The pathogenesis of rheumatoid arthritis

Alivernini, S., Firestein, G. S. and McInnes, I. B. (2022) The pathogenesis of rheumatoid arthritis. Immunity, 55(12), pp. 2255-2270. (doi: 10.1016/j.immuni.2022.11.009) (PMID:36516818)

Abstract

Significant recent progress in understanding rheumatoid arthritis (RA) pathogenesis has led to improved treatment and quality of life. The introduction of targeted-biologic and -synthetic disease modifying anti-rheumatic drugs (DMARDs) has also transformed clinical outcomes. Despite this, RA remains a life-long disease without a cure. Unmet needs include partial response and non-response to treatment in many patients, failure to achieve immune homeostasis or drug free remission, and inability to repair damaged tissues. RA is now recognized as the end of a multi-year prodromal phase in which systemic immune dysregulation, likely beginning in mucosal surfaces, is followed by a symptomatic clinical phase. Inflammation and immune reactivity are primarily localized to the synovium leading to pain and articular damage, but is also associated with a broader series of comorbidities. Here, we review recently described immunologic mechanisms that drive breach of tolerance, chronic synovitis, and remission.

• Item Type: Articles
• Additional Information: S.A. was supported by linea D1 (R4124500654) (Università Cattolica del Sacro Cuore) and Ricerca Finalizzata Ministero della Salute (GR-2018-12366992).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McInnes, Professor Iain
• Authors: Alivernini, S., Firestein, G. S., and McInnes, I. B.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Research Centre: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
• Journal Name: Immunity
• Publisher: Elsevier (Cell Press)
• ISSN: 1074-7613
• ISSN (Online): 1097-4180