A systems approach to sub-typing of rheumatoid arthritis

Wietmarschen, H.A. van (2012)

Doctoral Thesis

The current health care system is severely challenged by for instance rising costs, fewer new blockbuster drugs and increasing numbers of hospitalizations due to side effects. Especially in the area of chronic diseases the current disease fighting strategy is failing and a more personalized medicine approach is needed. In this thesis new sub-types of rheumatoid arthritis are characterized with metabolomics analysis and symptoms patterns. The sub-types are based on diagnostic knowledge from Chinese medicine. The two sub-types of RA patients were found to have differences in apoptosis regulation of T-cells and differences in urine acylcarnitine levels. A questionnaire was designed to distinguish the two sub-types and to evaluate symptom patterns of arthritis patients. In the future the response to treatment of these sub-types of patients can be studied and specific treatment can be targeted to these sub-types.

• Systems biology
• Symptom
• Rheumatoid arthritis
• Nonlinear principal component analysis
• Metabolomics
• Diagnosis
• Chinese medicine

• All authors: Wietmarschen, H.A. van
• Supervisor: Greef, J. van der; Meulman, J.J.
• Co-supervisor: Reijmers, T.H.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden/Amsterdam Center for Drug Research, Faculty of Science, Leiden University
• Date: 2012-12-18
• ISBN (print): 9789090271828
• Court: LEI Universiteit Leiden
• Sponsorship: Artrose & Reuma Stichting