Cited by 1,301Rheumatoid Arthritis Research and TherapiesNatural Compounds in Disease TreatmentAutoimmune and Inflammatory Disorders Research

Immunopathogenesis of Rheumatoid Arthritis

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Firestein, Gary S., McInnes, Iain B.·2017·Immunity

Abstract

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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Crossref · 10.1016/j.immuni.2017.02.006

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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)
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
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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