In inflammatory arthritides, such as rheumatoid arthritis (RA), synovial cells acquire aggressive and disruptive phenotypes that lead to joint disease. Three studies published in 2020 have described phenotypic variation in synovial cells, offering a novel perspective on the potential to resolve pathology and augment treatment options for patients with RA.
Key advances
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A subset of synovial macrophages with a pro-resolving phenotype can be used to predict remission in rheumatoid arthritis (RA)1; promoting the formation of pro-resolving macrophages might be therapeutically viable.
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Different fibroblast subtypes exist in RA synovium; blocking the NOTCH3 pathway can attenuate the proliferation of an aggressive subtype within the pannus in experimental arthritis with therapeutic benefit2.
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Agonism of melanocortin type 1 receptor can temper the activation of synovial fibroblasts via the induction of senescence and is associated with a reparative phenotype3.
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References
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Acknowledgements
M.P. acknowledges the support of the Medical Research Council (grant MR/K013068/1), Versus Arthritis UK (grant 21274) and the William Harvey Research Foundation.
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M.P. declares that he is on the Scientific Advisory Board of Antibe Therapeutics. He also consults for Bristol Meyers Squibb, Palatin Technologies and SynAct Pharma AS and is a founding member of Resolomics Ltd and a shareholder of ResoTher Pharma AS.
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Perretti, M. Switching on resolution to treat RA moves closer to reality. Nat Rev Rheumatol 17, 73–74 (2021). https://doi.org/10.1038/s41584-020-00549-z
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DOI: https://doi.org/10.1038/s41584-020-00549-z
