Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease of unknown etiology. To ultimately cure or prevent this chronic disease, it is critical to understand the earliest changes in the immune system that cause RA. Recent work has shown that systemic autoimmunity precedes cellular inflammation in the synovium of RA patients. Animal models have suggested that changes in the lymph nodes may precede those in the synovial tissue. To provide insight into the immunological mechanisms involved in the pathogenesis of RA, most research has been focused on the target tissue of arthritis, the synovium. We now developed a method to obtain lymph node biopsies under local anaesthesia in autoantibody positive individuals at risk of developing RA, early arthritis patients and healthy controls.

During this presentation our latest findings on synovial tissue as well as lymph node tissue changes during the pre-clinical and the earliest phase of arthritis will be discussed.

Funding: the Dutch Arthritis Association, the Netherlands Organization for Health Research and Development (ZonMw), Smart Mix and Innovative Medicines Initiative BeTheCure.

Disclosure of Interest None Declared