Could Rheumatoid Arthritis Be Linked to Heart Valve Disease?

Research may lead to improve rheumatoid arthritis treatment.

An overproduction of tumor necrosis factor (TNF) in patients with rheumatoid arthritis (RA) was linked to disease of the heart valves, including aneurysms, a recent study indicates.

The findings of the study could lead to improved treatments for RA and suggests using existing anti-inflammatory medications for the treatment of heart valve diseases, such as rheumatic heart disease.

TNF is an inflammatory protein given off by patients with RA. It works to recruit immune cells that damage the joints and keeps the body in a perpetual state of inflammation. The link between TNF and the development of RA has long been known, but only recently has it been discovered that the link extends to heart disease.

“People with RA have too much TNF in their joints and in their blood,” said Dr. Philippe Bouillet, lead researcher. “We have identified a previously unknown way that the body destabilizes the molecules during the process of TNF production to stop too much of the protein being made. We could essentially develop agents that put a spanner in the works, stopping the factory production of TNF.”

While the treatment of RA patients with drugs that soak up excess TNF have been effective, it does come with a downside, according to Dr. Bouillet. Up to 50% of patients have become unresponsive to the medications because they have developed immunity to the anti-TNF drugs.

“We think targeting the regions of the DNA that destabilize the molecule could be an innovative way to interfere with protein production to dampen the amount of TNF being made,” said Dr. Bouillet.

The study revealed that drugs that absorb the extra TNF in the system work to treat inflammatory diseases affecting heart valves.

“This is the first time that we have linked the overproduction of TNF to heart valve disease,” Dr. Bouillet said. “While it seems that genetics makes a substantial difference to the severity of the heart disease in our models, it does suggest that in humans we may be able to better diagnose heart valve disease in people with RA in the future.”

Dr. Bouillet continued to note that existing drugs that block and remove TNF could be investigated for the possible treatment of heart valve diseases. According to Dr. Bouillet, clinicians have previously trialed drugs that target TNF, but for diseases of the heart muscle.

These trials proved ineffective in the treatment of these types of heart diseases. But Dr. Bouillet explained that his study determined TNF affects the heart valve rather than the heart muscle, suggesting that anti-inflammatory drugs should be investigated in relation to the treatment of heart valve diseases, such as rheumatic heart disease.

With this latest discovery, patients with RA can look forward to more effective treatments and to more preventative measures being taken in order to avoid the development of heart valve disease. As scientists further investigate the matter, patients can soon look forward to medications that aid in stopping TNF production in the body.