Bone changes in early rheumatoid arthritis

doi:10.1053/berh.2000.0129

Best Practice & Research Clinical Rheumatology

Volume 15, Issue 1, March 2001, Pages 105-123

https://doi.org/10.1053/berh.2000.0129 Get rights and content

Abstract

Bone disease in rheumatoid arthritis affects the peri-articular and axial skeleton and is a major cause of disability. Recent studies have shown that pro-inflammatory cytokines stimulate the expression of osteoprotegerin ligand, a transmembrane protein of the tumour necrosis factor ligand superfamily, on synoviocytes and activated T cells. Osteoprotegerin ligand stimulates osteoclast formation and activation, membrane-bound and soluble osteoprotegerin ligand leading to osteoporosis as well as erosions. Bone densitometry using dual energy X-ray absorptiometry is an objective and precise method for monitoring this bone disease. Bone loss is more rapid in patients with early rheumatoid arthritis and correlates well with measures of inflammation and function. Data are emerging that monitoring bone loss of the hands in early rheumatoid arthritis could be an outcome measure and a prognostic indicator of future functional disability. Suppressing inflammation effectively and the use of bone active agents can reduce the rate of loss. In animal models, osteoprotegerin—a decoy receptor of osteoprotegerin ligand—blocks osteoporosis and erosions without affecting inflammation. The use of new biological agents could in future effectively prevent and treat rheumatoid bone disease.

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While we did not observe a significant increase in BMD when synovial macrophages were depleted locally using clodronate, we did observe a significant decrease in BMD in pre-depleted MaFIA mice (Day −2). This decrease in bone density accompanied by a significant increase in synovitis at 7 days following fracture is similar to early rheumatoid arthritis pathology of periarticular bone loss in association with active synovitis and inflammation44,45. Findings from this study further strengthen the evidence that macrophages play a critical role in bone homeostasis, particularly within the region of a fracture.
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Bone loss has been recognized as a complication of rheumatoid arthritis (RA) for more than a century [1] and presents in two different forms: as juxta-articular osteoporosis around inflamed joints, which is a radiological characteristic of “early” RA, and generalized osteoporosis, which is one of the most common extra-articular manifestations of the disease [2,3].
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View all citing articles on Scopus

^f1: Corresponding author.

View full text

Regular ArticleBone changes in early rheumatoid arthritis

Abstract

Cell

Cell

Journal of Biological Chemistry

Lancet

Lancet

Baillière's Clinical Rheumatology

Diseases of the Joints

Radiographic changes in early rheumatoid disease

Annals of the Rheumatic Diseases

American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis

Arthritis and Rheumatism

Bone mass measurement and bone metabolism in rheumatoid arthritis: a review

British Journal of Rheumatology

Osteoporosis in rheumatoid arthritis—the clinical view point

British Journal of Rheumatology

Bone mineral density in patients with recent onset rheumatoid arthritis: influence of disease activity and functional capacity

Annals of the Rheumatic Diseases

Effects of low dose corticosteroids on bone mass in rheumatoid arthritis: a longitudinal study

Annals of the Rheumatic Diseases

Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis?

Annals of the Rheumatic Diseases

Fractures after rheumatoid arthritis: a population based study

Arthritis and Rheumatism

Activated T cells regulate bone loss and joint destruction in adjuvant arthritis through osteoprotegerin ligand

Nature

Regulation of the differentiation and function of osteoclasts

Journal of Pathology

Involvement of receptor activator of nuclear factor kB ligand/osteoclast differentiation factor on osteoclastogenesis from synoviocytes in rheumatoid arthritis

Arthritis and Rheumatism

Activated human T cells induce osteoclast differentiation from peripheral monocytes via expression of osteoclast differentiation factor (ODF)/RANKL/TRANCE/OPGL

Arthritis and Rheumatism

Metalloproteinases and tissue damage

British Journal of Rheumatology

Mast cells, cytokines and metalloproteinases at the rheumatoid lesion: dual immunolocalization studies

Annals of the Rheumatic Diseases

Cathepsin B in synovial cells at the site of joint destruction in rheumatoid arthritis

Arthritis and Rheumatism

Determination of stromolysin-1, 72 and 92 kDa type IV collagenase, tissue inhibitor of metalloproteinase-1 (TIMP-1) and TIMP-2 in synovial fluid and serum from patients with rheumatoid arthritis

Journal of Rheumatology

Serum MMP-3 in rheumatoid arthritis: correlation with systemic inflammation but not with erosive status

Rheumatology

Rheumatoid arthritis, corticosteroid therapy and hip fracture

Risk of vertebral fracture in women with rheumatoid arthritis

British Medical Journal

Stress fractures of the pubic rami in rheumatoid arthritis

Annals of the Rheumatic Diseases

Regular Article
Bone changes in early rheumatoid arthritis