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      Dual Role of Chondrocytes in Rheumatoid Arthritis: The Chicken and the Egg

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          Abstract

          Rheumatoid arthritis (RA) is one of the inflammatory joint diseases that display features of articular cartilage destruction. The underlying disturbance results from immune dysregulation that directly and indirectly influence chondrocyte physiology. In the last years, significant evidence inferred from studies in vitro and in the animal model offered a more holistic vision of chondrocytes in RA. Chondrocytes, despite being one of injured cells in RA, also undergo molecular alterations to actively participate in inflammation and matrix destruction in the human rheumatoid joint. This review covers current knowledge about the specific cellular and biochemical mechanisms that account for the chondrocyte signatures of RA and its potential applications for diagnosis and prognosis in RA.

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          Diagnosis and Management of Rheumatoid Arthritis

          Rheumatoid arthritis (RA) occurs in about 5 per 1000 people and can lead to severe joint damage and disability. Significant progress has been made over the past 2 decades regarding understanding of disease pathophysiology, optimal outcome measures, and effective treatment strategies, including the recognition of the importance of diagnosing and treating RA early.
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            Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies

            Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects the lining of the synovial joints and is associated with progressive disability, premature death, and socioeconomic burdens. A better understanding of how the pathological mechanisms drive the deterioration of RA progress in individuals is urgently required in order to develop therapies that will effectively treat patients at each stage of the disease progress. Here we dissect the etiology and pathology at specific stages: (i) triggering, (ii) maturation, (iii) targeting, and (iv) fulminant stage, concomitant with hyperplastic synovium, cartilage damage, bone erosion, and systemic consequences. Modern pharmacologic therapies (including conventional, biological, and novel potential small molecule disease-modifying anti-rheumatic drugs) remain the mainstay of RA treatment and there has been significant progress toward achieving disease remission without joint deformity. Despite this, a significant proportion of RA patients do not effectively respond to the current therapies and thus new drugs are urgently required. This review discusses recent advances of our  understanding of RA pathogenesis, disease modifying drugs, and provides perspectives on next generation therapeutics for RA.
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              Th17 Cells and the IL-23/IL-17 Axis in the Pathogenesis of Periodontitis and Immune-Mediated Inflammatory Diseases

              Innate immunity represents the semi-specific first line of defense and provides the initial host response to tissue injury, trauma, and pathogens. Innate immunity activates the adaptive immunity, and both act highly regulated together to establish and maintain tissue homeostasis. Any dysregulation of this interaction can result in chronic inflammation and autoimmunity and is thought to be a major underlying cause in the initiation and progression of highly prevalent immune-mediated inflammatory diseases (IMIDs) such as psoriasis, rheumatoid arthritis, inflammatory bowel diseases among others, and periodontitis. Th1 and Th2 cells of the adaptive immune system are the major players in the pathogenesis of IMIDs. In addition, Th17 cells, their key cytokine IL-17, and IL-23 seem to play pivotal roles. This review aims to provide an overview of the current knowledge about the differentiation of Th17 cells and the role of the IL-17/IL-23 axis in the pathogenesis of IMIDs. Moreover, it aims to review the association of these IMIDs with periodontitis and briefly discusses the therapeutic potential of agents that modulate the IL-17/IL-23 axis.
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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                06 February 2020
                February 2020
                : 21
                : 3
                : 1071
                Affiliations
                [1 ]Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; 990331kmuh@ 123456gmail.com (C.-C.T.); chernkmu@ 123456gmail.com (Y.-J.C.); 960215kmuh@ 123456gmail.com (W.-A.C.)
                [2 ]Division of Rheumatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; d10153@ 123456ms14.hinet.net (W.-C.T.); tsanteng@ 123456yahoo.com.tw (T.-T.O.); wucc@ 123456cc.kmu.edu.tw (C.-C.W.); hemidark@ 123456yahoo.com.tw (W.-Y.S.)
                [3 ]Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
                [4 ]School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
                [5 ]Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
                [6 ]Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
                Author notes
                [* ]Correspondence: jehsye@ 123456kmu.edu.tw (J.-H.Y.); kuopolin@ 123456seed.net.tw (P.-L.K.); Tel.: +886-7-3121101-6088 (J.-H.Y.); Fax: +886-7-3118141 (J.-H.Y.); +886-7-312-1101-2512 (P.-L.K.)
                Author information
                https://orcid.org/0000-0002-1291-1739
                https://orcid.org/0000-0003-2487-2818
                Article
                ijms-21-01071
                10.3390/ijms21031071
                7038065
                32041125
                8e313897-6111-4ec4-84e5-468a1c37510c
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 January 2020
                : 04 February 2020
                Categories
                Review

                Molecular biology
                rheumatoid arthritis,chondrocyte,cartilage
                Molecular biology
                rheumatoid arthritis, chondrocyte, cartilage

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