Response: PEPITEM is a naturally occurring peptide that tells your immune system to stop moving from the blood into healthy tissues. Under normal conditions, your immune system does this to fight infection and heal damaged tissues. However, in arthritis the white blood cells stop responding to the hormone that releases PEPITEM causing widespread inflammation.

Response: What we know currently is PEPITEM is released by a type of immune cell called B-cells in response to a protein called adiponectin. PEPITEM is cut out of a much larger molecule that is expressed in a number of cell types, including the B-cells. Whether other cells can release PEPITEM and how it is cut out of its parent protein are questions we are trying to answer in ongoing studies.

Response: Initially we took blood samples from adults with suspected inflammatory arthritis, including early undiagnosed rheumatoid arthritis and psoriatic arthritis, who had not started any medication yet. We showed that patient white blood cells were less likely to be able to respond to adiponectin and had lower amounts of PEPITEM in joint fluid.

This lead us to hypothesise that supplementation with PEPITEM could restore immune regulation and reduce the inflammatory changes seen in early-stage disease. We tested this in animal studies, showing that PEPITEM was as effective as the standard-of-care prescription drug infliximab at reducing arthritis-related inflammation and bone damage. Detailed studies revealed this was due to changes in the joint ecosystem that reduced amounts of proteins that drive inflammation and increased amounts of white blood cell types that suppress immune responses. This flips the balance in the joint towards less inflammation and tissue repair.

Response: If our results are confirmed in human trials, PEPITEM could offer a new approach for treating early-stage arthritis, potentially reversing joint damage rather than just managing symptoms.

Response:The next step would be to test the efficacy of PEPITEM in humans through clinical trials in patients with early stage arthritis.