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[Joint destruction and its repair in rheumatoid arthritis].

It is supposed that autoaggressive T cell activation, triggered by unknown microorganisms, initiates inflammation in rheumatoid arthritis. It leads to activation of macrophages and synovial fibroblasts in the synovial tissues, which form a granulomatous pannus tissue. It becomes a platform of joint destruction activating osteoclastogenesis and release of cartilage-degrading enzymes. Biological reagents recently brought into the clinics are potently anti-rheumatic, and, in some cases, stop progression of the joint destruction and even repair the joint. It is now a realistic goal for next-generation anti-rheumatic treatments to inhibit joint destruction completely.