Vaccine development for rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic synovial joint inflammation, destruction of articular cartilage and erosion of subchondral bone. Major advances have been made in the medical management of RA with the introduction of various types of biologic drugs which neutralize the activity of pro-inflammatory cytokines as well as T-cell and B-cell proliferation. Furthermore, a Janus Kinase small molecule inhibitor which suppresses Signal Transducers and Activators of Transcription protein phosphorylation has now been added to the RA drug armamentarium. Despite the development of these novel drugs, there are still no “preventive” measures available for RA. The recent discovery that autoantibodies are produced against cyclic citrullinated proteins/peptides in a significant number of individuals with or without undifferentiated arthritis which can precede the clinical symptoms of RA has provided an impetus for a prophylactic vaccine therapy for RA. Experimental evidence which showed that various vaccine formulations ameliorated arthritis in well-validated animal models has now led to the development of “Rheumavax” which has already been evaluated with promising results in a phase I RA clinical trial.