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World J Orthop. Nov 18, 2014; 5(5): 653-659
Published online Nov 18, 2014. doi: 10.5312/wjo.v5.i5.653
Inhibition of rheumatoid arthritis by blocking connective tissue growth factor
Kazuhisa Nozawa, Maki Fujishiro, Yoshinari Takasaki, Iwao Sekigawa
Kazuhisa Nozawa, Yoshinari Takasaki, Department of Rheumatology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan
Maki Fujishiro, Iwao Sekigawa, Institute for Environment and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Chiba 261-7114, Japan
Iwao Sekigawa, Department of Internal Medicine and Rheumatology, Juntendo University Urayasu Hospital, Chiba 261-7114, Japan
Author contributions: All authors contributed to this paper.
Supported by Grant-in-Aid for Scientific Research (C), The Ministry of Education, Culuture, Sports, Science and Technology and The Institute for Environment and Gender-specific Medicine, Juntendo University Graduate School of Medicine
Correspondence to: Kazuhisa Nozawa, MD, PhD, Department of Rheumatology, School of Medicine, Juntendo University 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. k-nozawa@juntendo.ac.jp
Telephone: +81-3-58021067 Fax: +81-3-58004893
Received: December 26, 2013
Revised: April 14, 2014
Accepted: July 17, 2014
Published online: November 18, 2014
Abstract

The pathogenesis of rheumatoid arthritis (RA) remains to be completely elucidated so far; however, it is known that proinflammatory cytokines play a pivotal role in the induction of RA. Tumor necrosis factor (TNF-α), in particular, is considered to play a central role in bone destruction by mediating the abnormal activation of osteoclasts or the production of proteolytic enzymes through direct or indirect mechanisms. The use of TNF-α blocking agents has a significant impact on RA therapy. Anti-TNF-α blocking agents such as infliximab are very effective for treatment of RA, especially for the prevention of articular destruction. We have previously shown that several proteins exhibited extensive changes in their expression after amelioration of RA with infliximab treatment. Among the proteins, connective tissue growth factor (CTGF) has a significant role for the development of RA. Herein, we review the function of CTGF in the pathogenesis of RA and discuss the possibility of a novel treatment for RA. We propose that CTGF is a potentially novel effector molecule in the pathogenesis of RA. Blocking the CTGF pathways by biological agents may have great beneficial effect in patients with RA.

Keywords: Connective tissue growth facto, Rheumatoid arthritis, Osteoclasts, Condrocytes, Tumor necrosis factor-α

Core tip: Connective tissue growth factor (CTGF) plays an important role in the pathogenesis of rheumatoid arthritis (RA). We propose that CTGF is a potentially novel effector molecule in the pathogenesis of RA. Blocking the CTGF pathways by biological agents may have great beneficial effect in patients with RA.