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The discovery of common molecular targets for joint resident and inflammatory cells may help to develop the most effective therapeutic strategy.
The joint resident cells, FLS are unique for RA in that they, like innate immune cells, express several TLRs, are implicated in inflammatory response, and play critical roles in osteoarticular destruction [ 73].
In recent years, epigenetic modifications were found to strongly contribute to the development of RA by affecting diverse aspects of the disease and modifying gene expression levels and behavior of several cell types, first and foremost joint resident synovial fibroblasts (SF).
The JAK/STAT signaling pathways mediate the effects of many cytokines/interferons and growth factors important in RA (e.g., IL-2, IL-6, IL-7, IL-10, IL-12, IL-15, IL-21, IL-23, interferons (IFNs), granulocyte macrophage colony-stimulating factor (GM-CSF)) and regulate the activity of hemopoietic and joint resident cells.
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With both normal human and animal joints having resident SF-MSCs [ 17], it is possible that HN-MSCs are entrapped from SF extruded through sites of weakness in the joint capsule [ 34] and that, like the knee, small joints contain a resident SF-MSC population.
As the above discussion shows, the distributions of immigration and emigration, and their joint distributions with resident fitness, can have a strong effect on phenotypic evolution.
These results support the notion that resident joint cells (chondrocytes and synovial fibroblasts) produce GM-CSF in culture in response to TNF-α and IL-1β [ 30, 31].
Taking this into consideration, one could draw the conclusion that the lack of the expected severe disease in DBA-lpr/lpr mice is due to a local attenuating effect of the Fas mutation in pathological processes involving resident joint cells.
Activation of fibroblast-like synoviocytes produces a broad array of cell surface and soluble mediators that help to recruit, retain, and activate cells of the immune system and resident joint cells, leading to the promotion of ongoing inflammation and tissue destruction [ 67].
The role of IL-1 in Th17 differentiation, as well as its potent stimulatory effects on resident joint cells leading to local inflammation, neither of which are shared by IL-36, may explain the differential involvement of these two cytokines in arthritis.
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