Investigation- journal #9 : Rheumatoid Arthritis

Today, I'm reviewing two articles that I personally found interesting when I was researching about Rheumatoid Arthritis!!

The first article that I found interesting was about the proteomic analysis to define the predictors of some treatment options in RA patients. Even though this whole article talked about many other common treatment options, the main treatments included the use of adalimumab or methotrexate. In this article, the researchers used a multiplex bead-based approach where they analyzed the healthy controls as well as the RA patients for their similarities and differentiation in the autoantibody expression and the co-expression profiles to test the outcome of their treatment. Also if any of the autoantibodies expressed are the response from the treatment. For this study, the healthy controls were selected from the specimens from blood donors of Bavarian Red Cross, Germany, and the experimental subjects were 18 years or older RA patients commencing Methotrexate along with other DMARDS and oral steroids from the Rheumatoid Arthritis medication study. The other set of experimental subjects were RA patients commencing adalimumab which is an anti-tumor necrosis factor (TNF) used to treat the inflammation in the joints. Out of 376 autoantibodies tested 39 autoantibodies were expressed differentially in the patients with Rheumatoid arthritis when compared with the healthy controls and most of them were in a citrullinated form. The patients who tested seropositive for citrullinated form had an improved DAS28, whereas, patients with seronegative citrullinated form tend to get a worsen DAS28 in their first 3 to 6 months of treatment. 

This article is a peer reviewed article which was published in Pharmacogenomics journal in December 10, 2019 by the authors Stephanie F. Ling, Nisha Nair, Suzanne M. M. Verstappen, Anne Barton, Hans-Dieter Zucht, Petra Budde, Peter Schulz-Knappe, MATURA consortium, and, Darren Plant. 

The second article I read was about a small study conducted to study the perspectives of Primary Care Physicians when dealing with RA patients. For this study, the researchers randomly selected PCPs practicing in the United States. As part of the study, they conducted a survey via email which included questions about their experiences with the RA patients, how comfortable they are, rheumatological referrals, and their prescribing of the disease-modifying anti-rheumatic drugs (DMARDS drugs). The main goal of this study was to check and understand the experiences, attitudes, knowledge about how these PSPs have with the Rheumatoid arthritis patients since these were the doctors who get the first contact with the patients. There were also some complaints raised by the RA patients about how much care they receive from the PCPs and Rheumatologists. Therefore, this survey to a certain extent I believe was able to capture some insights about the treatments, attitudes, and experience of some PCPS. The study recorded that around 1,103 PCPs opened the survey but only 267 PCPs completed the survey. It was mostly men with an experience of 10 years having six RA patients completed this survey. It was interesting that only half of the doctors receive training for treating RA patients after their medical school years and out of this only one-third were confident in their treatment. Overall, from the study, it was clear that most of the PCPs weren't comfortable treating RA patients either due to lack of confidence and/or lack of experience. 

This article is also a peer-reviewed article written by Katie L Garneau, Mura D Iversen, Hsun Tsao & Daniel H Solomon published by Department of Physical Therapy School of Health Professions, Bouve College of Health Sciences Northeastern University on the November 18th, 2011. 

Citation:

Ling, S.F., Nair, N., Verstappen, S.M.M. et al. Proteomic analysis to define predictors of treatment response to adalimumab or methotrexate in rheumatoid arthritis patients. Pharmacogenomics J20, 516–523 (2020). https://doi.org/10.1038/s41397-019-0139-4

Garneau, K.L., Iversen, M.D., Tsao, H. et al. Primary care physicians' perspectives towards managing rheumatoid arthritis: room for improvement. Arthritis Res Ther 13, R189 (2011). https://doi.org/10.1186/ar3517

Vocabulary- Journal #8

Let's learn some new Immunological terms!! 

ITAM 

Immunoreceptor Try-based Activation Motif is a region in the cytoplasmic tail region where it is a mediator of intracellular signals and also a domain in the signaling chain that consists of protein and receptors. 

TCR

T-cell receptor is a complex containing integral membrane proteins which helps in the activation of T-cells in response to antigens.

Glycosylation

This is an important function that takes place in the Golgi apparatus and in the endoplasmic reticulum where it plays a role in the biosynthetic secretory pathway. About half of proteins that are expressed in cells undergo this change with sugar fragments covalently added to specific amino acids.

Reflection- journal #7: Know about Arthritis??

 

Hello Journal, 

    It was World Arthritis Day on October 12th, 2021! So, what is this Arthritis? 

A simple definition for arthritis would be swelling, tenderness, and pain in the joints which may come with many more symptoms. There are different types of arthritis. Some common types of arthritis that found are osteoporosis, psoriatic arthritis, rheumatoid arthritis, gout, and lupus. 

This past week, I had a project due for my immunology class and I did a small poster on the topic Rheumatoid arthritis. There's no specific reason why I chose this topic even though I do have family members who has diagnosed with arthritis in general. Since, I completed my project, I thought its ideal to reflect on what I said on my project through an immuno-journal. On my project, I started with a small introduction by defining what specifically "Rheumatoid arthritis" is. Rheumatoid arthritis is an autoimmune, inflammatory disease where the immune system sends the antibody to the lining of the joints and tissues which thereby causing the synovium to spread across the joints causing inflammation. My overall project also included sections of signs and symptoms, the risk factors and diagnosis, treatments, and also some detailed diagrams of the process in which rheumatoid arthritis occur. 

Working on this project was helpful for me as it gave me more knowledge on this specific disease which is widely seen in many population especially in the older community. Therefore, it always helps to educate ourselves and the people we know who has arthritis or show symptoms that is similar to rheumatoid. And I do support with all these projects because it allows us to choose the topic we love to research on and develop our abilities, skills, and knowledge needed for further studies. 

Immuno-Encounter #6!!

Hello journal readers...

On a Saturday evening, doing a bit of door dash food delivery, I was assigned an order from a nearby restaurant to an elderly nursing home/assisted home. I collected the food and reached the assigned location, parked my car, and walked into the building. I found myself in a silent hallway with a lot of small apartments on either side. As I was searching for the correct apartment number for the delivery, there were different signboards on each door. I didn't care much to read all the signboards until I reached my assigned apartment, where I saw a signboard stating "DANGER! Someone in this apartment has an Autoimmune disease". As I was unaware of what to do next, I knocked on the apartment door. A female voice through the speaker, which was beside the door told me to place the food package by the door. I kept the food outside and as I started walking back, the door opened and a person in a full PPE gown stepped out, sanitized the outer cover of the package, and took it inside the apartment. 

At that moment, I remembered the class at my university on autoimmune disorders and the discussions held in class. Autoimmune disease is a condition in which one's immune system attacks its own healthy living cells. This compromises the immune system, making it susceptible to diseases easily which can have fatal consequences. Apparently, this might be the reason why the person was wearing a PPE kit gown and sanitized the package before taking it into the apartment regardless of the covid safety measures.