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Patogenia de la artritis reumatoide, manejo terapéutico actual y perspectivas futuras
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Introducción: La artritis reumatoide con más frecuencia en mujeres que en hombres, y se observa predominantemente en ancianos.
Objetivo: presentar el resultado de una revisión bibliográfica sobre aspectos generales relacionados con la patogenia de la artritis reumatoide y el manejo terapéutico actual, así como perspectivas futuras de nuevos enfoques terapéuticos.
Desarrollo: Existen dos subtipos principales de artritis reumatoide según la presencia o ausencia de anticuerpos anti-proteína citrulinada. La citrulinación es catalizada por la enzima peptidilarginina-deiminasa dependiente de calcio, que cambia una arginina cargada positivamente a una citrulina polar pero neutra como resultado de una modificación postraduccional. Este trabajo se centra en el subconjunto de artritis reumatoide positivo para anticuerpos anti-proteína citrulinada y se divide la progresión del proceso de artritis reumatoide en varias etapas. Cabe mencionar que estas etapas pueden ocurrir de forma secuencial o simultánea.
Conclusiones: Se requiere con urgencia una mejor comprensión de cómo los mecanismos patológicos impulsan el deterioro del progreso de la artritis reumatoide en los individuos con el fin de desarrollar terapias que tratarán eficazmente a los pacientes en cada etapa del progreso de la enfermedad.
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