Selim Nalbant

By Selim Nalbant and Ahmet Merih Birlik

Cytokines are cell molecules that are secreted by immune cells and aid cell to cell communication in immune responses and stimulate the movement of cells towards sites of inflammation, infection and trauma. So, the cytokines are the main part of the immune network to provide the communication in rheumatoid arthritis (RA) too. In RA, cytokines may be classified into four groups: pro-inflammatory cytokines, inflammatory cytokines in joints, anti-inflammatory cytokines and natural cytokine antagonists. After the initial stimuli have occurred, cytokines play a role in communication between the parts of immune system in every step of the pathophysiology process of RA. The differentiation of narve T cells into Th17 cells results in inflammation (synovitis) in joints. B cells further the pathogenic process through antigen presentation and autoantibody and cytokine production. The release of cytokines, especially tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1, causes synovial inflammation. In addition to their articular effects, pro-inflammatory cytokines promote the development of systemic effects (anemia, cardiovascular disease, fatigue and depression). So, cytokines are the main molecules contributing to all facets of the disease.

Part of the book: New Developments in the Pathogenesis of Rheumatoid Arthritis