The importance of the t cell in initiating and maintaining the chronic synovitis of rheumatoid arthritis

✍ Scribed by G. S. Panayi; J. S. Lanchbury; G. H. Kingsley

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 633 KB
• Volume: 35
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780350702

✦ Synopsis

Our understanding of the immunopathogenesis of rheumatoid arthritis (RA) has undergone a major revolution if we compare the concepts propounded 30 years ago with those proposed today. Synovitis is no longer conceived as an antibody-mediated process involving rheumatoid factors and immune complexes, but rather as a cell-mediated process involving T cells, antigen-presenting cells (APC), macrophages, synoviocytes, and cytokines. Recently, Firestein and Zvaifler have proposed that the pathogenesis of RA is predominantly based on macrophages (1). This hypothesis stems from their observations, and those by other groups, that the rheumatoid synovium (SM) expresses messenger RNA (mRNA) and protein products for a whole host of macrophage monokines, while it is d a c u l t to detect T cell products. These differences between the T cell and the macrophage "schools" may only be quantitative; nevertheless,