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Commentary

Pathogenesis of rheumatoid arthritis: how early is early?

Gary S Firestein

Author Affiliations

Division of Rheumatology, Allergy and Immunology, UCSD School of Medicine, La Jolla, California, USA

Arthritis Research & Therapy 2005, 7:157-159  doi:10.1186/ar1780

Published: 17 June 2005

Abstract

Studies of cytokine expression in rheumatoid arthritis have provided key insights into the pathogenesis of disease and have offered clues for effective therapy. Patterns of T-cell products in chronic rheumatoid synovitis suggest that T helper type 1 cells contribute to the perpetuation of disease. However, there is no guarantee that the mechanisms of late disease are identical to very early rheumatoid arthritis. Evaluation of the cytokine profile at the earliest time points after onset of symptoms could identify novel targets that prevent progression to chronic arthritis.