Rheumatoid Arthritis
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Pathogenesis:
- Type IV hypersensitivity: CD4 Th-1 cell mediated.
- Macrophages phagocytose self antigens and can present peptides on their MHC Class II molecules. The autoreactive TH-1 cells release IFN-gamma which activates macrophages to release prostaglandins, MMP enzymes and TNF-alpha (pro-inflammatory mediator), see diagram. These cytokines cause inflammation and tissue destruction.