In rheumatoid arthritis, the vascular endothelium is among the key targets
for circulating mediators of inflammation and controls the trafficking of c
ells and molecules from the bloodstream: toward the synovial tissue. Local
blood vessel proliferation allows the pannus to develop and grow, thereby p
romoting cartilage and bone destruction and joint remodeling. Angiogenesis,
the production of new capillaries from preexisting blood vessels, is a key
process in rheumatoid arthritis that involves multiple substances such as
cytokines, chemokines, growth factors, cell adhesion molecules, proteinases
, proteinase inhibitors, and matrix proteins. in animal models of arthritis
, angiogenesis inhibitors have been found to im prove clinical and radiolog
ical outcomes, opening up the possibility of therapeutic applications in hu
mans. Before this possibility is realized, the steady accumulation of data
on the mechanisms that regulate angiogenesis wilt have to continue until a
clear picture of angiogenesis is formed. (C) 2000 Editions scientifiques et
medicales Elsevier SAS.