Dear All,

Greetings of the day!

Highlights of this issue are two important studies. First one is mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II) trial published in Lancet Respir Med. 2016;4(9):708.This trial compared mycophenolate mofetil (MMF) with oral cyclophosphamide in 142 patients with SSc-ILD, exertional dyspnea, and features of progressive disease. Pulmonary function and dyspnea improved in both groups, without a significant difference between groups. MMF was better tolerated than cyclophosphamide based on a longer time to patient withdrawal and lower incidence of leukopenia and thrombocytopenia. This trial results suggest initiating treatment for symptomatic progressive SSc-ILD with mycophenolate, rather than cyclophosphamide, due to comparable efficacy, better safety profile, and the option for longer-term therapy.

Second study published in the medical journal Science Immunology20 Jan 2017: Vol. 2, Issue 7(Complement C5a receptor is the key initiator of neutrophil adhesion igniting immune complex–induced arthritis.). Authors in this study used multiphoton intravital microscopy that allows immune cell movements to be tracked in real time - to follow the development of arthritis in mice with rheumatoid arthritis. They found that the presence of immune complexes within the joint space leads to the production of complement C5a receptor (C5aR), which is then displayed on the inner walls of adjacent blood vessels and causes neutrophils to pass into the joint. C5a directly initiates the adherence of neutrophils to the vessel walls through interaction with the C5a receptor on neutrophils, which then pass into the joint space and set off inflammation. The deposition of immune complexes (ICs) in tissues induces a “type III hypersensitivity” that results in tissue damage and underlies the pathogenesis of many autoimmune diseases.

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Regards,

Banwari Sharma

Editor, IRA e-Newsletter