take each day to be pain free.
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Understanding more about the immune system and the role it plays in conditions like lupus, rheumatoid arthritis and psoriatic arthritis will help us to develop more effective treatments in the future.

The immune system is the body’s defence against foreign cells that cause infection or disease, known as pathogens, including viruses.

What is a normal immune response?

When the body encounters a pathogen, alarm bells start ringing. The immune system mounts two types of immune response. The first is the Innate immune response – the body’s first line of defence. This response refers to all the non-specific defence mechanisms of the body to help fight disease as quickly as possible.

These include:

  • Physical barriers (the skin, stomach acid, eyelashes)
  • Chemicals in the blood
  • Certain types of immune cell

Then there’s the adaptive immune response – the body’s second line of defence. This is a specific response, which results in the body creating a ‘memory’ of the pathogen (just like after a vaccine). It involves types of white blood cells known as ‘B-cells’ and ‘T-cells’.

Disorders of the immune system

Sometimes the immune system can mount responses against the body’s own healthy cells, these are known as disorders of the immune system, and includes autoimmune or inflammatory diseases.

Over 80 autoimmune diseases have been identified, including musculoskeletal diseases like rheumatoid arthritis (caused by the immune system attacking the lining of the joint, called the synovium) lupus (caused by overactive B-cells) and psoriatic arthritis (caused by overactive T-cells).

The importance of our research

Our funded research was instrumental in discovering the class of treatments for inflammatory arthritis known as biologics.

Our clinical trial in 1994 demonstrated the effectiveness of anti-TNF therapy in rheumatoid arthritis and led to the development of anti-TNF drugs (like infliximab), which have treated millions of patients with inflammatory disease since approval in 1998.

What are immunosuppressants and how do they help?

Treatments of autoimmune diseases vary depending on the type and severity of the condition, and immunosuppressants are often required alongside pain-relieving medication.

Immunosuppressants are drugs that reduce or suppress the strength of the immune system to stop it from attacking healthy cells.

While preventing the attack of healthy cells, immunosuppressants also leave the body more vulnerable to infections, and can make infections harder to treat.

Immunosuppressants used to treat people with certain types of arthritis include:

  • Steroids (e.g. prednisolone). Used to reduce inflammation, often used short term to treat flare-ups.

They are known as ‘all-rounders’, inhibiting a variety of different immune cells to supress the immune response.

Used to ease the symptoms of a condition and slow its progression, often a long-term medication. Each DMARD drug has a unique plan of action, targeting different components of the inflammatory pathway.

Typically used in combination with, or instead of the conventional DMARDS. They are designed to target individual molecules in the immune system.

  • JAK-Inhibitors (e.g. tofacitinib). A new type of medication, often given to people who cannot take conventional DMARDS or biological therapies. These drugs block the action of JAK molecules in the immune system.

Those with an autoimmune condition and/or receiving treatment to control the immune system are at higher risk from COVID-19.

We’re committed to supporting research

We currently invest £134.6 million in cutting-edge research, of which over £60 million (45%) is dedicated to inflammatory arthritis and immune system research, aiming to better understand arthritis as well as develop new drugs, treatments and ways to manage the condition. Ultimately, this research aims to improve the quality of life for people with arthritis .

Find out how you can support our vital services and help people living with arthritis.

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