Infectious disease agents arthritis

The cysteine proteases cathepsin B, L, K, and S are involved in diseases such as osteoporosis, cancer metastasis, rheumatoid arthritis, and infectious diseases [352-357]. Thus, the proteases became an important target for developing inhibitors as therapeutic agents [358-363]. 

Infection risk The risk of infections and serious infections with rituximab may be similar to that with the TNT antagonists. To date, there have been no reports from trials of an increased risk of tuberculosis or opportunistic infections with rituximab [162 ]. Some investigators have reported an increase in Pneumocystis jirovecii pneumonia, and increased number of infections has been documented in patients treated with maintenance rituximab for low-grade lymphoma and in patients with concomitant severe immunodeficiency, whether caused by HIV or immunosuppressive agents [152 ]. In rheumatoid arthritis, the susceptibility factors for severe infections include chronic lung and/or cardiac disease, extra-articular involvement, and low IgG before rituximab treatment [163 ]. After kidney transplantation, the off-label use of rituximab is associated with a high risk of infectious disease and death related to infectious disease [164 ]. 

Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown aetiology with some autoimmune features. Current thinking favours the hypothesis that interplay between genetic factors, sex hormones, and possibly an infectious agent or another immune activating agent initiates an autoimmune pathogenic mechanism that culminates in a disease with inflammatory and destructive features. 

PLH and where lymphoid aggregates without follicles may predominate (82), congenital immune deficiency syndromes such as Wiskott-Aldrich syndrome, collagen vascular diseases (particularly rheumatoid arthritis), prolonged exposure to certain environmental agents such as polyethylene flock, and infectious and obstructive pneumonias including localized infections (10,81,83-89). It can also occur as an idiopathic finding (88). 

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