Publicação
Rheumatoid arthritis and Paget’s disease of the bone : osteoimmunology and the role of interleukin 6
| Resumo: | Rheumatoid arthritis (RA) is a chronic multisystemic disease, affecting 0.5–1% of the adult population, characterized by synovial and systemic inflammation. Paget’s disease of the bone (PDB) is a chronic metabolic bone disorder, affecting up to 3% of adults over 55 years of age, characterized by areas of increased bone remodelling. In both RA and PDB, excessive local bone resorption and inadequate bone formation result in progressive bone erosions, reflecting the clinical consequence of the close interplay between immune activation and bone metabolism. Although the aetiology of both diseases is still unknown, genetic and environmental factors contribute to a common underlying immune dysregulation. Interleukin-6 plays a dominant role in the pathogenesis of the increased bone resorption observed in both conditions. Understanding the interplay between the immune and skeletal systems may enable further insights into the pathogenesis of bone destruction, as well as serving as new strategy for drug design. This thesis reports the case of a 60-year-old female diagnosed with both RA and PDB. Both pathologies seldom coexist in the same patient, making this case singular not only because of the inherent complexity of the clinical and imaging evaluation, but also for the possibility of a common therapeutic target. |
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| Autores principais: | Boavida, Leonor Peixoto Pestana |
| Assunto: | Artrite reumatóide Osteíte deformante Doença de Paget do osso Interleucina-6 Osteoimunologia |
| Ano: | 2015 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Rheumatoid arthritis (RA) is a chronic multisystemic disease, affecting 0.5–1% of the adult population, characterized by synovial and systemic inflammation. Paget’s disease of the bone (PDB) is a chronic metabolic bone disorder, affecting up to 3% of adults over 55 years of age, characterized by areas of increased bone remodelling. In both RA and PDB, excessive local bone resorption and inadequate bone formation result in progressive bone erosions, reflecting the clinical consequence of the close interplay between immune activation and bone metabolism. Although the aetiology of both diseases is still unknown, genetic and environmental factors contribute to a common underlying immune dysregulation. Interleukin-6 plays a dominant role in the pathogenesis of the increased bone resorption observed in both conditions. Understanding the interplay between the immune and skeletal systems may enable further insights into the pathogenesis of bone destruction, as well as serving as new strategy for drug design. This thesis reports the case of a 60-year-old female diagnosed with both RA and PDB. Both pathologies seldom coexist in the same patient, making this case singular not only because of the inherent complexity of the clinical and imaging evaluation, but also for the possibility of a common therapeutic target. |
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