Which type of cells are prominently infiltrated in Rheumatoid arthritis?
**Core Concept**
Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by inflammation and destruction of joints, involving a complex interplay between immune cells and inflammatory mediators. The pathogenesis of RA involves the activation of various immune cells, including T lymphocytes.
**Why the Correct Answer is Right**
T cells, particularly CD4+ T cells, play a central role in the pathogenesis of RA. They are prominently infiltrated in the synovial tissue of affected joints, where they interact with antigen-presenting cells (APCs) such as dendritic cells and macrophages. Activated T cells then release cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), and interleukin-17 (IL-17), which contribute to the inflammatory cascade and joint destruction. The presence of T cells in the synovium is a hallmark of RA and is associated with disease severity.
**Why Each Wrong Option is Incorrect**
**Option A:** B cells are also present in RA synovium but are not the primary effector cells driving the disease process. While B cells can produce autoantibodies, such as rheumatoid factor (RF), their role is more supportive than central to the pathogenesis of RA.
**Option C:** Natural killer (NK) cells are not primarily involved in the pathogenesis of RA. While NK cells can be activated in response to inflammatory cytokines, they are not the key immune cells driving the autoimmune response in RA.
**Option D:** While both B and T cells are present in the RA synovium, T cells are the primary effector cells driving the disease process. B cells play a more supportive role, and their presence is not as characteristic of RA as that of T cells.
**Clinical Pearl / High-Yield Fact**
In RA, the presence of T cells in the synovium is a key feature that distinguishes it from other forms of arthritis, such as osteoarthritis. The activation of T cells and the release of cytokines are critical targets for therapeutic interventions in RA, including biologic agents that block TNF-α and other pro-inflammatory cytokines.
**✓ Correct Answer: B. T-cells**