Active rheumatoid arthritis originates from few joints but subsequently affects the majority of joints. Thus far, the pathways of the progression of the disease are largely unknown. As rheumatoid arthritis synovial fibroblasts (RASFs) which can be found in RA synovium are key players in joint destruction and are able to migrate in vitro, we evaluated the potential of RASFs to spread the disease in vivo. To simulate the primary joint of origin, we implanted healthy human cartilage together with RASFs subcutaneously into severe combined immunodeficient (SCID) mice. At the contralateral flank, we implanted healthy cartilage without cells. RASFs showed an active movement to the naive cartilage via the vasculature independent of the site of application of RASFs into the SCID mouse, leading to a marked destruction of the target cartilage. These findings support the hypothesis that the characteristic clinical phenomenon of destructive arthritis spreading between joints is mediated, at least in part, by the transmigration of activated RASFs.

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This study was funded by a start-up grant of the German Society of Rheumatology, by research grants of the German Research Foundation (Deutsche Forschungsgemeinschaft: NE1174/3-1, MU1383/14-1, FOR 696), by the Swiss National Fond 32000-116842 and by the Sixth Framework Programme Autocure and Seventh Framework Programme Masterswitch of the EU initiatives. We wish to thank S. Benninghoff, B. Riepl, S. Brückmann and C. Schreiyäck for technical assistance.

Author information


  1. Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Clinic, Bad Nauheim, Germany.

    • Stephanie Lefèvre
    • , Anette Knedla
    • , Christoph Tennie
    • , Andreas Kampmann
    • , Robert Dinser
    • , Ingo H Tarner
    • , Ulf Müller-Ladner
    •  & Elena Neumann
  2. Institute of Experimental Musculoskeletal Medicine, University Hospital Muenster, Muenster, Germany.

    • Christina Wunrau
    •  & Thomas Pap
  3. Department of Internal Medicine D, Nephrology and Rheumatology, University Hospital Muenster, Muenster, Germany.

    • Adelheid Korb
  4. Department of Dermatology, University Hospital Muenster, Muenster, Germany.

    • Eva-Maria Schnäker
  5. Department of Microbiology and Molecular Genetics, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.

    • Paul D Robbins
  6. Center for Molecular Orthopedics, Harvard Medical School, Boston, Massachusetts, USA.

    • Christopher H Evans
  7. Department of Orthopedics and Orthopedic Surgery, University Hospital Giessen and Marburg, Giessen, Germany.

    • Henning Stürz
  8. Department of Orthopedics and Experimental Orthopedics, University Hospital Giessen and Marburg, Giessen, Germany.

    • Jürgen Steinmeyer
  9. Center for Experimental Rheumatology, Zürich Center for Integrative Human Physiology, USZ, Zürich, Switzerland.

    • Steffen Gay
  10. Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.

    • Jürgen Schölmerich


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S.L., experiment selection, design and performance, manuscript preparation; A. Knedla, SCID mouse surgery and evaluation; C.T., detection and evaluation of RASFs in mice; A. Kampmann, LMM and evaluation of integrins; C.W., TEER assay and evaluation; R.D., collagenase injection and evaluation; A. Korb, TEER adhesion assay and evaluation; E.-M.S., TEER assay and evaluation; I.H.T., SCID mouse surgery; P.D.R. and C.H.E., preparation of adenoviral vectors; H.S., orthopedic surgery and collection for research; J. Steinmeyer, tissue preparation for experiments; S.G., project design and experimental design; J. Schölmerich, project and experimental design; T.P., project and experimental design, TEER and adhesion assay; U.M.-L., project development and design, experimental design and manuscript preparation; E.N., project development and coordination, study and experimental design and performance and manuscript preparation,

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Correspondence to Elena Neumann.

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