Hypothesis
Rheumatoid arthritis: A synovial disease?
Katsuyuki Fujii, Michiko Tsuji, Mitsuko Tajima
Department of
Orthopaedic Surgery, The Jikei University, School of Medicine, 3-25-8
Nishi-Shinbashi, Minato-ku, Tokyo 105 Japan
Correspondence to: Dr Fujii.
Accepted for publication 19 June 1999.
| The first 150 words of the full text of this article appear below. |
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Hypothesis |
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Although rheumatoid arthritis (RA) is believed to be primarily an inflammatory disease of synovium, there is a good possibility that the initiation of the rheumatoid process is triggered by the autoimmune reaction involving type II collagen in the articular cartilage as a consequence of an unknown aetiological agent. Synovitis and other extra-articular features may be induced secondary to the immune complex formation in the subchondral area.
Extensive scientific data on the immune nature of RA have been accumulated.1 According to this, RA is considered to be an autoimmune disease that is presently incurable. Although its aetiology remains unknown, most investigators believe that RA is primarily an inflammatory disease of synovial membrane of the joints. However, here we show evidence that RA primarily involves articular cartilage and subchondral bone, not the synovium; this new direction of research may allow for the development of a specific treatment for the disease.
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