Oxidative Stress in Rheumatoid Arthritis: What the Future Might Hold regarding Novel Biomarkers and Add-On Therapies

Figure 2

Marching on towards joint destruction: the timeline of rheumatoid arthritis. Years or even decades before clinical disease, rheumatoid arthritis individuals may already exhibit elevated levels of circulating autoantibodies in a systemic subclinical proinflammatory milieu. As the intra-articular oxidative stress and local inflammatory mediators, either cellular or soluble ones, take their places in disease progression, the clinical manifestations become apparent, manifested mainly by joint pain and swelling, with consequent inflammatory morning stiffness. This occurrence characterizes the prototype of inflammatory arthritis, which if not properly treated, preferentially at early stages, might evolve to permanent articular damage, with prominent joint destruction and disability. RA: rheumatoid arthritis.