title: How undifferentiated arthritis evolves into chronic arthritis.
abstract: Undifferentiated arthritis (UA) is a frequently occurring clinical presentation with a variable outcome. While some forms of UA will spontaneously remit, other forms will progress to chronic arthritis; an outcome that would preferably be prevented. Which immunological factors are normally at the basis of resolution of inflammation, and what, on the other hand, causes inflammation to persist? This review provides an overview of the immunological mechanisms involved in these two scenarios, including specific examples of how these mechanisms apply, or can be influenced in rheumatic diseases. Furthermore, what do we know about risk factors for chronic arthritis, such as the development of autoantibodies? The recent years have provided many insights concerning risk factors for autoantibody-positive versus autoantibody-negative rheumatoid arthritis, which are discussed along with a possible pathophysiological model incorporating autoantibodies into the larger process of disease development. Finally, the evolution of the autoantibody response over time is described.
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, The Netherlands. Electronic address: dvanderwoude@lumc.nl.
authors.forename: D
authors.initials: D
authors.lastname: van der Woude
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, The Netherlands. Electronic address: r.e.m.toes@lumc.nl.
authors.forename: R E M
authors.initials: RE
authors.lastname: Toes
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, The Netherlands. Electronic address: h.u.scherer@lumc.nl.
authors.forename: H U
authors.initials: HU
authors.lastname: Scherer
mesh_terms: D001168:Arthritis / Q000276:immunology*; D001172:Arthritis, Rheumatoid / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D012307:Risk Factors
chemical_list: D001323:Autoantibodies
keywords: Autoantibodies; Disease course; Inflammation; Rheumatoid arthritis; Risk factors