Rheumatoid arthritis is a painful and debilitating condition that affects around 2.1 million Americans, with similar proportions of the population affected in other Western countries. It is not known exactly what causes this condition, and until now, the only therapies were analgesic prescriptions (painkillers), and exercises. While these old stand-bys are not ready to be replaced yet, an exciting option has emerged in the field of gene therapy for treating rheumatoid arthritis, and possibly preventing the need for joint replacement surgery and spine surgery.
Rheuamtoid arthritis leads to a substantial loss in the quality of life, and is a degenerative disease which cannot currently be cured - only managed. The disease causes the body to attack the joints, causing inflammation and destruction of the joint tissues. Joint replacement therapy is sometimes needed, especially hip replacement therapy, if patients are to walk without a great deal of pain. Analgesics, anti-inflammatories and steroids are the usual treatments for this disease, but this cocktail of prescription medicines can wreak its own unwanted effects on the body. Gene therapy is an emerging science that offers hope for treating rheumatoid arthritis.
Gene therapy replaces the traditional chemical agents used in prescription medicines, and aims (and often succeeds) in reducing the side effects of disease treatment. Often in gene therapy, a mutant allele (part of a gene or a patient's DNA) is replaced with a functional, healthy one. However, this gene therapy for rheumatoid arthritis sufferers is different. The particular gene that may help prevent the need for joint replacement surgery actually produces a protein, human interleukin-1 receptor antagonist. When the protein is produced, it blocks the production of human interleukin receptor-1, one of the main culprits of inflamed joints and tissue. While the therapy does not treat the actual cause if the disease (since it is unknown), it stymies one of rheumatoid arthritis' main processes.
A phase 1 trial in humans has been completed, which studied the effects of gene therapy in the treatment of rheumatoid arthritis. This study was published in the Proceedings of the National Academy of Sciences, and has been noted by many other large research facilities, like the University of Florida. Elvire Gouze, an assistant research professor at the University's Department of Orthopedics and Rehabilitation, believes the study is important in proving that gene therapy can be safely, efficiently and effectively conducted for rheumatoid arthritis in humans.
In the study, tissue was taken from the joints of nine women with an advanced stage of the disease, and injected a harmless retrovirus into the tissues. The virus was the vehicle for introducing the receptor antagonist into the joints.
Medical tourism has also proven a valuable option for treating rheumatoid arthritis. The joint replacement therapy which is sometimes needed in advanced stages of the disease can be done at a much lower cost in countries like Thailand than in the West, where the disease prevails. Joint replacement surgery in Thailand and arthroplasty in Thailand involves replacing or remodelling an arthritic joint and realigning the joint. Look for hospitals like Bangkok Hospital and Bumrungrad that have specialized orthopaedic clinics.
