Disease mechanisms in preclinical rheumatoid arthritis: a narrative review

Bibliographic Details
Main Author: Romão, Vasco C.
Publication Date: 2022
Other Authors: Fonseca, João Eurico
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10451/58074
Summary: Copyright © 2022 Romão and Fonseca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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spelling Disease mechanisms in preclinical rheumatoid arthritis: a narrative reviewPre-RAEtiologyPathogenesisPreclinical rheumatoid arthritisRheumatoid arthritisCopyright © 2022 Romão and Fonseca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.In the last decades, the concept of preclinical rheumatoid arthritis (RA) has become established. In fact, the discovery that disease mechanisms start years before the onset of clinical RA has been one of the major recent insights in the understanding of RA pathogenesis. In accordance with the complex nature of the disease, preclinical events extend over several sequential phases. In a genetically predisposed host, environmental factors will further increase susceptibility for incident RA. In the initial steps of preclinical disease, immune disturbance mechanisms take place outside the joint compartment, namely in mucosal surfaces, such as the lung, gums or gut. Herein, the persistent immunologic response to altered antigens will lead to breach of tolerance and trigger autoimmunity. In a second phase, the immune response matures and is amplified at a systemic level, with epitope spreading and widening of the autoantibody repertoire. Finally, the synovial and bone compartment are targeted by specific autoantibodies against modified antigens, initiating a local inflammatory response that will eventually culminate in clinically evident synovitis. In this review, we discuss the elaborate disease mechanisms in place during preclinical RA, providing a broad perspective in the light of current evidence.VCR work was funded by Fundação para a Ciência e Tecnologia (Interno Doutorando Bursary reference SFRH/SINTD/95030/2013); European League Against Rheumatism (EULAR Scientific Training Bursary 2014); and Sociedade Portuguesa de Reumatologia (Fundo de Apoio à Investigação da SPR 2015 & 2016 to VCR).FrontiersRepositório da Universidade de LisboaRomão, Vasco C.Fonseca, João Eurico2023-06-07T14:25:41Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/58074engFront Med (Lausanne). 2022 Aug 19;9:68971110.3389/fmed.2022.6897112296-858Xinfo:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-03-17T14:58:13Zoai:repositorio.ulisboa.pt:10451/58074Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T03:30:32.070736Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
title Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
spellingShingle Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
Romão, Vasco C.
Pre-RA
Etiology
Pathogenesis
Preclinical rheumatoid arthritis
Rheumatoid arthritis
title_short Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
title_full Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
title_fullStr Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
title_full_unstemmed Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
title_sort Disease mechanisms in preclinical rheumatoid arthritis: a narrative review
author Romão, Vasco C.
author_facet Romão, Vasco C.
Fonseca, João Eurico
author_role author
author2 Fonseca, João Eurico
author2_role author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Romão, Vasco C.
Fonseca, João Eurico
dc.subject.por.fl_str_mv Pre-RA
Etiology
Pathogenesis
Preclinical rheumatoid arthritis
Rheumatoid arthritis
topic Pre-RA
Etiology
Pathogenesis
Preclinical rheumatoid arthritis
Rheumatoid arthritis
description Copyright © 2022 Romão and Fonseca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-01T00:00:00Z
2023-06-07T14:25:41Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/58074
url http://hdl.handle.net/10451/58074
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Front Med (Lausanne). 2022 Aug 19;9:689711
10.3389/fmed.2022.689711
2296-858X
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers
publisher.none.fl_str_mv Frontiers
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
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instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
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reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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