The Challenges of Local Intra-Articular Therapy

Fibroblast-like synoviocytes (FLSs) are among the main disease-driving players in most cases of monoarthritis (MonoA), oligoarthritis, and polyarthritis. In this review, we look at the characteristics and therapeutic challenges at the onset of arthritis and during follow-up management. In some cases...

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Main Authors: Gailute Kirdaite, Jaroslav Denkovskij, Diana Mieliauskaite, Jolita Pachaleva, Eiva Bernotiene
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/11/1819
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author Gailute Kirdaite
Jaroslav Denkovskij
Diana Mieliauskaite
Jolita Pachaleva
Eiva Bernotiene
author_facet Gailute Kirdaite
Jaroslav Denkovskij
Diana Mieliauskaite
Jolita Pachaleva
Eiva Bernotiene
author_sort Gailute Kirdaite
collection DOAJ
description Fibroblast-like synoviocytes (FLSs) are among the main disease-driving players in most cases of monoarthritis (MonoA), oligoarthritis, and polyarthritis. In this review, we look at the characteristics and therapeutic challenges at the onset of arthritis and during follow-up management. In some cases, these forms of arthritis develop into autoimmune polyarthritis, such as rheumatoid arthritis (RA), whereas local eradication of the RA synovium could still be combined with systemic treatment using immunosuppressive agents. Currently, the outcomes of local synovectomies are well studied; however, there is still a lack of a comprehensive analysis of current local intra-articular treatments highlighting their advantages and disadvantages. Therefore, the aim of this study is to review local intra-articular therapy strategies. According to publications from the last decade on clinical studies focused on intra-articular treatment with anti-inflammatory molecules, a range of novel slow-acting forms of steroidal drugs for the local treatment of synovitis have been investigated. As pain is an essential symptom, caused by both inflammation and cartilage damage, various molecules acting on pain receptors are being investigated in clinical trials as potential targets for local intra-articular treatment. We also overview the new targets for local treatment, including surface markers and intracellular proteins, non-coding ribonucleic acids (RNAs), etc.
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spelling doaj-art-13f731ff83cf43d898528e945af42cc42024-11-26T18:12:32ZengMDPI AGMedicina1010-660X1648-91442024-11-016011181910.3390/medicina60111819The Challenges of Local Intra-Articular TherapyGailute Kirdaite0Jaroslav Denkovskij1Diana Mieliauskaite2Jolita Pachaleva3Eiva Bernotiene4Department of Personalised Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, LithuaniaDepartment of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, LithuaniaDepartment of Personalised Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, LithuaniaDepartment of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, LithuaniaDepartment of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, LithuaniaFibroblast-like synoviocytes (FLSs) are among the main disease-driving players in most cases of monoarthritis (MonoA), oligoarthritis, and polyarthritis. In this review, we look at the characteristics and therapeutic challenges at the onset of arthritis and during follow-up management. In some cases, these forms of arthritis develop into autoimmune polyarthritis, such as rheumatoid arthritis (RA), whereas local eradication of the RA synovium could still be combined with systemic treatment using immunosuppressive agents. Currently, the outcomes of local synovectomies are well studied; however, there is still a lack of a comprehensive analysis of current local intra-articular treatments highlighting their advantages and disadvantages. Therefore, the aim of this study is to review local intra-articular therapy strategies. According to publications from the last decade on clinical studies focused on intra-articular treatment with anti-inflammatory molecules, a range of novel slow-acting forms of steroidal drugs for the local treatment of synovitis have been investigated. As pain is an essential symptom, caused by both inflammation and cartilage damage, various molecules acting on pain receptors are being investigated in clinical trials as potential targets for local intra-articular treatment. We also overview the new targets for local treatment, including surface markers and intracellular proteins, non-coding ribonucleic acids (RNAs), etc.https://www.mdpi.com/1648-9144/60/11/1819monoarthritisinflammationsynovectomylocal treatmentfibroblast like synoviocytesnon-coding ribonucleic acids (RNAs)
spellingShingle Gailute Kirdaite
Jaroslav Denkovskij
Diana Mieliauskaite
Jolita Pachaleva
Eiva Bernotiene
The Challenges of Local Intra-Articular Therapy
Medicina
monoarthritis
inflammation
synovectomy
local treatment
fibroblast like synoviocytes
non-coding ribonucleic acids (RNAs)
title The Challenges of Local Intra-Articular Therapy
title_full The Challenges of Local Intra-Articular Therapy
title_fullStr The Challenges of Local Intra-Articular Therapy
title_full_unstemmed The Challenges of Local Intra-Articular Therapy
title_short The Challenges of Local Intra-Articular Therapy
title_sort challenges of local intra articular therapy
topic monoarthritis
inflammation
synovectomy
local treatment
fibroblast like synoviocytes
non-coding ribonucleic acids (RNAs)
url https://www.mdpi.com/1648-9144/60/11/1819
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