PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Review Article

Volume 6 Issue 4

The Synergy of Immunology and Precision Medicine in Therapeutic Revolution of Rheumatoid Arthritis

R Vinoth*, K Ramesh, N Jayaram, S Sivasankari, S Nagajothy and R Sapthasri

October 02, 2025

DOI : 10.56831/PSSRP-06-213

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Abstract

Rheumatoid arthritis (RA) is an autoimmune disease with prevalent of clinical expressions on the joints of the body especially in the inflammation of synovial membrane, degeneration of cartilage and bone and multi-organ involvement. The current review is an integrative framework synthesising the view of RA immunopathogenesis, biomarkers development, precision medicine, and novel ways of treating RA. Pathogenesis is the result of an interaction of genetic risk alleles such as HLA-DRB1, environmental exposures, and dysregulated immune pathways which converge around Th1/Th17 cells, B lymphocytes and fibroblast-like synoviocytes. The inflammatory condition in the complex rheumatic disease is a clinico-pathological convergence sampling that is based on epigenomic reprogramming and metabolic adaptations. Recent serological and multi-omics assay developments, anti-citrullinated protein antibodies (ACPAs), 14-3-3eta, microRNAs, and exosomes have made early diagnostic sensitivity, longitudinal pattern of disease, and therapeutic accuracy possible. The emergence of precision medicine as defined by pharmacogenomic testing and synovial testing assists in the support of personalised approaches to treatment. Artificial intelligence is more and more being used in order to normalise heterogeneous data on biomarkers in order to facilitate dynamic risk evaluation. The therapeutic front has advanced as usual beyond traditional disease modifying antirheumatic medicines (DMARDs) to biologics medicines, JAK / BTK blockers, and experimental avenues like tolerazine vaccines, stem cell-based medicine, and nanomedicine. Despite of recent advances in therapeutic practice, patients with malignant neoplasms still pose complications in terms of symptom control, namely pain, fatigue and comorbidities. Further, it has increasingly become more and more common with acquired treatment resistance. Therefore, it is imperative to engage a multidisciplinary patient centred paradigm to facilitate the long term remission and foster long term clinical outcomes.

Keywords: rheumatoid arthritis; pharmacogenomics; biomarkers; immunopathogenesis; regenerative therapies

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