Decker J L, Malone D G, Haraoui B, Wahl S M, Schrieber L, Klippel J H, Steinberg A D, Wilder R L
Ann Intern Med. 1984 Dec;101(6):810-24. doi: 10.7326/0003-4819-101-6-810.
Rheumatoid arthritis is a chronic inflammatory synovitis that primarily involves peripheral diarthrodial joints. Immunohistologic analysis of diseased synovium has shown a spectrum of abnormalities that resemble various stages of a cell-mediated, or delayed-type, immune reaction. The infiltrating mononuclear cells produce various factors that modulate adjacent tissues and appear to produce the characteristic destructive features of the disorder. Our understanding of the mechanisms of action of various therapeutic modes also indicates that the disease is primarily mediated by activated mononuclear cells. All effective therapies have been shown to affect either mononuclear cell function or the rates of production or elimination of these cells. The disorder likely represents the pathologic expression of a genetically controlled host immune response to an undefined causative stimulus. The stimulus could be an infectious agent(s), a product(s) derived from an infectious agent(s), a constituent(s) of synovial or connective tissue, or a combination of these.
类风湿性关节炎是一种主要累及外周滑膜关节的慢性炎症性滑膜炎。对患病滑膜的免疫组织学分析显示出一系列异常，这些异常类似于细胞介导的或迟发型免疫反应的各个阶段。浸润的单核细胞产生各种调节邻近组织的因子，并似乎产生该疾病的特征性破坏特征。我们对各种治疗方式作用机制的理解也表明，该疾病主要由活化的单核细胞介导。所有有效的治疗方法均已证明可影响单核细胞功能或这些细胞的产生或清除速率。该疾病可能代表了宿主对未明确致病刺激的基因控制免疫反应的病理表现。该刺激可能是一种感染因子、源自感染因子的一种产物、滑膜或结缔组织的一种成分，或这些的组合。
