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Advisor(s)
Abstract(s)
A artrite reumatóide é uma doença inflamatória crónica sistémica, de causa
desconhecida, associada a alterações imunológicas diversas.
As células do sistema imunológico são altamente específicas e cada tipo de
célula exerce funções próprias , que concorrem para uma resposta imune
efectiva e bem organizada. Estão envolvidas neste processo citocinas pró
inflamatórias, que medeiam a inflamação.
Apesar de ainda não estarem completamente clarificados todos os
componentes relevantes da resposta inflamatória, os seus mecanismos de
acção e as suas funções na patologia na Artrite Reumatóide, os dados
disponíveis permitiram nos últimos 10 anos o desenvolvimento de agentes
terapêuticos inovadores – os fármacos biotecnológicos.
São agentes anti-reumáticos modificadores da doença que actuam bloqueando
citocinas específicas ou os seus receptores, envolvidos no processo
imunológico.
Os fármacos biotecnológicos Infliximab, Etanercept e Adalimumab actuam
antagonizando o Factor de Necrose Tumoral Alfa e o fármaco Anakinra
antagoniza os receptores da interleuciina 1. O Abatacept liga-se às moléculas
CD80/CD86 bloqueando a activação das células T, o Rituximab é um anticorpo
monoclonal anti-CD20, existentes na superfície das células B e o Tociluzimab
antagoniza as funções da interleucina 6.
Como são potentes imunossupressores, existe o risco de surgirem ou de se
agravarem infecções agudas ou crónicas ou de reactivar infecções latentes,
com efeitos prejudiciais para o hospedeiro.
A utilização desta terapêuticaobriga a cuidados permanentes na cirurgia e na
gravidez.
Com este estudo pretende-se fazer uma revisão detalhada da fisiopatologia da
artrite reumatóide, nomeadamente no que se refere aos mecanismos
moleculares subjacentes e explicar o enquadramento das diferentes terapias
com agentes biológicos modificadores da doença.
Adicionalmente pretende-se rever as indicações dos agentes biológicos nesta
patologia, os critérios de monitorização do tratamento no que se refere à
avaliação de eficácia e segurança e a sua utilização em casos particulares
como a gravidez e cirurgias.
The rheumatoid arthritis is a systemic disease inflammatory cronic, of unknown cause, associated with inflammatory immunological changes. The cells of immunological system are highly specific and each type of cell performs its own functions that contribute to an effective immune response and well-organized. Are involved in this process pró inflammatory cytokines which mediate inflammation. Though still not completely clarified all relevant components of the inflammatory response, their mechanisms of action and their role in the pathology of rheumatoid arthritis, the available data in the last 10 years have enabled the development of innovative therapeutic agents - biological agents Agents modifying anti-rheumatic disease that act by blocking specific cytokines or their receptors involved in immunologic process. The biological agents Infliximab, Etanercept and Adalimumab act by antagonizing the Tumor Necrosis Factor Alpha and drug Anakinra antagonizes receptor interleukin 1. The Abatacept binds to CD80/CD86 molecules blocking the activation of T cells, Rituximab is a monoclonal antibody anti-CD20 on the surface of B cells and Tociluzimab antagonizes the functions of interleukin 6. Beeing potent immunosuppressants, exist the risk of arise or worsen acute or chronic infections or reactivated latent infections, with harmful effects to the host. The use of that therapy creates particularities in surgery and pregnancy. With this study we intend to do a detailed review of the pathophysiology of rheumatoid arthritis, particularly in relation to adjacent molecular mechanisms and explain the environment of different treatments with biological diseasemodifying agents. Additionally we intend to review the particulars of biological agents in this disease, the criteria for monitoring of treatment with regard to the evaluation of efficacy and safety and their use in special cases such as pregnancy and surgery.
The rheumatoid arthritis is a systemic disease inflammatory cronic, of unknown cause, associated with inflammatory immunological changes. The cells of immunological system are highly specific and each type of cell performs its own functions that contribute to an effective immune response and well-organized. Are involved in this process pró inflammatory cytokines which mediate inflammation. Though still not completely clarified all relevant components of the inflammatory response, their mechanisms of action and their role in the pathology of rheumatoid arthritis, the available data in the last 10 years have enabled the development of innovative therapeutic agents - biological agents Agents modifying anti-rheumatic disease that act by blocking specific cytokines or their receptors involved in immunologic process. The biological agents Infliximab, Etanercept and Adalimumab act by antagonizing the Tumor Necrosis Factor Alpha and drug Anakinra antagonizes receptor interleukin 1. The Abatacept binds to CD80/CD86 molecules blocking the activation of T cells, Rituximab is a monoclonal antibody anti-CD20 on the surface of B cells and Tociluzimab antagonizes the functions of interleukin 6. Beeing potent immunosuppressants, exist the risk of arise or worsen acute or chronic infections or reactivated latent infections, with harmful effects to the host. The use of that therapy creates particularities in surgery and pregnancy. With this study we intend to do a detailed review of the pathophysiology of rheumatoid arthritis, particularly in relation to adjacent molecular mechanisms and explain the environment of different treatments with biological diseasemodifying agents. Additionally we intend to review the particulars of biological agents in this disease, the criteria for monitoring of treatment with regard to the evaluation of efficacy and safety and their use in special cases such as pregnancy and surgery.
Description
Keywords
Artrite reumatóide Artrite reumatóide - Sistema imunitário Artrite reumatóide - Fármacos biotecnológicos Artrite reumatóide - Imunosupressores Artrite reumatóide - Terapia biotecnológica - Cirurgia Artrite reumatóide - Terapia biotecnológica - Gravidez
Citation
Publisher
Universidade da Beira Interior