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Erschienen in: Current Rheumatology Reports 3/2012

01.06.2012 | OSTEOPOROSIS AND METABOLIC BONE DISEASE (KG SAAG, SECTION EDITOR)

Bone Loss in Rheumatoid Arthritis: Systemic, Periarticular, and Focal

verfasst von: Chad Deal

Erschienen in: Current Rheumatology Reports | Ausgabe 3/2012

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Abstract

Rheumatoid arthritis is a chronic inflammatory disease that results in generalized bone loss and increased fracture risk. Characteristic radiologic features of rheumatoid arthritis include periarticular osteopenia and marginal erosions. An emerging literature highlights the importance of osteoclasts as mediators of the erosive process, with an impairment of bone formation by inhibition of the Wnt signaling pathway as a cause of lack of repair of erosions. MRI has demonstrated the importance of inflammation in the bone marrow compartment as a cause of periarticular osteopenia. The term osteoimmunology has evolved to highlight the association between cells and cytokines of the immune system and their relationship to bone metabolism in rheumatoid arthritis and other forms of chronic inflammatory arthritis.
Literatur
1.
Zurück zum Zitat van Staa TP, Geusens P, Bijlsma JW, Leufkens HG, Cooper C. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum. 2006;54:3104–12.PubMedCrossRef van Staa TP, Geusens P, Bijlsma JW, Leufkens HG, Cooper C. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum. 2006;54:3104–12.PubMedCrossRef
2.
Zurück zum Zitat Orstavik RE, Haugeberg G, Uhlig T, et al. Vertebral deformities in 229 female patients with rheumatoid arthritis: associations with clinical variables and bone mineral density. Arthritis Rheum. 2003;49:355–60.PubMedCrossRef Orstavik RE, Haugeberg G, Uhlig T, et al. Vertebral deformities in 229 female patients with rheumatoid arthritis: associations with clinical variables and bone mineral density. Arthritis Rheum. 2003;49:355–60.PubMedCrossRef
3.
Zurück zum Zitat Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19:385–97.PubMedCrossRef Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19:385–97.PubMedCrossRef
4.
Zurück zum Zitat Engvall IL, Svensson B, Tengstrand B, Brismar K, Hafstrom I. Better Anti-Rheumatic FarmacO Therapy Study Group. Impact of low-dose prednisolone on bone synthesis and resorption in early rheumatoid arthritis: experiences from a two-year randomized study. Arthritis Res Ther. 2008;10:R128.PubMedCrossRef Engvall IL, Svensson B, Tengstrand B, Brismar K, Hafstrom I. Better Anti-Rheumatic FarmacO Therapy Study Group. Impact of low-dose prednisolone on bone synthesis and resorption in early rheumatoid arthritis: experiences from a two-year randomized study. Arthritis Res Ther. 2008;10:R128.PubMedCrossRef
5.
Zurück zum Zitat Wijbrandts CA, Klaasen R, Dijkgraaf MG, Gerlag DM, van Eck-Smit BL, Tak PP. Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss. Ann Rheum Dis. 2009;68:373–6.PubMedCrossRef Wijbrandts CA, Klaasen R, Dijkgraaf MG, Gerlag DM, van Eck-Smit BL, Tak PP. Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss. Ann Rheum Dis. 2009;68:373–6.PubMedCrossRef
6.
Zurück zum Zitat Seriolo B, Paolino S, Sulli A, Ferretti V, Cutolo M. Bone metabolism changes during anti-TNF-alpha therapy in patients with active rheumatoid arthritis. Ann N Y Acad Sci. 2006;1069:420–7.PubMedCrossRef Seriolo B, Paolino S, Sulli A, Ferretti V, Cutolo M. Bone metabolism changes during anti-TNF-alpha therapy in patients with active rheumatoid arthritis. Ann N Y Acad Sci. 2006;1069:420–7.PubMedCrossRef
9.
Zurück zum Zitat Ritchlin CT, Haas-Smith SA, Li P, Hicks DG, Schwarz EM. Mechanisms of TNF-alpha- and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis. J Clin Invest. 2003;111:821–31.PubMed Ritchlin CT, Haas-Smith SA, Li P, Hicks DG, Schwarz EM. Mechanisms of TNF-alpha- and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis. J Clin Invest. 2003;111:821–31.PubMed
10.
Zurück zum Zitat Zaiss MM, Axmann R, Zwerina J, et al. Treg cells suppress osteoclast formation: a new link between the immune system and bone. Arthritis Rheum. 2007;56:4104–12.PubMedCrossRef Zaiss MM, Axmann R, Zwerina J, et al. Treg cells suppress osteoclast formation: a new link between the immune system and bone. Arthritis Rheum. 2007;56:4104–12.PubMedCrossRef
11.
Zurück zum Zitat Vis M, Havaardsholm EA, Haugeberg G, et al. Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NFkappaB ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2006;65:1495–9.PubMedCrossRef Vis M, Havaardsholm EA, Haugeberg G, et al. Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NFkappaB ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2006;65:1495–9.PubMedCrossRef
12.
Zurück zum Zitat Guler-Yuksel M, Allaart CF, Goekoop-Ruiterman YP, et al. Changes in hand and generalised bone mineral density in patients with recent-onset rheumatoid arthritis. Ann Rheum Dis. 2009;68:330–6.PubMedCrossRef Guler-Yuksel M, Allaart CF, Goekoop-Ruiterman YP, et al. Changes in hand and generalised bone mineral density in patients with recent-onset rheumatoid arthritis. Ann Rheum Dis. 2009;68:330–6.PubMedCrossRef
13.
Zurück zum Zitat Dirven L, Guler-Yuksel M, de Beus WM, et al. Changes in hand bone mineral density and the association with the level of disease activity in patients with rheumatoid arthritis: bone mineral density measurements in a multicenter randomized clinical trial. Arthritis Care Res (Hoboken). 2011;63:1691–9.CrossRef Dirven L, Guler-Yuksel M, de Beus WM, et al. Changes in hand bone mineral density and the association with the level of disease activity in patients with rheumatoid arthritis: bone mineral density measurements in a multicenter randomized clinical trial. Arthritis Care Res (Hoboken). 2011;63:1691–9.CrossRef
14.
Zurück zum Zitat Schett G, Kiechl S, Weger S, et al. High-sensitivity C-reactive protein and risk of nontraumatic fractures in the Bruneck study. Arch Intern Med. 2006;166:2495–501.PubMedCrossRef Schett G, Kiechl S, Weger S, et al. High-sensitivity C-reactive protein and risk of nontraumatic fractures in the Bruneck study. Arch Intern Med. 2006;166:2495–501.PubMedCrossRef
15.
Zurück zum Zitat Weitzmann MN, Pacifici R. Estrogen deficiency and bone loss: an inflammatory tale. J Clin Invest. 2006;116:1186–94.PubMedCrossRef Weitzmann MN, Pacifici R. Estrogen deficiency and bone loss: an inflammatory tale. J Clin Invest. 2006;116:1186–94.PubMedCrossRef
16.
Zurück zum Zitat Charatcharoenwitthaya N, Khosla S, Atkinson EJ, McCready LK, Riggs BL. Effect of blockade of TNF-alpha and interleukin-1 action on bone resorption in early postmenopausal women. J Bone Miner Res. 2007;22:724–9.PubMedCrossRef Charatcharoenwitthaya N, Khosla S, Atkinson EJ, McCready LK, Riggs BL. Effect of blockade of TNF-alpha and interleukin-1 action on bone resorption in early postmenopausal women. J Bone Miner Res. 2007;22:724–9.PubMedCrossRef
17.
Zurück zum Zitat Roggia C, Gao Y, Cenci S, et al. Up-regulation of TNF-producing T cells in the bone marrow: a key mechanism by which estrogen deficiency induces bone loss in vivo. Proc Natl Acad Sci U S A. 2001;98:13960–5.PubMedCrossRef Roggia C, Gao Y, Cenci S, et al. Up-regulation of TNF-producing T cells in the bone marrow: a key mechanism by which estrogen deficiency induces bone loss in vivo. Proc Natl Acad Sci U S A. 2001;98:13960–5.PubMedCrossRef
19.
Zurück zum Zitat McQueen FM. The MRI view of synovitis and tenosynovitis in inflammatory arthritis: implications for diagnosis and management. Ann N Y Acad Sci. 2009;1154:21–34.PubMedCrossRef McQueen FM. The MRI view of synovitis and tenosynovitis in inflammatory arthritis: implications for diagnosis and management. Ann N Y Acad Sci. 2009;1154:21–34.PubMedCrossRef
20.
Zurück zum Zitat Jimenez-Boj E, Nobauer-Huhmann I, Hanslik-Schnabel B, et al. Bone erosions and bone marrow edema as defined by magnetic resonance imaging reflect true bone marrow inflammation in rheumatoid arthritis. Arthritis Rheum. 2007;56:1118–24.PubMedCrossRef Jimenez-Boj E, Nobauer-Huhmann I, Hanslik-Schnabel B, et al. Bone erosions and bone marrow edema as defined by magnetic resonance imaging reflect true bone marrow inflammation in rheumatoid arthritis. Arthritis Rheum. 2007;56:1118–24.PubMedCrossRef
21.
Zurück zum Zitat Schett G, Firestein GS. Mr Outside and Mr Inside: classic and alternative views on the pathogenesis of rheumatoid arthritis. Ann Rheum Dis. 2010;69:787–9.PubMedCrossRef Schett G, Firestein GS. Mr Outside and Mr Inside: classic and alternative views on the pathogenesis of rheumatoid arthritis. Ann Rheum Dis. 2010;69:787–9.PubMedCrossRef
22.
Zurück zum Zitat Gravallese EM, Harada Y, Wang JT, Gorn AH, Thornhill TS, Goldring SR. Identification of cell types responsible for bone resorption in rheumatoid arthritis and juvenile rheumatoid arthritis. Am J Pathol. 1998;152:943–51.PubMed Gravallese EM, Harada Y, Wang JT, Gorn AH, Thornhill TS, Goldring SR. Identification of cell types responsible for bone resorption in rheumatoid arthritis and juvenile rheumatoid arthritis. Am J Pathol. 1998;152:943–51.PubMed
23.
Zurück zum Zitat Schett G, Teitelbaum SL. Osteoclasts and arthritis. J Bone Miner Res. 2009;24:1142–6.CrossRef Schett G, Teitelbaum SL. Osteoclasts and arthritis. J Bone Miner Res. 2009;24:1142–6.CrossRef
24.
Zurück zum Zitat Jarrett SJ, Conaghan PG, Sloan VS, et al. Preliminary evidence for a structural benefit of the new bisphosphonate zoledronic acid in early rheumatoid arthritis. Arthritis Rheum. 2006;54:1410–4.PubMedCrossRef Jarrett SJ, Conaghan PG, Sloan VS, et al. Preliminary evidence for a structural benefit of the new bisphosphonate zoledronic acid in early rheumatoid arthritis. Arthritis Rheum. 2006;54:1410–4.PubMedCrossRef
25.
Zurück zum Zitat Cohen SB, Dore RK, Lane NE, et al. Denosumab treatment effects on structural damage, bone mineral density, and bone turnover in rheumatoid arthritis: a twelve-month, multicenter, randomized, double-blind, placebo-controlled, phase II clinical trial. Arthritis Rheum. 2008;58:1299–309.PubMedCrossRef Cohen SB, Dore RK, Lane NE, et al. Denosumab treatment effects on structural damage, bone mineral density, and bone turnover in rheumatoid arthritis: a twelve-month, multicenter, randomized, double-blind, placebo-controlled, phase II clinical trial. Arthritis Rheum. 2008;58:1299–309.PubMedCrossRef
26.
Zurück zum Zitat Ideguchi H, Ohno S, Hattori H, Senuma A, Ishigatsubo Y. Bone erosions in rheumatoid arthritis can be repaired through reduction in disease activity with conventional disease-modifying antirheumatic drugs. Arthritis Res Ther. 2006;8:R76.PubMedCrossRef Ideguchi H, Ohno S, Hattori H, Senuma A, Ishigatsubo Y. Bone erosions in rheumatoid arthritis can be repaired through reduction in disease activity with conventional disease-modifying antirheumatic drugs. Arthritis Res Ther. 2006;8:R76.PubMedCrossRef
27.
Zurück zum Zitat Walsh NC, Reinwald S, Manning CA, et al. Osteoblast function is compromised at sites of focal bone erosion in inflammatory arthritis. J Bone Miner Res. 2009;24:1572–85.PubMedCrossRef Walsh NC, Reinwald S, Manning CA, et al. Osteoblast function is compromised at sites of focal bone erosion in inflammatory arthritis. J Bone Miner Res. 2009;24:1572–85.PubMedCrossRef
28.
Zurück zum Zitat Walsh NC, Gravallese EM. Bone remodeling in rheumatic disease: a question of balance. Immunol Rev. 2010;233:301–12.PubMedCrossRef Walsh NC, Gravallese EM. Bone remodeling in rheumatic disease: a question of balance. Immunol Rev. 2010;233:301–12.PubMedCrossRef
29.
Zurück zum Zitat Diarra D, Stolina M, Polzer K, et al. Dickkopf-1 is a master regulator of joint remodeling. Nat Med. 2007;13:156–63.PubMedCrossRef Diarra D, Stolina M, Polzer K, et al. Dickkopf-1 is a master regulator of joint remodeling. Nat Med. 2007;13:156–63.PubMedCrossRef
Metadaten
Titel
Bone Loss in Rheumatoid Arthritis: Systemic, Periarticular, and Focal
verfasst von
Chad Deal
Publikationsdatum
01.06.2012
Verlag
Current Science Inc.
Erschienen in
Current Rheumatology Reports / Ausgabe 3/2012
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-012-0253-7

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