The earliest signs of rheumatoid arthritis (RA) are tiny injuries to the synovial membrane and an increase in the number of synovial cells. At this point, long before symptoms are experienced, there is evidence of immune cell penetration into the synovial membrane. Over time, the immune response continues to gain momentum and inflict damage on the synovial membrane.
The exact mechanism of bone and cartilage destruction during RA is not completely understood. One theory suggests that the pro-inflammatory cytokines interleukin-1 and tumor necrosis factor-alpha (TNF-alpha) stimulate the production of enzymes that degrade cartilage and inhibit the production of new cartilage and also contribute to the local demineralization of bone by activating osteoclasts (cells that break down bone) (Kasper DL et al 2005). Read more...
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