Biography
Biography: Margaret Wislowska
Abstract
Rheumatology in the 21st century specializes in a number of disorders that have defied understanding by the application of current cellular, biochemical and immunologic techniques. The genome revolution does provide us with new tools, which are already beginning to have an impact. Polymorphisms in drugs metabolizing enzymes have been associated with both clinical response and adverse effects of treatment. Proteomics and genomics offer new opportunities to identify biomarkers that provide surrogates of disease activity and response to therapy. MicroRNAs are small, double-stranded RNAs expressed in all cells that regulate the expression of hundreds of genes. MicroRNAs act as master regulators of how a cell responds to changes in its environment, including stresses and inflammation. There have been substantial advances in the field of rheumatology with considerable changes in the management approach of rheumatoid arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE). There is a need to consider the selection of the most appropriate therapy for an individual RA patient and to review how and when to switch treatments in those patients who do not show an optimal response. On 6 November 2012 FDA approve inhibitors of kinases to RA treatment. In SpA the new Assessment of SpondyloArthritis International Society (ASAS) classification criteria have been developed, e.g. classification criteria for axial and for peripheral SpA. In lupus, belimumab, a fully human monoclonal antibody that inhibits B-lymphocyte stimulator BLYSS, was approved for the treatment of lupus in 2011 and there are a number of other therapies in development.
