Review Article

Molecular and Cellular Pathways Contributing to Joint Damage in Rheumatoid Arthritis

Table 2

Various chemokines in RA development.

MembersSourcesLigand(s)Target(s)Major functions

CXC
 CXCL1/groαFLS, chondrocyte, macrophage, endothelial cell, synovial lining cell, and osteoclastCXCR2, DARCNeutrophil, macrophage, and fibroblastsEnhances collagen deposition on RA fibroblasts, thereby fibrillating the synovium.
 CXCL4/PF4Macrophage, monocyte, and T cellCXCR3Neutrophil, fibroblast, monocyte, and Th17 cellPrevents monocyte apoptosis, induces differentiation of macrophages and enhances monocyte phagocytosis and oxygen radical production, exacerbates synovial inflammation, and promotes its chronicity by attracting and activating monocytes to the inflamed tissue.
 CXCL5/ENA-78Monocyte, fibroblast, synovial lining cell, macrophage, and endothelial cellCXCR2, DARCNeutrophil, Th17 cell, and FLSPotent chemotactic factor for neutrophils and also an angiogenic factor. Increased levels of CXCL5 contribute to enhanced levels of RANKL expression.
 CXCL6/GCP-2Fibroblast, endothelial cellCXCR2Neutrophil, vascular endothelial cell, and chondrocytePlays an important role in neutrophil migration and angiogenesis, promotes angiogenesis, and aggravates joint inflammation.
 CXCL7/CTAP-IIIMacrophage, monocyteCXCR2Neutrophil, connective tissue cellIt has an angiogenic effect that affects many aspects of connective tissue metabolism, including the proliferation of synovial fibroblasts and stimulation of synovial fibrosis.
 CXCL8/IL-8Synoviocyte, macrophage, synovial lining cell, endothelial cell, and monocyteCXCR1, CXCR2, and DARCNeutrophil, osteoblast, NK cell, T cell, synovial cell, and chondrocyte, macrophageRegulates leukocyte adhesion molecule expression and acts as a mediator of angiogenesis.
 CXCL9/MigSynoviocyte, macrophage, neutrophil, monocyte, endothelial cell, fibroblast, and keratinocyteCXCR3T cell, eosinophil, monocyte, and NK cellPromotes recruitment of activated T lymphocytes and mast cell precursors and their migration to the site of inflammation.
 CXCL10/IP-10Synoviocyte, leukocyte, FLS, chondrocyte, neutrophil, monocyte, endothelial cell, fibroblast, and keratinocyteCXCR3Macrophage, FLS, T cell, eosinophil, monocyte, and NK cellInduces osteoclast differentiation and mediates RANKL expression in synovial CD4+ T cells.
 CXCL12/SDF-1Synoviocyte, endothelial cell, osteoblast, and stromal cellCXCR4T cell, monocyte, endothelial cell, osteoclast, and stromal cellInvolved in the recruitment of CD4+ T cells to the RA synovium, synovial inflammation, and synovial lymphoid neogenesis. It binds to endoglin, which mediates the development of integrin-dependent leukocyte transendothelial migration, osteoclastogenesis, and bone erosion, leading to radiological progression of RA.
 CXCL13/BLCFibroblast, endothelial cell, follicular dendritic cell, CD4+ T cell, monocyte, and macrophageCXCR5B cell, Tfh cell, Th17 cell, and Treg cellCoordinates the migration and preferential sequestration of B and T cells in the inflammatory areas.
 CXCL16Macrophage, fibroblast, dendritic cell, monocyte, B cell, T cell, smooth muscle cell, and endothelial cellCXCR6T cells, NK cell, B cell, FLS, plasma cell, and APCMediates leukocyte infiltration into synovial tissue involving the MAP kinase (MAPK) pathway and also in lymphocyte recruitment and lymph node organization.

CC
 CCL2/MCP-1Synoviocyte, fibroblast, macrophage, and osteoblastCCR2, CCR10,Monocyte, T cell, NK cell, basophil, macrophage, and osteoclastInduces angiogenesis, recruits macrophages to the joints, and involves in TNF-mediated osteoclast differentiation.
 CCL3/MIP-1αSynoviocyte, monocyte, fibroblast, FLS, neutrophil, macrophage, lymphocyte, basophil, mast cell, and dendritic cellCCR1, CCR5, and CCR3Monocyte, T cell, B cell, NK cell, basophil, eosinophil, and dendritic cellInduces leukocyte chemotaxis, promotes the circulation of T cells into the inflammatory tissues, activates proinflammatory cytokines and RANKL by modulating activation of the PI3K/AKT signaling pathway, and upregulates CD4+ T cells.
 CCL5/RANTESFibroblast, T cell, endothelial cell, chondrocyte, monocyte, and macrophageCCR1, CCR3, and CCR5Monocyte, T cell, NK cell, eosinophil, and basophilInduces MMP-1 and MMP-13 expression as well as collagenase activity by activating RA synovial fibroblasts and may promote IL-1β-induced bone destruction.
 CCL13/MCP-4Chondrocyte, fibroblast, epithelial cell, and endothelial cellCCR2, CCR3Eosinophil, monocyte, T cell, FLS, and basophilStimulates proliferation of synovial fibroblasts.
 CCL18/PARCNeutrophil, dendritic cellUnknownT cell, APC, B cell, and macrophagePromotes the recruitment of T cells by APC.
 CCL20/MIP-3αSynovial lining cell, monocyteCCR6Th17 cell, B cell, monocyte, dendritic cell, osteoblast, and osteoclastRecruits IL-17-producing CCR6+ Th17 cells into the synovium and promotes osteoblast proliferation and osteoclast differentiation and may cooperate with the RANKL to affect bone formation and resorption.
 CCL25/TECKDendritic cell, epithelial cell, endothelial cell, and macrophageCCR9Macrophage, monocyte, and T cellCCL25 may be involved in the differentiation of monocytes into macrophages, especially in RA.

C
 XCL1CD8+ T cell, CD4+ Th1 cell, and NK cellXCR1Monocyte, FLS, T cell, thymocyte, B cell, NK cell, neutrophil, and CD8+ dendritic cellPromotes T cell chemotaxis, stimulates the accumulation of T cells in arthritis joints, and downregulates production of MMP-2 by synovial fibroblasts.

CX3C
 CX3CL1/FractalkineMonocyte, macrophage, FLS, endothelial cell, and dendritic cellCX3CR1T cell, CD16+ monocyte, macrophage, FLS, and osteoclastMediates angiogenesis, enhances the adhesion of senescent T cells to synovial fibroblasts, costimulates the production of proinflammatory cytokines, and regulates cytoskeletal structure, proliferation, and migration of synovial fibroblasts.

Abbreviations: APC: antigen-presenting cell; BLC: B lymphocyte chemoattractant; CTAP-III: connective tissue activating protein-III; CX3CL1: Fractalkine; CXCR: CXC chemokine receptor; DARC: duffy antigen receptor for chemokines; ENA-78: epithelial-neutrophil activating protein-78; FLS: fibroblast-like synoviocytes; GCP-2: granulocyte chemotactic protein-2; groα: growth-related gene product α; IL-8: interleukin-8; IP-10: interferon-γ-inducible protein; Mig: monokine induced by IFN-γ; MAPK: mitogen-activated protein kinase; MCP: monocyte chemoattractant protein; MIP: macrophage inflammatory protein; PARC: pulmonary- and activation-regulated chemokine; PF4: platelet factor 4; RANKL: receptor activator of nuclear factor kappa Β ligand; RANTES: regulated upon activation normally T cell expressed and secreted; SDF-1: stromal cell-derived factor; TECK: monocyte differentiation and chemotaxis to chemokine ligand 25; Tfh cell: follicular helper T cell; XCL1: lymphotactin.