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19 Cards in this Set
- Front
- Back
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What is rheumatoid arthritis?
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- A systemic illness characterized by polyarticular (many joints) inflammatory arthritis, associated with other systemic symptoms
- It is a model of chronic inflammation |
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How is RA different than OA or spondylitis?
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RA: inflammatory disease of synovium. Affects small joints (PIP)
OA: degenerative disease of cartilage. Affects hands (DIP) Spondylitis: Inflammatory disease of synovium and enthesis. Affects axial/LARGE joints |
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What MCH molecule is associated with severe RA?
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MHC II HLA-DRB1
- Genetic component of RA SAME AS ANTIBIOTIC RESISTANT LYME DISEASE |
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What is the major environmental risk factor for RA?
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SMOKING EWWWWW
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How is smoking thought to cause RA?
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- Induces citrullination
- Antibodies against Cyclic citrullinated peptide (CCP) are formed - Abs attack citrulline residues of Type II collagen in joints |
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What mouth thing is a risk factor for RA?
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Periodontal disease
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What becomes inflamed in RA?
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The synovium - undergoes hyperplasia and hypertrophy
- increased vascularity |
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What cell types are seen in the inflamed RA synovium?
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1. B cells
2. T cells 3. Macrophages 4. Dendritic cells |
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Due to the high amount of leukocytes in the RA synovium, what can form in the joints?
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Immune cells can organize into lymphoid structures
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What are the 2 main autoantibodies found in RA?
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1. Rheumatoid Factor (RF) antibody against IgG
2. Anti-CCP |
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How can B cells producing RF activate a variety of antigen specific T cells?
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Bc can bind and present any antigen that is part of an immune complex with RF (because RF binds Fc portion of IgG)
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What does RF form that fix complement and can activate additional inflammatory processes?
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Immune Complexes
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What is the most important cytokine produced by the activated B cells in RA?
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TNF-a
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Why do patients feel bad in RA?
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Because of circulating cytokines such as TNF-a!!!
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What is the pathway for cartilage destruction in RA?
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Inflammatory cytokines (TNFa) activate collagenases
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What is the pathway for bone destruction in RA?
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Inflammatory cytokines (TNF-a) activate osteoclastogenesis via RANKL
- Activates OSTEOCLASTS that resorb (destroy) bone |
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What molecule prevents RANKL binding to RANK and inhibits osteoclasts?
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Osteoprotegerin (OPG)
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What is the primary cause of death of RA patients?
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Carviovascular mortality due to athlerosclerosis
- Recall: RA = chronic inflammation which is factor in athlerosclerosis as well as RA |
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What is the primary treatment for RA?
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Decreasing the levels of TNF-a
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