- Scientists Discover Cure
For Arthritis
- By Robert Matthews, Science Correspondent
- http://www.telegraph.co.uk
- 10-29-00
- The first evidence of a safe and effective
cure for rheumatoid arthritis, the crippling disease that affects
many, is to be unveiled by British scientists.
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- Until now doctors have been able to offer only
limited pain relief. Now a team of researchers at University
College, London, has identified drugs that produce significant
improvements in patients. In results to be announced at an
international scientific conference tomorrow, the team will show
that patients see a dramatic improvement after a single treatment,
with some apparently cured of the disease completely.
- The success with patients treated so far - all of
whom had failed to respond to any standard therapy - has been so
impressive that an international trial of the treatment is now under
way.
- Richard Gutch, the chief executive of Arthritis
Care, a charity, said last night: "This sounds like one of the
new biologic treatments for rheumatoid arthritis which we feel
represent a very exciting breakthrough. Although they are not
necessarily going to be appropriate for all people with arthritis,
certainly those with more severe rheumatoid arthritis would benefit
greatly. Drug budgets should be increased to allow for that."
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- The scientists believe that they have discovered
what causes the body's defenses mistakenly to attack healthy joints
and tissue. The breakthrough focuses on the role of so-called
B-cells, white blood cells that defend the body against viruses and
bacteria by making antibodies. Although these antibodies are made at
random by B-cells, most of them prove useful against some microbe or
other.
- Every so often, however, the B-cells accidentally
make antibodies that attack healthy tissue. Worse still, some of
these errant antibodies also trigger the production of copies of
themselves. The result, according to the University College team, is
a huge self-sustained attack on joints and tissue, which appears in
the sufferer as rheumatoid arthritis.
- Professor Jonathan Edwards, who is leading the
research team, told The Telegraph: "It probably takes just one
genetic mistake in a
lifetime to trigger this reaction but once it gets going it becomes
a vicious circle."
- Prof. Edwards and his colleagues believe that they
have found a way to break the circle, using drugs that seek out and
destroy B-cells. He said: "Unlike with other cells in the
immune system, most people can live without any B-cells for a while.
By the time we reach adulthood we have already made most of the
antibodies we need."
- After a single treatment to wipe out all the
B-cells, the body responds by making fresh ones. The chances of
these new B-cells making the same mistake as their predecessors,
however, thereby triggering a return of
rheumatoid arthritis, is small.
-
According to Prof Edwards, results from the 20
patients treated so far have been extremely encouraging. He
said:." After 18 months the first five patients - who have had
rheumatoid arthritis for an average of 20 years - now have only some
residual pain from the damage already done. They have returned to
leading a more or less normal life, with one going to the gym and
one taking up gardening for the first time in ages. So far, of the
total of 20 patients only two have had no benefit at all." These initial findings - about to be published in
Rheumatology, the leading journal - will be announced tomorrow at
the annual meeting of the American College of Rheumatology. Until
now doctors could offer one sufferer, Marion Selfe, aged 61, from
Enfield, nothing beyond painkillers. She said: "I'm really
excited by the new research."
-
- Mrs Selfe, who has suffered with the disease since
1965, losing the use of her wrists and now in need of an artificial
elbow joint, went on: "Not all drugs work for everyone but
without all the hard work of these scientists there wouldn't be any
treatment at all." Prof Edwards and his team believe that their
B-cell-based therapy might also offer hope to patients with other
auto-immune diseases, such as Crohn's disease, lupus and even
multiple sclerosis.
- Prof Edwards said: "If our explanation is
right, auto-immune diseases may be like bugs in a computer program.
If you happen to press certain keys in a particular order it
crashes. The solution is to turn everything off and start up afresh
- which in this case means using drugs to eliminate all the
B-cells."
- The team is hoping to refine the therapy by
targeting only the errant B-cells. Prof Edwards said: "This
would allow us to use a rapier rather than a bludgeon. Even so, on
the basis of the data we have we now believe it is typically
possible to keep people completely well for at least a year, with
virtually no side-effects."
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