TY - JOUR T1 - ADAMTS Revenge on Eve? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1377 LP - 1379 DO - 10.3899/jrheum.100406 VL - 37 IS - 7 AU - EUGEN FEIST AU - GERD-R. BURMESTER Y1 - 2010/07/01 UR - http://www.jrheum.org/content/37/7/1377.abstract N2 - Despite major progress in diagnosis and treatment of rheumatoid arthritis (RA), this systemic autoimmune disorder is still a challenge for predicting the course of disease, therapeutic response, and outcome on the individual level. This is no surprise: the pathogenesis of RA is extremely complex, involving genetic predisposition, gender bias, dys-regulation of immunologic tolerance, and environmental factors, to name a few factors. Finally, an infiltrating army of various immune-competent cells induces production and release of proinflammatory cytokines as well as proteinases, inevitably causing destruction of cartilage and bone. On the other hand, our skills and opportunities to stop this process have significantly improved through introduction of biologic disease-modifying antirheumatic drugs. However, it again became evident that RA is not uniform, and new efforts have been made to identify markers for stratification of disease, also allowing prediction of response. As an example, encouraging data have come from clinical trials using rituximab, where seropositive patients (positive for rheumatoid factor and/or antibodies against citrullinated antigens) were characterized as the subgroup responding better to therapy1,2,3. Recently, a stronger reduction in disease activity under tumor necrosis factor (TNF) blockers was observed in seronegative patients with RA in a multicenter study in the UK4, and this unexpected finding was also confirmed in Italian and German cohorts. Since biomarkers to predict response are available not only from the autoantibody profile (as part of the immunome), but may also be encoded in the genes (the genome) or provided by the composition of mRNA expression (the transcriptome), proteins, and metabolites (proteome and metabolome), the field for future research … Address correspondence to Dr. Burmester. E-mail: gerd.burmester{at}charite.de ER -