Rheumatoid arthritis: new insights into the role of synovial inflammation in joint destruction
M. D. Smith1, P. P. Tak2
(1)Department of Medicine, Flinders Medical Centre and Repatriation General Hospital, Adelaide, Australia
(2)Division of Clinical Immunology and Rheumatology, F4-218 Academic Medical Center/University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands
Abstract Rheumatoid arthritis (RA) is characterized by inflammation and proliferation of synovial tissue, leading to degradation of articular cartilage and bone with functional impairment as a result. It has recently become clear that early suppression of synovial inflammation is essential in preventing progressive joint destruction, although inflammation and destruction are in part uncoupled. New insights into the role of matrix metalloproteinases (MMPs), aggrecanase, granzyme B, receptor activator of nuclear factor 3B (RANK)-receptor activator of nuclear factor 3B ligand (RANKL) interaction, and other factors involved in joint destruction may lead to the development of novel therapies aimed at specific inhibition of cartilage and bone degradation.
