2017 Fiscal Year Final Research Report

Establishment of treatment strategy of elderly rheumatoid arthritis based on treat-to-target strategy, Peptidylarginine Deiminase 4, and single nucleotide polymorphisms

Research Project

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Project/Area Number	26461480
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Collagenous pathology/Allergology
Research Institution	Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
Principal Investigator	Sugihara Takahiko 地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究員 (00716441)
Co-Investigator(Kenkyū-buntansha)	南木敏宏東邦大学, 医学部, 教授 (00282749) 針谷正祥東京女子医科大学, 医学部, 特任教授 (20238207) 石崎達郎地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究部長 (30246045) 石神昭人地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究部長 (50270658) 田中雅嗣地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究員 (60155166)
Project Period (FY)	2014-04-01 – 2018-03-31
Keywords	関節リウマチ / 高齢者 / 治療戦略 / 身体機能 / 疾患感受性遺伝子 / 核内タンパク質シトルリン化酵素
Outline of Final Research Achievements	The patients with elderly-onset rheumatoid arthritis (RA) can achieve clinical remission and normal physical function by therapeutic strategy targeting low disease activity(T2T). Anti-cyclic citrullinated peptide antibody, bone erosion, high disease activity, and clinical responses at initial treatment are predictors of joint destruction. Serious adverse events under T2T strategy of EORA have great impact on physical dysfunction in patients who achieved treatment goals. Peptidylarginine Deiminase 4 (PAD4) protein expression in peripheral blood is not associated with disease activity. Genome-wide association studies (GWAS) have identified new single nucleotide polymorphisms (SNPs) related to susceptibility of RA. However the SNP cannot predict treatment response of EORA in our prospective cohort. We would like to establish T2T strategy cooperated with SNP related to treatment response and adverse events, but not RA susceptibility.
Free Research Field	関節リウマチ