TY - JOUR
T1 - Established rheumatoid arthritis. The pathogenic aspects
AU - Bugatti, Serena
AU - Bozzalla Cassione, Emanuele
AU - De Stefano, Ludovico
AU - Manzo, Antonio
PY - 2020/1/1
Y1 - 2020/1/1
N2 - The development of rheumatoid arthritis (RA), at least in its autoantibody-positive subset, evolves through a series of events starting well before the appearance of synovitis. The distinction between ‘early’ and ‘established’ RA is, therefore, an evolving concept. In routine practice, however, the management of RA still starts with the occurrence of clinically detectable synovitis. As such, the synovial membrane remains a major target for the exploitation of possible stage-specific drivers of the disease. The recognition of a ‘window of opportunity’, in which treatment is more likely to succeed, raises the hypothesis that there might be a period in which the biological processes of RA are less mature and potentially reversible. The present review aims to provide a general picture of the modifications occurring in RA synovium, analysing the contribution of both infiltrating immune cells and stromal cells. When available, differences between early and established RA will be discussed.
AB - The development of rheumatoid arthritis (RA), at least in its autoantibody-positive subset, evolves through a series of events starting well before the appearance of synovitis. The distinction between ‘early’ and ‘established’ RA is, therefore, an evolving concept. In routine practice, however, the management of RA still starts with the occurrence of clinically detectable synovitis. As such, the synovial membrane remains a major target for the exploitation of possible stage-specific drivers of the disease. The recognition of a ‘window of opportunity’, in which treatment is more likely to succeed, raises the hypothesis that there might be a period in which the biological processes of RA are less mature and potentially reversible. The present review aims to provide a general picture of the modifications occurring in RA synovium, analysing the contribution of both infiltrating immune cells and stromal cells. When available, differences between early and established RA will be discussed.
KW - Fibroblasts
KW - Lymphocytes
KW - Macrophages
KW - Rheumatoid arthritis
KW - Synovitis
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U2 - 10.1016/j.berh.2019.101478
DO - 10.1016/j.berh.2019.101478
M3 - Review article
AN - SCOPUS:85078231993
JO - Best Practice and Research in Clinical Rheumatology
JF - Best Practice and Research in Clinical Rheumatology
SN - 1521-6942
M1 - 101478
ER -