Rheumatoid Arthritis

77 Pages·2009·1.61 MB·English

Rheumatoid Arthritis
Edward Dwyer, M. D.
Division of Rheumatology
New Therapies in Rheumatoid Arthritis
Diarthroidal Joint
New Therapies in Rheumatoid Arthritis
Diarthroidal Joint in Rheumatoid Arthritis
New Therapies in Rheumatoid Arthritis
Normal Synovium
New Therapies in Rheumatoid Arthritis
Synovium in Rheumatoid Arthritis
New Therapies in Rheumatoid Arthritis
Synovium in Rheumatoid Arthritis
New Therapies in Rheumatoid Arthritis
Cartilage-Pannus Interface
Pannuscomposed of macrophages and mesenchymalcells which erode into cartilage and bone
New Therapies in Rheumatoid Arthritis
Cellular Components of Synovial Inflammation in RA
T cells
(cid:131)
CD4 TH1 phenotype (IFN-γ, IL-2)
(cid:131)
Macrophages
(cid:131)
TNF and IL-1
(cid:131)
B cells
(cid:131)
Rheumatoid Factor
(cid:131)
Anti-Cyclic Citrullinated Peptide Ab (anti-CCP Ab)
(cid:131)
New Therapies in Rheumatoid Arthritis
Emerging Cytokine Targets in RA
Cytokine Produced by Activity
IL-1 MΦ “TLR-like”; activates NF-κB
IL-6 MΦ, Ly, Fibr Induces IL-17; stimulates bone resorption
IL-15 MΦ, Syn, Endo “IL-2-like”; stimulates T 1 polarization
H
IL-17 T 17 cells Induces TNF-α, IL-1, RANKL
H
IL-18 MΦ “TLR-like”; activates NF-κB
IL-23 MΦ IL-12 family member; induces IL-17
IL-32 MΦ, Ly Induces TNFα, IL-1β, IL-6, and chemokines
New Therapies in Rheumatoid Arthritis
Epidemiology of Rheumatoid Arthiritis
Prevalence of 1% in most populations
(cid:131)
Age of onset: 30-50 yrs
(cid:131)
Sex: F:M 3:1
(cid:131)
New Therapies in Rheumatoid Arthritis