by Roger Dobson
PUBLISHED: 21:34 EST, 20 August 2012 | UPDATED: 21:34 EST, 20 August 2012
Patients are being given injections of their own immune cells to help ease the pain of arthritic knees.
The treatment is being tested in a new clinical trial at Newcastle University — the theory is that it will ‘reprogramme’ the immune system in patients with rheumatoid arthritis.
The condition, which affects around 400,000 people in the UK, is triggered by the immune system malfunctioning and mistakenly attacking healthy tissue in the body, specifically the cells that line the joints.
Rheumatoid arthritis can strike at any age, unlike osteoarthritis, which tends to affect older people
This causes swelling, aching, throbbing pain and, eventually, deformity and damage to the joint.
It can strike at any age, unlike osteoarthritis, which tends to affect older people.
Hands, feet and wrists are most commonly affected, although other parts of the body can be damaged, too.
The cause of the disease is not yet known, but it’s thought an infection or a virus may be responsible, acting in some way on the immune system to turn off its protective ‘safety switch’.
There is no cure for rheumatoid arthritis and treatments are designed to improve symptoms, reducing inflammation in the joints, easing pain, and slowing joint damage.
Current treatments include disease-modifying drugs that slow down its progression by helping to dilute the strength of the immune-system attack, but side-effects can include sickness, diarrhoea, mouth ulcers, hair loss and rashes.
The new treatment is aimed at combating the disease at an earlier stage, by ‘re-educating’ immune system cells (patients in the trial have had the disease for six months or more).
The treatment is based on dendritic cells, key players in the immune system.
Their job is to patrol the body, seeking out threats such as bacteria or viruses.
As well as attacking these invaders, they also help to recruit other immune cells, called antibodies, which help defend the body.
Recent research at The Rockefeller University in New York and other centres has shown that dendritic cells have another key role: preventing immune cells from turning on the body and attacking healthy tissue.
Experts believe that, for some reason, in rheumatoid arthritis the dendritic cells lose their power.
Research on laboratory animals has shown that reducing dendritic cells leads to a collapse in the immune system’s ability to tolerate even harmless invaders, leading to the development of autoimmune disease.
Scientists think that a lack of dendritic cells may also play a role in other autoimmune conditions, such as multiple sclerosis and ulcerative colitis, where the large intestine becomes inflamed.
In the trial at Newcastle University, dendritic cells will be taken from the patient’s blood and then injected directly into their knee joints. The researchers aim to initially treat 12 patients.
Using an arthroscopy — a camera examination of a joint — nine of the patients will be injected with the dendritic cells and three with saline solution as a control treatment.
Their symptoms will be measured after seven, 14, and 91 days after the injection.
Commenting on the research, Anthony Hollander, professor of rheumatology and tissue engineering at the University of Bristol and a spokesperson for Arthritis Research UK, said: ‘The eventual goal here is to use the administered cells to suppress the autoimmune response, so switching off the arthritic process.
‘if it works, it might halt disease progression, but would not repair already damaged parts of the joint, and the cells would have to be administered regularly.’
An antibiotic used to treat acne is being given to patients with rheumatoid arthritis.
Scientists believe that the painful condition may be linked to bacteria in the mouth or intestinal tract.
It’s thought that killing the bacteria with antibiotics may have an effect on the immune system and reduce levels of inflammation around the joints.
In a trial at New York University, patients are being prescribed one of two antibiotics, doxycycline or vancomycin, or given a dummy treatment, for eight weeks.
Their levels of bacteria will be measured and immune system function assessed for up to five months after treatment.
Changes in either will be compared with those patients in the trial who did not receive antibiotics.
Doxycycline is commonly used to treat chest infections and malaria (as well as acne) — and stops bacteria from functioning — while vancomycin is also used to treat bowel complaints, and prevents bacteria from growing.