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An evolutionary concept for changes of synovial tissue innervation in patients with rheumatoid arthritis
Author(s) -
Straub R. H.,
Besedovsky H. O.
Publication year - 2004
Publication title -
experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.108
H-Index - 96
eISSN - 1600-0625
pISSN - 0906-6705
DOI - 10.1111/j.0906-6705.2004.00212o.x
Subject(s) - immune system , rheumatoid arthritis , pathogenesis , arthritis , inflammation , immunology , homeostasis , disease , autoimmunity , biology , neuroscience , medicine , pathology , microbiology and biotechnology
The pathogenesis of chronic disabling inflammatory diseases (CDIDs) is partly understood. The presently used concepts focus mainly on abnormalities of the immune system, but this view is incomplete. The presented concept is a new framework for the pathogenesis of CDIDs. It integrates evolutionary theories with the classical immunological standpoint, which is further linked with a neuroendocrine immune view of erroneous homeostatic adaptation of the other supersystems (nervous system, endocrine system and reproductive system): 1) In CDIDs, the loss of tolerance against self and harmless foreign antigens leads to continuous immune aggression which is dependent on a multifactorial genetically polymorph background (the initiation); 2) However, advantageous or disadvantageous adaptation to CDIDs were not evolutionary conserved, because CDIDs severely impaired reproduction or appeared after the reproductive phase and, thus, imply a strong negative selection pressure; 3) Reactions of all supersystems are evolutionary conserved for transient inflammatory reactions such as the elimination of infectious agents, wound healing, foreign body reaction and many others; and 4) The sum of the false reactions of all supersystems, conserved for transient inflammation, provides the pathogenetic background for the chronification of CDIDs, because a continuous aggressive situation is created (the chronification). The human disease of rheumatoid arthritis is used as a prototypic CDID to illustrate the integrated view point. The synovial tissue innervation is in the focus of this concept.