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Editorial
. 2012 Jun;64(6):1708-12.
doi: 10.1002/art.34445.

Learning about the natural history of rheumatoid arthritis development through prospective study of subjects at high risk of rheumatoid arthritis-related autoimmunity

Kevin D Deane
Editorial

Learning about the natural history of rheumatoid arthritis development through prospective study of subjects at high risk of rheumatoid arthritis-related autoimmunity

Kevin D Deane. Arthritis Rheum. 2012 Jun.
No abstract available

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Figures

Figure 1
Figure 1
Phases of development of rheumatoid arthritis (RA). In this model of RA development, disease begins with genetic risk (phase 1), followed by asymptomatic inflammation and autoimmunity (phase 2), with eventual progression to symptomatic inflammatory arthritis (IA) (phase 3) that may progress to classifiable RA (phase 4). Currently, the asymptomatic phases of disease development (phases 1 and 2) can be termed the “preclinical” period of development, although this nomenclature is in evolution. Not all subjects who are at risk of developing RA progress through all of these phases, and some subjects may have resolution of inflammation, autoimmunity, and even inflammatory arthritis (demonstrated by the bidirectional arrows). The mechanisms of transition between these phases are not well understood but likely involve complex relationships between genetic and environmental factors (which may differ between phases), age-related and stochastic immunologic changes, as well as psychosocial factors, access to health care, and response to therapy.
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