Immunopathogenesis of Rheumatoid Arthritis
Open accessAbstract
Rheumatoid arthritis (RA) is the most common inflammatory arthropathy. The majority of evidence, derived from genetics, tissue analyses, models, and clinical studies, points to an immune-mediated etiology associated with stromal tissue dysregulation that together propogate chronic inflammation and articular destruction. A pre-RA phase lasting months to years may be characterized by the presence of circulating autoantibodies, increasing concentration and range of inflammatory cytokines and chemokines, and altered metabolism. Clinical disease onset comprises synovitis and systemic comorbidities affecting the vasculature, metabolism, and bone. Targeted immune therapeutics and aggressive treatment strategies have substantially improved clinical outcomes and informed pathogenetic understanding, but no cure as yet exists. Herein we review recent data that support intriguing models of disease pathogenesis. They allude to the possibility of restoration of immunologic homeostasis and thus a state of tolerance associated with drug-free remission. This target represents a bold vision for the future of RA therapeutics.
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Additional inducers of low-grade inflammation are nutrients and metabolites acting as DAMPs and commensal bacteria representing a source of PAMPs/MAMPs.
“Additional inducers of low-grade inflammation are nutrients and metabolites acting as DAMPs (e.g., free fatty acids, oxidized lipoproteins) and commensal bacteria representing a source of PAMPs [sometimes also described with the more global term microbe-associated molecular patterns (MAMPs), as they are not necessarily pathogenic] (189, 240, 244, 295, 329, 347).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [189]
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- Authors
- Firestein, G. S., & McInnes, I. B.
- Affiliations
- University of California San Diego (US)
- University of Glasgow (GB)
- Corresponding author
- Firestein, Gary S.
- McInnes, Iain B.
- Venue
- Immunity
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 46
- Issue
- 2
- Pages
- 183-196
- ISSN
- 1074-7613 (ISSN-L)
- PMC
- PMC5385708
- OpenAlex
- W2589710212
- Cited by
- 1,301
- References
- 119
- Citations by year
- 2026: 162 · 2025: 154 · 2024: 136 · 2023: 148 · 2022: 194 · 2021: 153 · 2020: 129 · 2019: 119 · 2018: 73 · 2017: 30
- FWCI
- 15.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Immunity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Funders
- Medical Research Council (MR/N005813/1)
- National Institute of Allergy and Infectious Diseases (R01AI070555)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR065466)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Complementary and alternative medicine › Natural Compounds in Disease Treatment
- Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
- Keywords
- rheumatoid arthritis, immunopathogenesis, autoantibodies, chronic inflammation, articular destruction, synovitis, inflammatory cytokines, chemokines, drug-free remission, immune tolerance, immune homeostasis, disease-modifying antirheumatic drugs
- MeSH terms
- Animals, Arthritis, Rheumatoid, Humans
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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