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Highly Accessed Review

Cells of the synovium in rheumatoid arthritis. Synovial fibroblasts

Ulf Müller-Ladner1*, Caroline Ospelt2, Steffen Gay2, Oliver Distler2 and Thomas Pap3

Author Affiliations

1 Justus-Liebig-University Giessen, Department of Rheumatology and Clinical Immunology, Kerckhoff-Clinic Bad Nauheim, Benekestrasse, D-61231 Bad Nauheim, Germany

2 Center for Experimental Rheumatology, Department of Rheumatology and Zurich Center for Integrative Human Physiology (ZIHP), University Hospital Zürich, Gloriastrasse, CH-8091 Zürich, Switzerland

3 Division of Molecular Medicine of Musculoskeletal Tissue, University of Münster, Domagkstrasse, D-48149 Münster, Germany

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Arthritis Research & Therapy 2007, 9:223  doi:10.1186/ar2337

Published: 20 December 2007

Abstract

For some time synovial fibroblasts have been regarded simply as innocent synovial cells, mainly responsible for synovial homeostasis. During the past decade, however, a body of evidence has accumulated illustrating that rheumatoid arthritis synovial fibroblasts (RASFs) are active drivers of joint destruction in rheumatoid arthritis. Details regarding the intracellular signalling cascades that result in long-term activation and synthesis of proinflammatory molecules and matrix-degrading enzymes by RASFs have been analyzed. Molecular, cellular and animal studies have identified various interactions with other synovial and inflammatory cells. This expanded knowledge of the distinct role played by RASFs in the pathophysiology of rheumatoid arthritis has moved these fascinating cells to the fore, and work to identify targeted therapies to inhibit their joint destructive potential is underway.