Ar
Prevalenza:1‐2% ‐ Incidenza: 0,05%
ARTRITE REUMATOIDE
SPONDILITE ANCHILOSANTE
ARTRITE PSORIASICA
PREVALENZA 0,5‐1% 0,1‐1% 0,3‐1%(10‐36% DEI PZ. PSORIASICI)
INCIDENZA 9‐24/100.000 7,2/100.000 3,6‐9,5/100.000
ETA’ DI INSORGENZA 25‐45 < 40 30‐50
RAPPORTO M/F 1/3 3/1 1/1
Biomarker Producing Cells
TNF- Macrophages, T cells
IL-2 T cells
IL-6 Activated M, fibroblast-like synoviocytes
MMP Osteoclasts, fibroblasts, chondrocytes
RF B cells
ACPA B cells
E-selectin Cytokine-stimulated endothelial cells
ICAM-1 Fibroblasts
Autoantibodies (RF, ACPA)
Collagenases, MMPs, cathepsins, ICAM‐1, E‐selectin
Synovial fibroblast
IL‐6IL‐6 TNF‐α IL‐1
MHC
Antigen
TCR
CD 80/86
CD28
APC
Activated B cell
RANKL IL‐6
IFN‐ɣ IL‐2
IL‐17 TNF‐ɑ
Osteoclast
Inflammation and destruction
Chondrocyte
Activated T cell
Activated macrophage
Synovium
APC = antigen‐presenting cell; MHC = major histocompatibility complex; TCR = T‐cell receptor; RANKL = receptor activator of nuclear factor kappa‐B ligand; IFN = interferon; IL = interleukin; TNF = tumor necrosis factor; RF = rheumatoid factor; ACPA = anticitrullinated protein antibody; MMP = matrix metalloproteinase; ICAM = intercellular adhesion module.1. Choy EH, Panayi GS. N Engl J Med. 2001;344:907‐916; 2. Choy E. Rheumatology (Oxford). 2012;51(suppl 5):v3‐v11;3. Emery P, et al. Ann Rheum Dis. 2005;64(suppl 3):432.
Selected Biomarkers in RA– RA is a complex disease involving multiple cell types, cytokines, cell adhesion molecules, autoantibodies, and acute‐phase reactants1,2
– Changes in specific biomarkers may give an indication of etiology3
ARTRITE REUMATOIDE
LA DISABILITÀ IN AR
Nelle fasi precoci di malattia la disabilità è causata principalmente dall’infiammazione(componente reversibile); nella fase più tardiva invece è causata dalla distruzionearticolare (componente irreversibile)1,2.
1. Kirwan JR. J Rheumatol 2001;28:881‐6; 2. Aletaha D, et al. Arthritis Rheum 2006;54:2784‐92
Attività di malattia = Progressione Obiettivo: Remissione/Bassa attività di malattia