Now and then
Observations on the microenvironmental nature of cartilage degradation in rheumatoid arthritis
University Department of Medicine, Manchester
Royal Infirmary, Manchester
Correspondence to: Dr D E Woolley, University Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
Accepted for publication 21 November 1996
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Over the past 40 years rheumatoid arthritis (RA) has
been the subject of extensive immunological and histological
investigations. Rheumatoid synovial tissues, obtained from synovectomy,
joint arthroplasty or biopsy have been examined by various pathologists and researchers using a range of ever more sophisticated techniques. From conventional histology using haematoxylin and eosin, to
immunolocalisation, in situ hybridisation, and more recently to the use
of extracted RNA for specific gene analysis. From early studies
describing synovial A and B cells as the major components of rheumatoid
synovium, we now have a better understanding of T cell subsets,
monocyte-macrophage populations, and the expression of disease related
genes such as cytokines and proteinases. This knowledge undoubtedly
provides a better understanding of the inflammatory processes that
operate in rheumatoid synovial tissue; but the cardinal feature of RA is cartilage and bone degradation. Far fewer studies have been reported
on these sites of cartilage erosion or bone
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