MicroRNA: un nuovo approccio nella diagnosi, prognosi e nel trattamento dell'Artrite Reumatoide

Rheumatoid arthritis (RA) is an inflammatory progressive disease, affecting about 1% of the population, which in the absence of appropriate treatment can lead to joint destruction and disability. Prognosis of RA may be predicted based on the presence of some clinical and laboratory evidence, but the actual criteria for the diagnosis are inadequate. Identifying individuals at risk for RA is beneficial. The intervention in the preclinical phase may result in better outcomes providing the opportunity for earlier treatment and increased possibility of achieving remission. The most important challenging issue remains to find biomarkers for early diagnosis. In the last decade many epigenetic mechanisms that contribute to the pathogenesis of autoimmune disorders have been revealed. Research on RA epigenetics has focused mainly on microRNA (miRNA). These post-transcriptional regulators are small non-coding RNA discovered to be involved in RA pathogenesis from early to the established disease. Literature shows that miRNAs can be aberrantly expressed in inflamed synovium and circulation of RA patients. Altered expression of some miRNAs might predispose to RA development, it also differs depending on disease’s stage and activity. Circulatory miRNAs in RA patients and serum miRNA signature, that might precede clinical manifestations, were investigated. Finally, it was demonstrated the anti-inflammatory and anti-erosive role of miRNA-17-5p in experimental arthritis models. The beneficial effect involves the suppression of the IL-6 family autocrine-amplifying loop through the direct targeting of JAK1 and STAT3. MiRNA have been investigated as potential new biomarkers for RA diagnosis and treatment response prediction, paving the way to new targeted drugs discovery.