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Mesenchymal stromal cells. Nurse-like cells reside in the synovial tissue and bone marrow in rheumatoid arthritis

Takahiro Ochi1*, Hideki Yoshikawa2, Tomoko Toyosaki-Maeda3 and Peter E Lipsky4

Author Affiliations

1 Sagamihara National Hospital, Sagamihara, Kanagawa, Japan

2 Department of Orthopaedic Surgery, Osaka University Medical School, Suita, Osaka, Japan

3 Department of Immunology, Shionogi Research Laboratories, Shionogi & Co. Ltd, Osaka, Japan

4 National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD 20892, USA

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Arthritis Research & Therapy 2007, 9:201  doi:10.1186/ar2105

Published: 12 February 2007


A major question concerning the immunopathology of rheumatoid arthritis is why the disease is localized to particular joints. A possible explanation could be the presence within the synovium of cells that foster inflammation or easy accessibility of the synovium to migratory disease enhancing cells. Within both the bone marrow and the synovium, fibroblastic stromal cells play an important role in supporting the differentiation and survival of normal cells, and also contribute to the pathologic processes. Among fibroblastic stromal cells in synovial tissue and bone marrow, nurse-like cells are a unique population having the specific capacity to promote pseudoemperipolesis (adhesion and holding beneath) of lymphocytes, and also the ability to promote the growth and function of some populations of lymphocytes and monocytes. Nurse-like cells could therefore contribute to the immunopathogenesis of rheumatoid arthritis, and may contribute to the localization of inflammation within specific joints. The present review considers the evidence that supports these possibilities.