SP0056 Sustainable healthcare – it takes a village

B.A. Slusher
2018 THURSDAY, 14 JUNE 2018   unpublished
B cells are considered central to the pathogenesis of patients with rheumatic diseases (RD) including Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). In addition to producing autoantibodies, B cells suppressing inflammatory responses, known as regulatory B cells (Bregs) are numerically and functionally defective in rheumatic diseases. The production of interleukin 10 (IL-10) classically defines a Breg, however the stability and/or plasticity of this population is not well
more » ... on is not well understood. In addition to producing autoantibodies, B cells suppressing inflammatory responses, known as regulatory B cells (Bregs) are numerically and functionally defective in RD patients. The production of interleukin 10 (IL-10) classically defines a Breg, however the stability and/or plasticity of this population is not well understood. Additionally, IL-10 +B cells have been shown to co-express pro-inflammatory cytokines such as TNFa and IL-6, further complicating Breg classification. Characterising the signals inducing Breg differentiation and the subsequent stability and/or plasticity of this population may aid in understanding the factors contributing to Breg dysfunction in RD patients. Novel findings unravelling the signals required and the stability of B regs versus B effector cells in RDs will be discussed. Introduction: According to the World Health Organisation (WHO) "an integrated, people-centred approach is crucial to the development of health systems that can respond to emerging and varied health challenges, including urbanisation, the global tendency towards unhealthy lifestyles, ageing populations, the dual disease burden of communicable and non-communicable diseases, multi-morbidities, rising health care costs, disease outbreaks and other health-care crises". In supporting health services to become more integrated and people-centred a Framework was developed that proposes five interdependent strategies: 1. Empowering and engaging people and communities; 2. Strengthening governance and accountability; 3. Reorienting the model of care; 4. Coordinating services within and across sectors; 5. Creating an enabling environment. Given that health systems are highly context-specific, the Framework does not propose a single model but interdependent (sub) strategies, policy options, and interventions that need to be adopted.
doi:10.1136/annrheumdis-2018-eular.7718 fatcat:nulnubuerrc77m3favqebgn2pi