| Different stages of rheumatoid arthritis: features of the synovium in the preclinical phase. | |
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MedLine Citation:
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PMID: 21177292 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: /st> The aetiology of rheumatoid arthritis (RA), a prototype immune-mediated inflammatory disorder, is poorly understood. It is currently unknown whether the disease process starts in the synovium, the primary target of RA, or at other sites in the body. OBJECTIVE: /st> To examine, in a prospective study, the presence of synovitis in people with an increased risk of developing RA. METHODS: /st> Thirteen people without evidence of arthritis, who were positive for IgM rheumatoid factor and/or anticitrullinated protein antibodies, were included in the study. To evaluate synovial inflammatory changes, all participants underwent dynamic contrast-enhanced MRI and arthroscopic synovial biopsy sampling of a knee joint at inclusion. RESULTS: were compared with knee MRI data and synovial biopsy data of 6 and 10 healthy controls, respectively. Results MRI findings evaluated by measurement of maximal enhancement, rate of enhancement, synovial volume and enhancement shape curve distribution were similar between the autoantibody-positive subjects and the healthy controls. Consistent with these findings, all but one autoantibody-positive subject showed very low scores for phenotypic markers, adhesion molecules and vascularity, all in the same range as those in normal controls. The one person with higher scores had patellofemoral joint space narrowing. CONCLUSION: /st> Subclinical inflammation of the synovium does not coincide with the appearance of serum autoantibodies during the pre-RA stage. Thus, systemic autoimmunity precedes the development of synovitis, suggesting that a 'second hit' is involved. This study supports the rationale for exploring preventive strategies aimed at interfering with the humoral immune response before synovial inflammation develops. |
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Authors:
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M G H van de Sande; M J H de Hair; C van der Leij; P L Klarenbeek; W H Bos; M D Smith; M Maas; N de Vries; D van Schaardenburg; B A C Dijkmans; D M Gerlag; P P Tak |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-12-21 |
Journal Detail:
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Title: Annals of the rheumatic diseases Volume: - ISSN: 1468-2060 ISO Abbreviation: - Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372355 Medline TA: Ann Rheum Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Division of Clinical Immunology and Rheumatology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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