New targets and nanotheranostics in rheumatoid arthritis therapy: a review

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Abstract

Rheumatoid arthritis is a severe chronic disease affecting the joints. It is associated with autoimmune imbalance and synovial inflammation. Despite the use of biological agents, a significant proportion of patients remain refractory to standard therapy. Consequently, the development of monoclonal antibodies against novel targets and the application of nanotheranostics to improve therapeutic efficacy and selectivity are of particular interest.

This work aimed to critically review promising future therapeutic targets for monoclonal antibody–based treatments—interferon gamma, granulocyte–macrophage colony-stimulating factor, interleukin-7 receptor alpha, bile salt–stimulated lipase, and programmed cell death receptor-1—and to assess nanotheranostic approaches as a means to improve the treatment of rheumatoid arthritis.

Novel monoclonal antibodies against inflammatory effectors, including emapalumab, otilimab, OSE-127, SOL-116, and peresolimab, may reduce rheumatoid arthritis progression and improve clinical outcomes. However, the nonspecific action of monoclonal antibodies toward autoreactive cells can cause severe adverse effects, necessitating more advanced approaches such as nanotheranostics. Current trends in the treatment of rheumatoid arthritis show increasing use of nanomaterials, particularly liposomes, delivered via monoclonal antibodies. The efficacy of such combinations may be improved by drugs encapsulated within liposomes, such as small noncoding RNAs capable of suppressing specific genes responsible for the development and persistence of rheumatoid arthritis. Targeted localization and internalization of liposomal contents can be activated by physical factors, including infrared radiation and ultrasound, or achieved through targeting receptors overexpressed on autoreactive cells that are capable of internalization into the cellular compartment.

The integration of monoclonal antibodies with nanomaterials as drug carriers represents a promising direction in the treatment of rheumatoid arthritis, providing greater selectivity, safety, and potential for personalized treatment. Further development of these strategies may significantly improve outcomes and quality of life in patients resistant to standard therapies.

About the authors

Alexander A. Sukhov

The First Sechenov Moscow State Medical University

Email: a.suhov2003@yandex.ru
ORCID iD: 0009-0003-7450-9213
Russian Federation, Moscow

Vladimir N. Chubarev

The First Sechenov Moscow State Medical University

Author for correspondence.
Email: chubarev_v_n@staff.sechenov.ru
ORCID iD: 0000-0002-7047-1436
SPIN-code: 6320-7369

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

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