Rheumatoid arthritis: regulation of synovial inflammation

Int J Biochem Cell Biol. 2004 Mar;36(3):372-8. doi: 10.1016/s1357-2725(03)00259-0.


Rheumatoid arthritis (RA) is a systemic, inflammatory autoimmune disorder that presents as a symmetric polyarthritis associated with swelling and pain in multiple joints, often initially occurring in the joints of the hands and feet. Articular inflammation causes activation and proliferation of the synovial lining, expression of inflammatory cytokines, chemokine-mediated recruitment of additional inflammatory cells, as well as B cell activation with autoantibody production. A vicious cycle of altered cytokine and signal transduction pathways and inhibition of programmed cell death contribute to synoviocyte and osteoclast mediated cartilage and bone destruction. A combination of targeted interventions at various stages in the pathogenesis of RA will likely be required to control symptoms in certain patients with this complex and potentially disabling disease. The regulation of rheumatoid synovial inflammation will be reviewed, followed by a brief summary of the therapeutic implications of these advances, including strategies targeting key cytokines, signal transduction molecules, co-stimulatory molecules, B cells, chemokines, and adhesion molecules.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid* / etiology
  • Arthritis, Rheumatoid* / immunology
  • Arthritis, Rheumatoid* / therapy
  • Bone and Bones / pathology
  • Cartilage / pathology
  • Cytokines / economics
  • Cytokines / immunology
  • Cytokines / therapeutic use
  • Drug Delivery Systems
  • Humans
  • Joints / pathology
  • Signal Transduction
  • Synovial Membrane / immunology
  • Synovial Membrane / pathology*
  • Synovitis / immunology
  • Synovitis / pathology
  • Transcription Factors / immunology


  • Cytokines
  • Transcription Factors