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Lecture notes

Rheumatoid Arthritis - Musculoskeletal System

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Summary of rheumatoid arthritis including the mechanisms of action.

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  • May 19, 2016
  • 2
  • 2014/2015
  • Lecture notes
  • Unknown
  • No. 8
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Rheumatoid Arthritis

 Autoimmune disease primarily affecting synovial joints

 Fatigue due to proinflammatory cytokines

 Initiating event not fully understood but associated with both self
and microbial antigens such as the Epstein-Barr virus and heat
shock proteins (these are super antigens so don’t require
processing).

 Self-antigens to the FC portion of IgG are called rheumatoid factors.

 Imune response leads to pannus and synovitis.

 Pannus is the formation of granulation tissue (fibrovascular tissue,
that forms as part of the wound healing process), in the rheumatoid
arthritis it is caused by synovial hyperplasia.

 Furthermore the cartilage and underlying bone begin to
disintegrate.

 The synovitis is responsible for the symptoms and the pannus is
responsible for the joint erosion (cartilage and bone).

 Cells involved in pannus are: 2/3 fibroblasts and 1/3 macrophages.
Also contains B-cells, T-cells, dendritic cells, plasma cells and mast
cells.


Role of B-cells:

Production of autoantibodies:

 Antibodies to the FC (rheumatoid factor) of the self-IgG molecule.
 RF found in 70% of rheumatoid arthritis patients, not actually a
useful diagnostic.

Production of proinflamitory cytokines e.g. IL-6, TNF-α


Role of T-cells:

Based on a lecture delivered by Dr M Sharif at the university of Bristol 2015

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