A 47-year-old woman comes to the physician with progressive joint pain and swelling in her hands for the past several months. She also has easy fatigability that has gradually worsened over the same period. Morning activities are especially difficult due to stiffness lasting 1 to 2 hours after waking. Examination shows warmth, swelling, and tenderness involving the proximal interphalangeal joints, metacarpophalangeal joints, and wrists bilaterally. Plain radiographs of the symptomatic joints show joint space narrowing and marginal erosions. Which of the following cytokines are primarily involved in the pathogenesis of this patient's joint destruction?

Question

A 47-year-old woman comes to the physician with progressive joint pain and swelling in her hands for the past several months.  She also has easy fatigability that has gradually worsened over the same period.  Morning activities are especially difficult due to stiffness lasting 1 to 2 hours after waking.  Examination shows warmth, swelling, and tenderness involving the proximal interphalangeal joints, metacarpophalangeal joints, and wrists bilaterally.   Plain radiographs of the symptomatic joints show joint space narrowing and marginal erosions.  Which of the following cytokines are primarily involved in the pathogenesis of this patient's joint destruction?

Quizplus · Accepted Answer

Eductional Objective: The pathogenesis of rheumatoid arthritis involves early activation of CD4⁺ T cells (especially Th1 and Th17 subsets) with release of cytokines such as tumor necrosis factor-alpha and IL-1 that cause destruction of cartilage and bone. Monoclonal antibodies that inhibit tumor necrosis factor-alpha or IL-1 receptors can slow progression of the disease.

A 47-Year-Old Woman Comes to the Physician with Progressive Joint