ANTIADHESION THERAPY IN RHEUMATOID-ARTHRITIS - A REVIEW OF RECENT PROGRESS

A novel therapeutic approach for systemic inflammatory diseases such a s rheumatoid arthritis is directed towards adhesion receptors. Interac tions mediated by adhesion receptors govern the recruitment of inflamm atory cells into inflammatory sites, such as the rheumatoid synovium, and the activation of immunocompetent cells. Therefore, adhesion recep tors maybe valuable therapeutic targets for immunologically driven, sy stemic inflammatory diseases such as rheumatoid arthritis. For example , antiadhesion therapy might hinder the ability of arthritogenic T cel ls to access the synovium and perpetuate the inflammatory response. Al ternatively, inhibition of adhesion receptors might modulate the funct ion of immunocompetent cells already present in the inflamed synovium, thereby attenuating the progression of disease. The potential utility of antiadhesion therapy in inflammatory arthritis has been confirmed in various animal models. Moreover, an antibody directed against the a dhesion receptor intercellular adhesion molecule-1 (ICAM-1) has been s uccessfully utilised in several open trials in patients with rheumatoi d arthritis. Recent progress in this exciting discipline is reviewed, and relevant future directions are considered.