Rheumatologists tend to be a conservative bunch of people. We’re law abiding and we (mostly) follow guidelines. Which is fine when they are in the best interests of our patients, but what do we do when we fundamentally disagree?
Physicians as a group are trained to have excellent clinical skills, but the difference between an average and extremely successful physician often comes down to factors outside of their ability to provide clinical care.
Human NK cells express multiple receptors that interact with HLA class I molecules which, in turn, suppy peptides that bind HLA-E to form CD94/NKG2A NK receptor ligands. These peptides correspond to -22 to -14 residues in the leader sequences of HLA-A, HLA-B and HLA-C binding to the HLA-E site. Methionine – 21 delivers functional peptides in stark contrast to threonine – 21 which does not.
By Sam Whittle, MBBS (Hons), MClinEpi, FRACP | 23 Oct 2018
Like most rheumatologists, I retain a deep and abiding love for methotrexate. And with each passing decade since the drug’s ‘re-discovery’ by rheumatology, evidence for a positive trade-off between its benefits and harms has continued to accrue, ensuring its role as the centrepiece of our treatment strategies for rheumatoid arthritis, even as an avalanche of biologics and targeted synthetic DMARDs has swept over us.
There are many avenues for interdisciplinary collaboration within rheumatology, as our specialty encompasses every organ system and diseases with protean manifestations. The intersection of rheumatology and immunology is well known and has become increasingly important, given the association of autoimmune conditions with many of the primary immunodeficiency syndromes.