Division and Laboratory of Rheumatology, University of Pavia School of Medicine, IRCCS Policlinico San Matteo Foundation, Piazzale Golgi 2, 27100 Pavia, Italy.
Curr Rheumatol Rep. 2011 Oct;13(5):440-8. doi: 10.1007/s11926-011-0201-y.
Rheumatoid arthritis is characterized by multiple pathobiological processes and heterogeneous clinical phenotypes. Not surprisingly, the inflamed synovium harbors an equally complex pathology. This includes variability in infiltrating and resident cell populations, spatial arrangements, and cell-cell interactions, as well as gene expression profiles. Remarkable progress in our understanding of the many facets of tissue heterogeneity has been facilitated by the increasing availability of patients' material and the development of advanced research technologies. The next challenge is to capitalize on the large amount of data generated to elucidate the specific pathogenic pathways disparately activated in different patients and/or different phases of the disease. When tissue pathology can be reliably explored through noninvasive circulating biomarkers, then the circle will be closed. We attempt to highlight key advances in the understanding of synovial tissue heterogeneity in rheumatoid arthritis and summarize novel perspectives in synovial biomarker discovery in relation to peripheral blood.
类风湿关节炎的特征是多种病理生物学过程和异质的临床表型。毫不奇怪，发炎的滑膜具有同样复杂的病理学。这包括浸润和固有细胞群体、空间排列和细胞-细胞相互作用以及基因表达谱的可变性。随着患者材料的日益丰富和先进研究技术的发展，我们对组织异质性的许多方面的理解取得了显著进展。下一个挑战是利用大量生成的数据来阐明在不同患者和/或疾病的不同阶段中差异激活的特定致病途径。当可以通过非侵入性循环生物标志物可靠地探索组织病理学时，这个循环就会完成。我们试图强调类风湿关节炎滑膜组织异质性理解方面的关键进展，并总结与外周血相关的滑膜生物标志物发现方面的新视角。
