Cited by 947Rheumatoid Arthritis Research and TherapiesBone Metabolism and DiseasesOsteoarthritis Treatment and Mechanisms

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Bone erosion in rheumatoid arthritis: mechanisms, diagnosis and treatment

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Schett, Georg, Gravallese, Ellen·2012·Nature Reviews Rheumatology

DOI 10.1038/nrrheum.2012.153PMC PMC4096779

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Abstract

Bone erosion is a central feature of rheumatoid arthritis and is associated with disease severity and poor functional outcome. Erosion of periarticular cortical bone, the typical feature observed on plain radiographs in patients with rheumatoid arthritis, results from excessive local bone resorption and inadequate bone formation. The main triggers of articular bone erosion are synovitis, including the production of proinflammatory cytokines and receptor activator of nuclear factor κB ligand (RANKL), as well as antibodies directed against citrullinated proteins. Indeed, both cytokines and autoantibodies stimulate the differentiation of bone-resorbing osteoclasts, thereby stimulating local bone resorption. Although current antirheumatic therapy inhibits both bone erosion and inflammation, repair of existing bone lesions, albeit physiologically feasible, occurs rarely. Lack of repair is due, at least in part, to active suppression of bone formation by proinflammatory cytokines. This Review summarizes the substantial progress that has been made in understanding the pathophysiology of bone erosions and discusses the improvements in the diagnosis, monitoring and treatment of such lesions.

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Authors: Schett, G., & Gravallese, E.
Affiliations: Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
University of Massachusetts Chan Medical School (US)
Corresponding author: Schett, Georg
ORCID: Schett, Georg
Gravallese, Ellen
Venue: Nature Reviews Rheumatology
Publisher: Springer Science and Business Media LLC
Published: 2012-09-25
Volume: 8
Issue: 11
Pages: 656-664
ISSN: 1759-4790 (ISSN-L)
1759-4804
DOI: 10.1038/nrrheum.2012.153
PMC: PMC4096779
OpenAlex: W2032362610
Cited by: 947
References: 124
Citations by year: 2026: 72 · 2025: 72 · 2024: 89 · 2023: 75 · 2022: 82 · 2021: 89 · 2020: 80 · 2019: 75 · 2018: 73 · 2017: 74 · 2016: 53 · 2015: 52 · 2014: 35 · 2013: 26
FWCI: 5.39
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Rheumatology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
Funders: American College of Rheumatology Research and Education Foundation
Rheumatology Research Foundation
European Commission
Deutsche Forschungsgemeinschaft
Bundesministerium für Bildung und Forschung
National Institutes of Health (5r01ar055952-05)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01-AR055952)
Topics: Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
Keywords: bone erosion, rheumatoid arthritis, bone resorption, osteoclasts, synovitis, inflammatory cytokines, RANKL, anti-citrullinated protein antibodies, bone formation, bone regeneration, radiographic erosions, antirheumatic therapy
MeSH terms: Animals, Arthritis, Rheumatoid, Bone Resorption, Cell Differentiation, Humans, Osteoclasts, Cytokines

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Bone erosion in rheumatoid arthritis: mechanisms, diagnosis and treatment

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