Rheumatology Medical News about JIA;heat shock protein 60 reactive T cells

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Heat shock protein 60 reactive T cells in juvenile idiopathic arthritis: What is new?
Arthritis Research & Therapy, 05/28/09

Vercoulen Y et al. – A Review on the role of heat shock proteins (HSPs), especially HSP60, in modulating immune responses in both experimental and human arthritis, with a focus on juvenile idiopathic arthritis (JIA). The tolerogenic immune responses induced by HSPs, which could have a beneficial effect in JIA is also discussed. The immune modulatory capacity of HSPs, and the underlying mechanisms of HSP60-mediated immune regulation in JIA, and how this can be translated into therapy is the main focus of this article.

HSPs in general can induce a tolerogenic immune response, in vitro, in vivo, and also in clinical trials in RA and type 1 diabetes
This tolerogenic response is marked by the induction of IL-10, an immune suppressive cytokine
Previous attempts at treatment with recombinant IL-10 in clinical trials have not led to improvements in RA pts
HSPs probably not only increase IL-10 production by T cells, but also promote interactions of these cells with other immune cells, eventually leading to a tolerogenic response

Towards therapy:

To create a therapeutic window for HSPs, it may be important to first dampen chronic inflammation in the joints by using anti-TNFα therapy
Second, the combination of HSPs and modulators of innate immunity, such as pathogenic patterns, should be investigated more thoroughly
The combination of these two immune modulators may induce a stronger and longer lasting effect on the immune system by HSPs

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