Evolving concepts of rheumatoid arthritis.
Rheumatoid arthritis is the most common inflammatory arthritis and is a major cause of disability. It existed in early Native American populations several thousand years ago but might not have appeared in Europe until the 17th century. Early theories on the pathogenesis of rheumatoid arthritis focused on autoantibodies and immune complexes. T-cell-mediated antigen-specific responses, T-cell-independent cytokine networks, and aggressive tumour-like behaviour of rheumatoid synovium have also been implicated. More recently, the contribution of autoantibodies has returned to the forefront. Based on the pathogenic mechanisms, specific therapeutic interventions can be designed to suppress synovial inflammation and joint destruction in rheumatoid arthritis.
Firestein
Gary S
GS
Division of Rheumatology, Allergy and Immunology, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093-0656, USA. gfirestein@ucsd.edu
D000936:Antigen-Antibody Complex / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000276:immunology* / Q000473:pathology*; D001323:Autoantibodies / Q000276:immunology; D016207:Cytokines / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D005786:Gene Expression Regulation; D006801:Humans; D012217:Rheumatoid Factor / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
D000936:Antigen-Antibody Complex; D001323:Autoantibodies; D016207:Cytokines; D012217:Rheumatoid Factor