En dag hände det sig, att konungen i landet beordrade en fest med dans och alla kvinnor bjöds in. Festen anordnades för att kungens son skulle få välja sig en hustru. Alla var glada och förväntansfulla.
Men vänta lite, inte riktigt alla var glada. Sorg och bedrövelse, gråt och tandagnisslan råder i människokroppen Askungen. Fötterna har svullnat upp och gör ont. Att få dem i glasskorna går inte. Smärta och svullnad har också dykt upp i händer, armbågar och knän. Dans tycks omöjligt. Tillståndet kallas ledgångsreumatism och är känt sedan länge.
En annan kvinna, Snödrottningen, i grannbyn Spetsbergen har också fått ledvärk men därtill uttalad torrhet i ögon och mun och kan i all sin bedrövelse knappt gråta. Hon har också blivit mycket sömnig och man misstänker att hennes huvud är drabbat. Även detta öde finns omvittnat sedan tidigare. De ursprungliga rapporterna kom från vår druid Henrik Sjögren (1899-1986) och benämns därför Sjögrens syndrom.
Förvirrade, självdestruktiva ynglingar i byn Immunsystemet, som ligger i benmärg och mjälte, är sedan lång tid tillbaka misstänkta för att vara inblandade i dessa nesligheter. Vår högt skattade och sanningssökande druid, Mats Dehlin, tror att de bland mycket annat använder sig av ett elixir, en dekokt på fms-lik tyrosinkinas 3 ligand, för att utföra sina tarvligheter. Dock kan ingen minnas det namnet så vi kallar det Flt3-ligand (Flt3-L). Byborna i immunsystemet dricker Flt3-L så det står härliga till. Det får dem att utvecklas, att mogna och föröka sig, kort sagt ett tillväxtelixir. Herr B, fru T och långarmade morbror DC är speciellt begivna i Flt3-L.
Upprörd över Askunges och Snödrottnings belägenhet och fast besluten att ordna danskvällen för dem har vår sanningssökande druid Dehlin experimenterat i sin grotta. Hans efterforskningar beskriver elixiret Flt3-ligands roll vid ledgångsreumatism och Sjögrens syndrom.
Människor med ledgångsreumatism uppvisar förhöjda nivåer av Flt3-L i sin ledvätska. Tillförsel av Flt3-L vid experimentell ledgångsreumatism hos mus förvärrar förstörelse och inflammation i leden. Druiden Dehlin har givit
mössen ett motgift mot Flt3-L, sunitinib, vilket givit god lindring av inflammation och förstörelse av leden vid experimentell ledgångsreumatism. Vid Sjögrens syndrom är Flt3-L i hjärnan hos människa länkat till nervcellernas ombyggnation. Vidare påvisas en nära koppling mellan Flt3-L och ett annat elixir, MCP-1. Det aktiverar byn Hjärnans dominerande immunokompetenta bybo, farbror mikroglia, för övrigt en nära släkting till långarmade morbror DC.
Sålunda, druiden Dehlins efterforskningar ger stöd för att Flt3-L är inblandad i inflammation och ledförstörelse vid artritsjukdom. Dehlin har också visat att Flt3-L är nära sammankopplat med nervcellernas ombyggnation och aktivering av mikroglia.
Askungen har nu fått modern anti-reumatisk behandling och mår mycket bättre. Snödrottningen har fått behandling mot sin ledvärk men har fortfarande ont om tårar. De båda kommer kunna bevista den kungliga danskvällen. Och vem vet, i en ej så avlägsen framtid kommer kanske motgift mot Flt3-L vara en kur för ledgångsreumatism.
ACKNOWLEDGEMENT
Andrej Tarkowski, handledare. Tack för inspiration och stort engagemang. Maria Bokarewa, handledare. Tack för ditt stora engagemang och din hjälp i allt från det lilla till det stora.
Mattias Magnusson, bihandledare. Tack för engagemang och hjälp.
Tack till mina medförfattare. Robert Rottapel; Simon J Foster; Leif E Dahlberg; Niels Andreasen.
Stort tack till alla mina medarbetare på avdelningen för reumatologi och inflammationsforskning och i synnerhet till (starring in order of appearance) Margareta Verdrengh, Tao Jin, Ing-Marie Jonsson, Malin Erlandsson, Mikael Brisslert, Sofia Andersson, Jan Bjersing, Kaisa Mannerkorpi, Mattias Svensson och Li Bian för råd, dåd och allt annat.
Henrik Zetterberg, stort tack för engagemang, intresse och draghjälp i löpspåret.
Tack till Tomas Bremell och Boel Mörck som har givit mig möjlighet till att genomföra min forskarutbildning.
Stort tack till alla mina medarbetare på reumatologkliniken Sahlgrenska och i synnerhet till (starring in order of appearance): Anneli Lund, Britt-Marie Karlsson och Marie-Louise Andersson.
Inger Gjertsson, stort tack för dina råd, engagemang och din klokhet.
Theresa Powell, stort tack för handledning under mina första stapplande steg på forskarbanan.
Tack till alla patienter.
Ove Dehlin, stort tack för visat intresse, råd och engagemang. Lotta, Olivia och Bella – vad vore livet utan Er!
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