Precision medicine in rheumatoid arthritis – new research findings

Investigations into a gene that increases the risk of severe rheumatoid arthritis in susceptible people may lead to the development of treatment based on genetic profiles, says a study in The Proceedings of the National Academy of Sciences.

Experts focused on MIF, a gene that is associated with severe rheumatoid arthritis.

They did experiments with cells from the rheumatoid joint of people who either had a disease-causing, high- expression variant of the MIF gene or a disease-protective, low-expression variant of the MIF gene.

“We showed that the presence of the high-expression risk variant led to more MIF production and to structural alterations in a cell surface protein that had long been associated with invasive cancers,” explains Dr Richard Bucala, who is involved in the work. “The high-expression MIF risk gene helps explain the cancer-like properties of the rheumatoid joint.”

This finding could lead to the application of MIF inhibitors for severe rheumatoid arthritis in genetically susceptible people. In the current study, the researchers used these drugs as well as new inhibitors to suppress the invasive effect of MIF on rheumatoid joint cells.

“It’s a precision-medicine approach to treating autoimmune disease,” Dr Bucala says. “Patients with a risk MIF genotype would be most effectively treated by such drugs.”

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