Cambridge scientists to study pregnancy-induced remission in women with rheumatoid arthritis
Scientists in Cambridge are trying to unravel the mystery of why women with rheumatoid arthritis go into remission during pregnancy – only for the disease to return with a vengeance after they give birth.
Although their work is only in its early stages, ultimately it could lead to new hormonal treatments which could control the disease more effectively in women rheumatoid arthritis patients.
Female sex hormones are known to play a major role in explaining why rheumatoid arthritis improves during pregnancy, but exactly how this happens has long been something of a mystery. Women on HRT and who take the contraceptive pill also find the symptoms of rheumatoid arthritis are reduced, but find it flares up again when they come off the drugs.
Now a team led by Dr Alexander Betz, an immunologist at the MRC Laboratory of Molecular Biology in Cambridge, has been awarded two years' funding of more than £160,000 by the Arthritis Research Campaign to examine the role of special cells in pregnancy-induced remission of RA.
Rheumatoid arthritis is an inflammatory form of arthritis, which leads to swollen, painful joints, and occurs as a result of the body's immune system attacking itself.
"We have recently discovered that during pregnancy, some of the mother's immune cells, called regulatory T cells, expand substantially to prevent the rejection of the foetus," explained Dr Betz. "The expansion of these regulatory T cells – which appear to be driven by the elevated hormone levels caused by pregnancy - has a beneficial effect on RA patients, and leads to an improvement in symptoms. It seems that these cells, instead of activating the immune system, actually dampen it down."
Dr Betz and his team now plan to study in more detail the role of regulatory T cells in the lab while colleagues at University College, London, will set up a small pilot study of pregnant RA patients. If their research is successful, it could lead to women RA patients being offered hormone treatment to counter the symptoms of their condition - particularly to prevent the return of RA after they have given birth - by keeping their hormone levels artificially raised.
