EDITORIAL - Collagen of articular cartilage: the neglected autoantigen of RA

[Guest guest]

Journal of Rheumatology

May 2008

Editorial

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Collagen of Articular Cartilage: The Neglected Autoantigen of

Rheumatoid Arthritis

IAN R. MACKAY, MD;

MERRILL J. ROWLEY, PhD,

Department of Biochemistry and Molecular Biology,

Monash University,

Clayton 3800,

Australia

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If we knew the antigenic determinants towards which the forbidden

clones...in rheumatoid arthritis are directed, major therapeutic

approaches would be in sight.

I.R. Mackay, F.M. Burnet, Autoimmune Diseases1

The lead quotation comprises the last 3 lines of a text on autoimmune

disease published 45 years ago. Since then an immense literature has

accumulated on various immunological aspects of rheumatoid arthritis

(RA), including an article from Finland in this issue of The Journal

describing the association between RA and immune responses to the

minor articular collagen type IX (CIX)2. While most scholars accept

that RA amply fulfils the markers and criteria for an autoimmune

disease, the actual identity of a provocative autoantigen(s) remains

an enigma. However, given the abundance of collagen in the primary

site of the disease in RA, and the proven autoantigenicity of the

collagen molecule, this could be expected to be high on the list of

suspects. Yet, curiously, there appear expert reviews covering the

pathogenesis of RA with barely a reference to autoimmunity to

collagen. Perhaps the striking successes of the new biological

therapies, whether anti-phlogistic or B cell-depleting, transcend the

need to consider " causes " in favor of modes of generation, and action,

of inflammatory immune complexes as mediators of disease. In this

editorial, and as outlined in more detail elsewhere3, we draw

attention to evidence that articular cartilage and particularly

collagen is a significant autoantigen for pathogenesis of RA.

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Read the rest of the editorial here:

http://www.jrheum.com/subscribers/08/05/731.html

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Not an MD