New hope for arthritis patients

Press, 25 July 1986, Page 17

New hope for arthritis patients

Better treatment for arthritis could come from a technique for observing what happens inside affected joints, the London Press Service reports. The discovery, made at the Strangeways Research Laboratory in Cambridge, is now in use at Addenbrooke’s Hospital nearby, and should make it possible to evaluate, for the first time, whether a drug or other therapy improves an arthritic joint — or, as some doctors suspect, only worsens it Dr John Dingle, director of the laboratory, says that it will be 1 f

possible also to monitor new drugs for their effect on the disease itself and not just the symptoms.

Explaining the development, Dr Dingle says that joint cartilage is made up of collagen fibres holding a substance called proteoglycan. This has a strong affinity for water and, swollen by it, absorbs stresses and strains as well as lubricating joints. Lack of proteoglycan results in the wear of cartilage and bone typical of advanced rheumatic disease. Proteoglycan, however, is broken down by another body A'

substance, interlukin one, known as ILL This is a messenger molecule, widespread in the body, which plays a role in the immune reaction and in fever, and, probably, also in tissue repair.

Fragments from the breakdown of proteoglycan survive for a short while in synovial fluid, and the amount can be measured by the technique. In preliminary trials, 100 arthritic patients have been studied, and all had more proteoglycan than healthy people but could be losing it faster than it

was being replaced. The amount increased six-fold from the mildly to the severely affected, providing a sensitive scale for comparison. Dr Pringle says that the laboratory has begun observing the changes in individual patients receiving different drug treatments. It will also monitor new pharmaceutical products which might protect proteoglycan by interfering with ILL These might help other conditions that could be caused by ILI, including heart-valve damage and some eye disorders.