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arthritis is one of the inflammatory disease and it was distinguished through
an immune –mediate destruction of joint tissue which promote through the
chronic inflammation can affecting on synovium, arthrodial joints as proximal
inter phalangeal and metacarpophalangeal joints of the knee and hands. Three
different bone are able to damage due to this autoimmune disease including systemic
osteoporosis, periarticular bone loss adjacent to the inflamed joints and local
bone erosions at the joint which have direct contact with the inflamed
synovium, as know all three forms above cause the osteopenia. The main feature
of RA as know is a chronic inflammation which touching arthrodial joints which
eventuality able to destruction of joints wrapped up inflammatory which
involvement of the synovial membrane, subchondral bone and cartilage.

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genesis is usually count on the presence of macrophage colony which able to stimulate
factor (M-CSF), receptor activator of nuclear factor Kappa-B ligand (RANKL) so
the impact on osteoclast able to expansion, then then the bone will resorption
in RA arthritis. In this stage, the bone resorption by secrete of protons,
phosphates and protease are mediated by osteoclasts. Osteoclast genesis is
improved through some autoantibodies, cytokinase and infiltrated immune cell,
the secretion inflammatory cytokinase as IL-6 and TNF-ALPHA that which over
able directly heighten osteoclast to increase the RANKL expression and differentiation.
The other inflammatory cytokinase as IL-1ß and IL-17 are both important
cytokinase which triggering bone destruction in RA. Other involvements of
NFATC1 as regulator of osteoclast genesis through the expression of osteoclast
gene as cathepsin K, osteoclasto associated receptor, calcitonin receptor,
vitronectin receptor and TRAP.

lymphoid-like structures:

the ectopic lymphoid-like structures implicative of secondary lymphoid organs
generally able to develop on sites of chronic inflammation at the point which
contribute to immune-mediated pathology. By estimate of synovial tissue from
patient which involve by this inflammatory disease as shown in different
experiment and research shown the minor level of interleukin -27 expression
conform with an increased prevalence of Ectopic lymphoid-like structures (ELS)
and gene designation associated with their activity and development. The
exsistance of synovial ectopic lymphoid-like structures had examined from mice
which lake in the IL-27R after onset of inflammatory this disease (RA).

in illuminate the role of TH-17 helper cells which able to expansion of ELS and
in this manner RA emphasize to how TH-17 cells specific convinced ectopic
lymphoid follicles at CNS. However, infiltrate of TH-17 cells in the central
nerve system of th-17 cell beneficiary accumulate in almost large organized
structure of ELS, so in this part have to suggestive the th-17 cells have
capable to bring out the ELS structure in the central nerve system. The withal
impacts of TH-17 can be detect and consideration base on IL-27 and also attention
on effect of ELS cells. In this essay show, how the IL-27 have main roll to
reduction of TH17 differentiation which efficacy due IL-6 and 7 and also
explore the role in TH17 differentiation and stimulation. The other main things
to mention is to how CXCL5, and CCL2 are neutrophil and monocyte chemokines
which are convinced IL-17, so that fact might reduce in damaging and
aggregation and the results is reduction of ELS formation.

effect on cellular and molecular pathway the effective of autoantibodies on
bone erosion by the rheumatoid factor (RF) which straight way against the
constant region of IgG and hence information of the serum immune
they able to mediate by a series enzyme which called peptideylalargenine
deiminases (PAD)and have been really important 
for couple of biological processed as skin keratinization ,extra
cellular tap formation and  apoptosis .when
the transformation of arginine in to citruline changed the charge of protein ,
so the neo-epitopes be able to arise and 
information of autoantibodies in this disease.

the Krishnamurthyl confirmed the ACPA straight attach to the citullinated
proteins then expressed on the cell surface of pre –osteoclasts, so the result
of this binding is hints to differentiation of osteoclast and finally increased
the bone resorption in vitro as well in vivo.

Modifications in RA:

Abnormal histone modifications as know have different
activation of RASFs, So the H3K27-specific HMT, accompaniment of zester
homologue 2 through the research is highly expressed in RASFs and through the
TNF? by Jun kinase pathways and
nuclear factor-kappa B. When the SFRP1and their inhibitor signaling, were
identified as the target of the gene and was linked with the of RASFs
activation. in other hands, the expression which found able to relate with
specific histone markers through the promoter, including H3K4me3 and H3K27me3,  also, the T-box transcription factor 5 in RASFs
is highly expression,  then the histone
markers,  which including of  H3K4me3 and histone acetylation, are both corresponded
to increase in the TBX5 promoter of RASFs.When the TBX5 have over expression
that changed and effect on other expression on 790 genes, which included of the
IL-8, C-X-C motif ligand 12, C-C motif ligand 20. In additional through the Reserch
about this disease two cytokinase as IL-6 and IL-8 expression able to reduce in
RA synovial tissues through the trichostatin A, HDAC inhibitors, nicotinamide
and sodium phenylbutyrate.



In summary of this reaserch have able to show the impact of
the IL-27 which had on a variety of molecules on Rheumatoid arthritis counting
TH-17 cell which expansion and aggregation and expression and also show how increasing
the level of ELS and also resolve if the IL-17 must reduce by ELS expression
and avoided or reduced the progression of RA.


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