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    Bone erosion in rheumatoid arthritis: mechanisms, diagnosis and treatment

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    Authors
    Schett, Georg
    Gravallese, Ellen M.
    UMass Chan Affiliations
    Department of Medicine, Division of Rheumatology
    Document Type
    Journal Article
    Publication Date
    2012-11-01
    Keywords
    Animals
    Arthritis, Rheumatoid
    Bone Resorption
    Cell Differentiation
    Cytokines
    Humans
    Osteoclasts
    Musculoskeletal Diseases
    Rheumatology
    Skin and Connective Tissue Diseases
    
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    Link to Full Text
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096779/
    Abstract
    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 kappaB 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.
    Source
    Nat Rev Rheumatol. 2012 Nov;8(11):656-64. doi: 10.1038/nrrheum.2012.153. Epub 2012 Sep 25. Link to article on publisher's site
    DOI
    10.1038/nrrheum.2012.153
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48760
    PubMed ID
    23007741
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1038/nrrheum.2012.153
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