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As a group they are characterized by increased activity of phagocytes and the release of inflammatory mediators, which cause tissue damage. In diseases that primarily affect the joints there is inflammation and proliferation of cells of the synovial membrane and damage to cartilage and bone, but other connective tissues and organs in the body can also be damaged. Rheumatoid arthritis is a chronic inflammatory autoimmune disease of largely unknown aetiology affecting about than men.
It is diagnosed after persistent symmetrical multiple joint inflammation of more than six weeks duration.
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Lipids do not dissolve easily in water. Therefore, they have to be transported in blood as lipoproteins.
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Sometimes pulse doses of corticosteroids are used to suppress inflammation while longer term and slower acting DMARDs are being started. Corticosteroids suppress all phases of the inflammatory response, including the early swelling, redness and pain and the later stages seen in chronic inflammation. Circulating lymphocytes and macrophages are reduced in number and the formation of prostaglandins and leukotrienes is inhibited via inhibition of phospholipase A enzyme that converts cell membrane phospholipids into arachidonic acid.
Prednisolone is used for most rheumatoid disease.