Godište 35 supplement 2 - Institut za reumatologiju

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SUMMARY
Clinical of Rheumatology, Military Medical Academy Belgrade
MEHANICAL DEMAGE OF JOINTS IN RHEUMATOID ARTHRITIS
DUŠAN STEFANOVIĆ
Rheumatoid arthritis is a chronic, inflammatory, systemic disease characterized by joint pain and
swelling, joint destruction and pannus formation. The RA pannus consists of a hypertrophic synovial
membrane composed of hyperplastic synoviocytes and inflammatory cells that infiltrate synovial
membrane. T cells, B cells, macrophage-like cells, mast cells and endothelial cells are all-present in the
RA synovium and contribute to the inflammatory processes. T cells play pivotal role in RA. Abnormal Tcell
immunity in RA is not limited to the joint. RA is characterized by massive abnormalities in the
composition of the T-cell pool. T cells recognize arthritogenic antigen on the surface of antigenpresenting
cells in the joint. Activated T cells in the synovium provide mediators that regulate the
functional ability of macrophages, fibroblasts and B cells. B cells produce auto antibodies that may be
pathogenic; fibroblasts secrete cytokines and metalloproteinases that have harmful effects on tissue; and
endothelial cells control the influx of inflammatory cells into the synovium.
K e y w o r d s: rheumatoid arthritis, T cells, pathogenesis