Autoimmunity

The high rate of learning disorders in the children of women with systemic lupus erythematosus could be caused by in utero exposure to maternally transferred autoantibodies. Experiments in a mouse model of the disease demonstrate that high titers of circulating neurotoxic antibodies impair the development of the fetal cortex and lead to long-term impairments in cognition.

Lee, J. Y. et al. Neurotoxic autoantibodies mediate congenital cortical impairment of offspring in maternal lupus. Nat. Med. 15, 91–96 (2009).

Rheumatoid arthritis

The addition of the tumor necrosis factor agonist golimumab improves the signs and symptoms of rheumatoid arthritis in patients with an inadequate response to methotrexate alone. The patients in the phase III GO-FORWARD study who had active disease despite methotrexate therapy showed significant improvements in symptoms and function following the addition of either 50 mg or 100 mg golimumab. Without concomitant methotrexate, however, the administration of 100 mg golimumab alone did not produce significant benefits.

Keystone, E. C. et al. Golimumab, a human antibody to TNF-α given by monthly subcutaneous injections, in active rheumatoid arthritis despite methotrexate: The GO-FORWARD Study. Ann. Rheum. Dis. doi:10.1136/ard.2008.099010 (2008).

Experimental arthritis

An antibody against vascular endothelial growth factor receptor 1 attenuates disease activity in a mouse model of rheumatoid arthritis, which suggests that it could be a new treatment for the disease in humans. In mice with collagen-induced arthritis, inflammatory cell infiltration and angiogenesis were suppressed following in vivo administration of the antibody.

Choi, S. T. et al. Therapeutic effect of anti-vascular endothelial growth factor receptor I antibody in the established collagen-induced arthritis mouse model. Clin. Rheumatol. 28, 333–337 (2009).

Spondyloarthropathies

In patients with juvenile spondyloarthropathies who do not respond to treatment with NSAIDs, therapy with tumor necrosis factor antagonists could induce remission. The safety and efficacy of these agents was demonstrated in a retrospective review of 20 cases, although prospective studies in large numbers of children are needed to confirm the observations.

Sulpice M. et al. Efficacy and safety of TNFα antagonist therapy in patients with juvenile spondylarthropathies. Joint Bone Spine 76, 24–27 (2009).