Network Symposium Rheumatology and Clinical Immunology

Journal/Book: Z Rheumatol 2000; 59:254-271. 2000;

Abstract: Scientific Abstracts Joint symposium of the "Kompetenznetzwerk Rheumatologie" and the "Deutsche Gesellschaft für Rheumatologie" March 23rd through 25th 2000 under the Patronage of the German Minister of Education and Research Ms. Edelgard Bulmahn Friday March 24 th 2000 Rheumatoid arthritis 8.30-12.00 Chairmen: H. Burkhardt Erlangen; G.-R. Burmester Berlin Pathogenic mechanismus in Rheumatoid Arthritis Peter E. Lipsky NIAMS NIH Bethesda Maryland USA Rheumatoid arthritis(RA) is a chronic inflammatory disease that primarily effects the synovial tissue of genetically susceptible individuals. During the course of RA many circulating cells including myeloid cells and lymphocytes are recruited to the synovium and add to the chronic inflammatory process. Contributing to the inflammation are the local stromal cells and fibroblasts that not only can produce pro-inflammatory mediators and tissuedegrading enzymes but also can play an important role in in blocking cellular apoptosis and promoting the survival and functional activity of lymphocytes in the synovium. Despite many years of study the initial events in rheumatoid inflammation remain obscure. It is clear however that one of the essential steps is the functional maturation of antigen presenting dendritic cells that permit breaking of tolerance and the activation of autoreactive T cells. The biased differentiation of these cells to pro-inflammatory Th1 cells and the capacity of these cells to stimulate the local differentiation of autoantibody producing B cells are two distinguishing features of RA that permit it to mature from a low-grade inflammatory process to an intensive one with tissue-damaging potential. Although many of the signs and symptoms of RA seem to originate from the production of myeloid-derived cytokines such as TNFalpha these appear to be produced as a result of local T cell activation. Newer treatments of RA afford the opportunity to delineate the aspects of RA that are governed by each of the steps of the inflammatory cascade. Genetics of Rheumatoid Arthritis Cornelia M. Wayand MD Mayo Clinic Rochester MN USA Rheumatoid arthritis (RA) is a complex genetic disorder with a contribution of multiple genes to disease pathogenesis.... Schm

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