Impact of Biological Agents and Tissue Engineering Approaches on the Treatment of Rheumatic Diseases

Abstract

The treatment of rheumatic diseases has been the focus of many clinical studies aiming to achieve the best combination of drugs for symptom reduction. Although improved understanding of the pathophysiology of rheumatic diseases has led to the identification of effective therapeutic strategies, its cure remains unknown. Biological agents are a breakthrough in the treatment of these diseases. They proved to be more effective than the other conventional therapies in refractory inflammatory rheumatic diseases. Among them, tumor necrosis factor inhibitors are widely used, namely Etanercept, Infliximab, or Adalimumab, alone or in combination with disease-modifying antirheumatic drugs. Nevertheless, severe adverse effects have been detected in patients with history of recurrent infections, including cardiac failure or malignancy. Currently, most of the available therapies for rheumatic diseases do not have sufficient tissue specificity. Consequently, high drug doses must be administrated systemically, leading to adverse side effects associated with its possible toxicity. Drug delivery systems, by its targeted nature, are excellent solutions to overcome this problem. In this review, we will describe the state-of-the-art in clinical studies on the treatment of rheumatic diseases, emphasizing the use of biological agents and target drug delivery systems. Some alternative novel strategies of regenerative medicine and its implications for rheumatic diseases will also be discussed.

Fabrication and characterization of Eri silk fibers-based sponges for biomedical application

“…In particular, some rheumatic diseases such as osteoarthritis can lead to cartilage degeneration. Such high incidence of chronic and aging-related diseases has increased the demand for highperforming biomaterials and therapeutic strategies envisaging cartilage regeneration [1,2]. Natural polymers have shown several advantages for biomedical applications due to their biodegradability, biocompatibility and cell-recognition ability [3,4].…”

Nanoparticle-based bioactive agent release systems for bone and cartilage tissue engineering

“…In the first circumstance, the cells need a specific micro-environmental context to proliferate and differentiate with the ultimate goal of repairing the defect [6]. Since the frequency and relevance of pathological situations involving bone and cartilage, the scientific community is actively pursuing progress in the control of the regeneration and healing of these tissues [93], [148]. Significant progress has been made in the development of surgical techniques for skeletal reconstruction.…”

“…Cartilage is not a very dynamic tissue: it exhibits a low metabolic rate, low turnover and long half-lives of the constituent structural proteins [1], [171]. Cartilage is composed by a low percentage of chondrocytes embedded in a dense nanostructured ECM network rich in collagen fibers, proteoglycans and elastin fibers [148]. Cartilage focal lesions resulting from trauma often occur during sport activities.…”

Biofunctional Nanofibrous Substrate for Local TNF-Capturing as a Strategy to Control Inflammation in Arthritic Joints

“…Considering the significant involvement of TNF-α in RA, as well as the rising evidences that this cytokine heads the pro-inflammatory cytokine cascade, it becomes a significant therapeutic target [31,32]. Specifically, these evidences led to the development of TNF inhibitors for the treatment of ADs [33,34,35,36,37], as they became the first class of biologic agents to be used in RA treatment [38].…”