Rheumatoid arthritis immune basis

Mechanism of Action. The basis for the antiar-thritic effects of penicillamine is unknown. Reductions in serum immunoglobulin M-rheumatoid factor have been observed with penicillamine, and this drug has been shown to depress T-cell function.53 These and similar findings suggest that penicillamine works by suppressing the immune response in rheumatoid arthritis, but the exact mechanisms remain to be determined. 

Because of the autoimmune basis of rheumatoid arthritis, various other drugs that affect the immune response are used on a limited basis. For instance, cyclosporine (Sandimmune), an immunosuppressant agent that is used to prevent rejection of organ transplants (see Chapter 37), is sometimes used to treat... 

Autoimmune responses seem to be the underlying basis for a number of diseases, including rheumatoid arthritis, diabetes mellitus, myasthenia gravis, systemic lupus erythematosus, scleroderma, polymyositis/der-matomyositis, and several other disorders.25,27,44 As indicated previously, it is not exactly clear what factors cause autoimmune responses, as well as why certain individuals are more prone to autoimmune-related diseases. Nonetheless, drugs that suppress the immune system can limit damage to various other tissues, and these drugs may produce dramatic improvements in patients with diseases that are caused by an autoimmune response. 

Bee venom, administered in the form of actual bee stings, has been used to treat people with multiple sclerosis, rheumatoid arthritis, and other disease that have an autoimmune basis.48 78 This treatment is supposed to modulate the immune response and suppress the damage caused by the activation and attack of immune cells on specific tissues.30 There is little evidence, however, that bee sting therapy can produce beneficial effects in humans.78 Additional research is needed to determine whether these treatments can promote short- or long-term benefits in persons with various autoimmune diseases. 

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