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Plasminogen Activators and Their Inhibitors in Arthritic Disease

Rheumatoid arthritis (RA) is a crippling and systemic common disease that primarily involves damage to peripheral joints. The cellular and molecular mechanisms underlying its pathogenesis are not well understood although it is a reasonable view that cytokines and proteolytic enzymes produced by cells in the affected joints may be involved. This article provides evidence for the possible involvement of the plasminogen activator (PA)/plasminogen activator inhibitor (PAI-1) system in RA; it demonstrates that several cell types, which are present in the inflamed lesions, can produce PAS and their inhibitors, whose formation can be modulated by locally generated cytokines. It is also proposed that a "colony-stimulating factor (CSF) network" may exist and be critical to RA development.