Viral infection including HIV and AIDS

Progressive joint destruction in a human immunodeficiency virus-infected patient with rheumatoid arthritis

This article reports the case of a 63-year-old patient with rheumatoid arthritis (RA) whose symptoms of RA improved after the occurrence of a secondary human immunodeficiency virus (HIV) infection; however, the HIV infection did not affect the histologic parameters of joint destruction to the same extent as it did the clinical symptoms. Histologic and immunohistologic joint examinations of this patient revealed an ongoing production of cartilage- and bone-degrading enzymes by macrophages and fibroblasts, without the presence of T cells. These findings demonstrate that progressive joint destruction in RA can occur in the absence of T cells. Moreover, our results support the hypothesis that both T cell-dependent and T cell-independent pathways play a significant role in the pathogenesis of RA.

Cellular immune mechanisms in rheumatoid arthritis and other inflammatory arthritides

Advances in molecular genetics, cellular immunology and microbiology have offered promise in unravelling the aetiopathogenesis of inflammatory arthritides such as rheumatoid arthritis and reactive arthritis. Such insights are challenging the orthodox view that these diseases are primarily autoimmune in nature, and should lead to exciting and novel therapeutic approaches.