Rheumatoid arthritis insights could lead to better treatments

Genetic insights into rheumatoid arthritis could help design better treatments, according to one researcher.

People with rheumatoid arthritis (RA) often have trouble getting out of bed in the morning, let alone getting to the rheumatologist for a checkup or participating in a research study. This makes a deeper understanding of the mysterious autoimmune disease all the more difficult. That’s a significant problem, because RA affects more than 1.5 million people in the U.S. and 18 million people worldwide—and as of now, there’s no cure.

No one knows this better than Dana Orange, a physician-scientist in the Laboratory of Molecular Neuro-oncology at Rockefeller University. Orange splits her time between lab research on the molecular mechanisms underlying RA—in which antibodies attack the lining of joints—and patient care in the Inflammatory Arthritis Center at the Hospital for Special Surgery.

A few years ago, when she realized her research was being stymied by the physical limitations RA imposed on her patients, she developed an at-home finger-prick RNA sequencing test to enable them to take part in studies from home. Using this groundbreaking method, she’s uncovered a number of significant discoveries, including why common medications don’t work for many people with RA and the surprising way that dental health is linked to the disease.

Since then, her work has pinpointed hundreds of changes in gene expression that precede a flare—or sudden onset of symptoms such as swelling and pain—generating invaluable insights that may also apply to related conditions such as osteoarthritis.

Here, Orange, an associate professor of clinical investigation at Rockefeller University, about how her research may help predict flares, provide precise drug targets, and enable effective interventions before symptoms begin:

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