Rheumatoid arthritis: neuroendocrine immune integrated physiopathogenetic perspectives and therapy.
Current concepts of neuroendocrine immune (NEI) aspects of rheumatoid arthritis (RA) are reviewed and recent clinical trials of glucocorticoids and sex steroids are summarized. A novel physiopathogenetic perspective is presented. Data are provided of amplified NEI interactions and dysregulation, many years before symptomatic onset of RA. Chronic imbalances between the NEI, vascular endothelial, neural, and other vital counterregulatory intertwined networks are proposed to cause RA and influence its disease activity. Future research may reveal means of diminishing the onset risk as well as disease activity of RA by controlling these imbalances of NEI and other vital networks.
Masi
Alfonse T
AT
Department of Medicine, University of Illinois College of Medicine at Peoria, One Illini Drive, PO Box 1649, Peoria, IL 61656, USA. amasi@uic.edu
Aldag
Jean C
JC
Jacobs
Johannes W G
JW
D000305:Adrenal Cortex Hormones / Q000502:physiology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D016207:Cytokines / Q000502:physiology; D005938:Glucocorticoids / Q000627:therapeutic use; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D009490:Neurosecretory Systems / Q000276:immunology* / Q000503:physiopathology*; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology
D000305:Adrenal Cortex Hormones; D016207:Cytokines; D005938:Glucocorticoids; D012739:Gonadal Steroid Hormones; D042461:Vascular Endothelial Growth Factor A