New Mechanism that Triggers Inflammation in Rheumatoid Arthritis Discovered

New Mechanism that Triggers Inflammation in Rheumatoid Arthritis Discovered

By Staff

Scientists believe that certain synovial cells contribute to inflammation by activating synovial fibroblasts in people who suffer from rheumatoid arthritis (RA).  They believe that having a deeper understanding of the mechanisms of inflammation in the disease is important for designing new therapies for RA.

In a study published in the Journal of Leukocyte Biology, points to synovial CD4+ T cells that produce IL-21 as the contributing factor to joint inflammation when they trigger synovial fibroblasts. 

“Patients with rheumatoid arthritis with active disease (inflamed joints) have difficulty for instance in using their hands and also with walking,” said Maria Cristina Lebre, Ph.D., a researcher involved in the work from the Academic Medical Center at the University of Amsterdam, Department of Experimental Immunology in Amsterdam, The Netherlands.

“New targeted therapies such as that proposed in this study (decrease in inflammation) will certainly improve the quality of life of patients by increasing their mobility,” she added.

Using a novel isolation method, scientists isolated T cells from synovial fluid from patients with rheumatoid arthritis that produced IL-21 and TNF and compared these with cells that did not produce this cytokine.

When cells that produced IL-21 were put in culture with synovial fibroblasts (which are the main contributors to joint inflammation in rheumatoid arthritis), they induced the production of pro-inflammatory cytokines by these synovial fibroblasts, and cells that do not produce IL-21, did not demonstrate this same outcome.

The results of this study suggest that a combined therapy targeting IL-21 and TNF might be beneficial for patients that do not respond to anti-TNF therapy or other current therapies.

This research could also have an impact on other diseases such as systemic lupus erythematosus, systemic sclerosis and Crohn’s disease.

“Patients with rheumatoid arthritis often become refractory to treatment provoking the need to try different drugs targeting different pathways,” said John Wherry, Ph.D., Deputy Editor of the Journal of Leukocyte Biology. “The identification of a new inflammatory target in rheumatoid arthritis holds promise for better treatment for these patients and perhaps those with other autoimmune or inflammatory diseases.”

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Authored by: Staff

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Jean Price

Some of the current biologics for RA and various other autoimmune diseases work on decreasing the TNF (tumor necrosis factor) and a few work by decreasing T cells…all to relieve the imnflammatiin AND to acutually halt the progression of joint damage or other damages from these diseases. So finding a additional correlated factor to add to the design seems like a good bit of information.

However, many of these are extremely expensive and some require monthly IV infusions versus giving injections to yourself at home just because of the differences in coverage! It would be nice to think the costs would eventually decrease, yet with new preparations this isn’t likely to happen anytime soon. As with all medications, there are risks to consider…and to weigh against the quality of life it may help add to. RA is a systemic disease and affects many areas of the body..not just joints! There is also severe fatigue from RA which can greatly decrease the ability to function. It remains another area of pain research to be aggressively pursued.


I’ve felt for some time now there is a witch hunt underway to persecute chronic pain patients. I have zero quality of life when I can’t manage my pain. Opiods offer me much needed help but what I would prefer is treatment for the cause of pain..
Not more drugs to mask it.

in 1988 an engine fell at work an took my right shoulder 2 surgery whole right side hurt way more than it did when I hurt it. dr. thought t might be RSD. whent to a pain clinic because of a law in Michigan SABACKA if a phcologist is any part of treatment you can not go there because chronic pain doest cause depression. ask (name of insurance company deleted), companie. also since it takes 10 months to get a hearing we will just take your wages till it gets straighten it out.4yrs. of that your life starts an will fall apart!now 28yrs. later an I can no longer be treated. looks bleak to me just cant see it any more.