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Joint inflammation tends to recur in the same joints during the rheumatoid arthritis disease course
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  • Published on:
    Correspondence on “Joint inflammation tends to recur in the same joints during the rheumatoid arthritis disease course” by Heckert et al
    • Hong Huang, Rheumatologist Department of Rheumatology and Clinical Immunology, Peking University First Hospital
    • Other Contributors:
      • Zhuoli Zhang, Rheumatologist

    With great interest, we read the recently published article by Heckert et al regarding the tendency of recurrence of joint inflammation in patients with rheumatoid arthritis (RA) based on the sub-analysis of the BeSt study 1. In this study, the authors found that joint swelling in RA patients tended to recur in the same joints over time (OR 2.37, 95% CI 2.30 to 2.43, p<0.001). We congratulate the teams for their great work. Meanwhile, the important and interesting findings prompt us to think about the possible underlying mechanisms, which was just simply explained in the discussion. The authors pointed out that previous exposure to inflammatory triggers might mount a local alert state in the joint, promoting site-specific recurrence of inflammation. 2 We agree to their hypothesis, and would like to comment on the possible mechanisms in more depth from the aspect of Resident memory T cells (TRM) to the clinical findings.
    TRM cells have been recognized as a group of sentinels maintained in diverse anatomic compartments which resident in the tissue niche for a long-term in both human and mouse models. TRM requires distinct signals for the maintenance and survival in specific tissues. 3 4 It has been found that TRM is associated with the onset, progression and relapse of autoimmune diseases, such as psoriasis, spondylarthritis and lupus. 5-7 Recently, TRM which residents in the synovium was proved to be essential for the flare of arthritis in the animal model of recur...

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    Conflict of Interest:
    None declared.