Jing Tian

Pharmacogenomics of biological treatment in rheumatoid arthritis

Introduction: Rheumatoid arthritis (RA) demonstrates a high heterogeneity in clinical responses to treatment. Although the efficacy of biological therapy has undoubtedly been established, the response differs considerably between individuals. This variability between individuals has aroused the research for biomarkers predictive of treatment response. Pharmacogenomics underlying individual responses to drugs is rapidly developed and has the potential of realizing the personalized therapy in RA. This review will summarize the pharmacogenomics of biological therapies approved for clinical RA treatment. Areas covered: The pharmacogenomics underlies individual responses to biological drugs in RA. Current studies on pharmacogenomics of biological therapy in RA are presented. Expert opinion: The personalized treatment in RA according to pharmacogenomics is promising, but the available pharmacogenomic data on biological treatment in RA are not adequate and consistent and still require further larger sample studies to corroborate.

Value of ultrasonography for diagnosis of synovitis associated with rheumatoid arthritis.

To investigate the value of ultrasonography (US) for diagnosing synovitis associated with rheumatoid arthritis (RA).

Application of omics in predicting anti-TNF efficacy in rheumatoid arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by progressive joint erosion. Tumor necrosis factor (TNF) antagonists are the most widely used biological disease-modifying anti-rheumatic drug in RA. However, there continue to be one third of RA patients who have poor or no response to TNF antagonists. Following consideration of the uncertainty of therapeutic effects and the high price of TNF antagonists, it is worthy to predict the treatment responses before anti-TNF therapy. According to the comparisons between the responders and non-responders to TNF antagonists by omic technologies, such as genomics, transcriptomics, proteomics, and metabolomics, rheumatologists are eager to find significant biomarkers to predict the effect of TNF antagonists in order to optimize the personalized treatment in RA.

Concurrence of malignant fibrohistiocytoma and Takayasu arteritis: a case report

Takayasu arteritis (TA) is a type of systemic large-vessel vasculitis that usually affects the aorta and its major branches. It remains unrecognized owing to delayed diagnosis (Boltin et al. in Rheumatol Int 27(10):985–987, 2007) and non-characteristic clinical features. It has been described in association with many autoimmune diseases, such as inflammatory digestive tract diseases. However, report of TA associated with tumors, especially malignant tumors, are rare. We here presented a case diagnosed by both Takayasu arteritis and malignant fibrous histiocytoma, from which we learned not only clinical lessons, but also consensus of relationships between these two diseases.

Longitudinal Myelitis of a Neuro-Behçet Patient

Behçets disease is a chronic, relapsing inflammatory disorder of unknown etiology. Neuro-Behçets disease (NBD) occurs in approximately 5 to 49% of patients with Behçets disease. Spinal cord involvement is very rare in NBD. In this article, we report a 22-year-old male patient of NBD with longitudinal myelitis involving the entire spinal cord. Patient was admitted with one-week of headache, vomiting, and urinary incontinence. Before admission, he felt motor weakness for two years and had noticed recurrent genital and oral ulcers with a frequency of more than three episodes per year for five years. T2-weighted spinal magnetic resonance images showed hyperintensities within the entire spinal cord. He was diagnosed as NBD with longitudinal myelitis. Intravenous methylprednisolone (120 mg/day) was administered for three days, followed by an oral administration of prednisolone (45 mg/day). In conjunction with the steroid therapy, intravenous cyclophosphamide (0.4 g/week) was administered twice. Rapid improvements were detected after receiving treatments for half a month. NBD associated longitudinal myelitis is really rare. This case provided important implications for the diagnosis and treatment of longitudinal myelitis in NBD patients.

Infliximab treatment in two Chinese patients with psoriatic arthritis

Psoriatic arthritis (PsA) is a rheumatoid factor (RF)-seronegative systemic inflammatory disorder associated with psoriasis. Current treatment for PsA in China is still focused on disease modifying anti-rheumatic drugs (DMARDs). In this paper, we report two Chinese patients with active longstanding PsA treated with infliximab, a human-mouse chimeric monoclonal antibody against tumor necrosis factor alpha (TNF-α). The results show that infliximab acted quickly and effectively in relieving peripheral and axial symptoms and refractory skin lesions, even in recombinant human TNF-α receptor (rhTNFR)-resistant case. The take-home message from our cases is that infliximab is a useful therapeutic option for refractory PsA, especially when a patient has a combination of psoriasis and psoriatic arthritis. Further local evidence and experience must be accumulated in order to make anti-TNF-α therapy more accessible to PsA patients in China.