Bone erosion in rheumatoid arthritis: mechanisms, diagnosis and treatment
Top Cited Papers
- 25 September 2012
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Rheumatology
- Vol. 8 (11), 656-664
- https://doi.org/10.1038/nrrheum.2012.153
Abstract
In this Review, the authors summarize the substantial progress that has been made in understanding the pathophysiology of bone erosions and discuss the improvements in the diagnosis, monitoring and treatment of such lesions. Bone erosion is a central feature of rheumatoid arthritis and is associated with disease severity and poor functional outcome. Erosion of periarticular cortical bone, the typical feature observed on plain radiographs in patients with rheumatoid arthritis, results from excessive local bone resorption and inadequate bone formation. The main triggers of articular bone erosion are synovitis, including the production of proinflammatory cytokines and receptor activator of nuclear factor κB ligand (RANKL), as well as antibodies directed against citrullinated proteins. Indeed, both cytokines and autoantibodies stimulate the differentiation of bone-resorbing osteoclasts, thereby stimulating local bone resorption. Although current antirheumatic therapy inhibits both bone erosion and inflammation, repair of existing bone lesions, albeit physiologically feasible, occurs rarely. Lack of repair is due, at least in part, to active suppression of bone formation by proinflammatory cytokines. This Review summarizes the substantial progress that has been made in understanding the pathophysiology of bone erosions and discusses the improvements in the diagnosis, monitoring and treatment of such lesions.Keywords
This publication has 124 references indexed in Scilit:
- Autoantibodies recognizing carbamylated proteins are present in sera of patients with rheumatoid arthritis and predict joint damageProceedings of the National Academy of Sciences, 2011
- Disease activity and severity in early inflammatory arthritis predict hand cortical bone lossRheumatology, 2010
- The relationship between focal erosions and generalized osteoporosis in postmenopausal women with rheumatoid arthritisArthritis & Rheumatism, 2009
- Therapeutic targeting of Janus kinasesImmunological Reviews, 2008
- Rheumatoid arthritis bone erosion volumes on CT and MRI: reliability and correlations with erosion scores on CT, MRI and radiographyAnnals Of The Rheumatic Diseases, 2007
- TNF-induced structural joint damage is mediated by IL-1Proceedings of the National Academy of Sciences, 2007
- Cytokines in the pathogenesis of rheumatoid arthritisNature Reviews Immunology, 2007
- Osteoimmunology: shared mechanisms and crosstalk between the immune and bone systemsNature Reviews Immunology, 2007
- Th17 functions as an osteoclastogenic helper T cell subset that links T cell activation and bone destructionThe Journal of Experimental Medicine, 2006
- Osteoclast differentiation and activationNature, 2003