The Pathology Of Arthritis Biology Essay

Published: Last Edited:

This essay has been submitted by a student. This is not an example of the work written by our professional essay writers.

Pathology is the branch of medical science that deals with the examination and detection of abnormalities, such as changes in structure and function of the body, with a view to understand its causes, its progression and its effects.The term pathology has its origins from the Ancient Greek work pathos which means "feeling or suffering "and logia" which means "the study of". Pathology can also be referred to simply as disease. [1] The term physiology has its origins from the Latin word physio which means "physical and natural" and logia "the study of." Physiology, therefore, refers to the branch of science which is concerned with the functioning of all living organisms and their parts. It deals with the mechanical, physical, and biochemical processes within animals and plants. While physiology is concerned with the study of "normal" biological functions of humans and animals, pathology is the study of the "abnormal" functions or diseases in humans or animals and their parts.

<a>Well-Known Pathologists</a>

The world would not have been what it is today if not for the pioneering work of several bold and dedicated physicians who have contributed in numerous important ways to the study of medicine and pathology. Society must acknowledge that all the well-known pathologists of yesteryears were already practicing physicians or surgeons. It was perhaps their quests to understand what caused a particular symptom or disease, which eventually led to the study of pathology. There are several such inspiring men and women who have taken pathology from its experimental early stages towards a much deeper understanding of diseases and how to treat them. Some of the more prominent among them have been discussed below.


The origins of pathology can be traced back to very early applications of using systematic scientific methods to study disease and this was initiated as early as the Third Century BC by Hippocrates, [2] In the early days, it was generally believed that illness and disease were punishments of divine origin. Hippocrates is actually credited with being the first person to believe that diseases were natural occurrences and not a consequence of superstition, destiny, or some kind of punishment meted out by the gods. Amongst the many other firsts that Hippocrates was recognised for, was his practical work connected with his studies of the human spine's anatomy and pathology. It may be surprising to know that some principles contained in Hippocrates' treatises called On Fractures and On Joints are applicable even today. [3] Hippocrates was the earliest known physician to [4] work on the subject of spine and its anatomy and pathology. His books present accurate descriptions of the different sections of the vertebral structure and the tendons attached to them. This great scientist even devised different apparatus to help cure diseases of the spine and vertebrae. These apparatus are, in fact, considered precursors to modern-day techniques used in spine surgery. [5] 


At around the same time, the ancient Greek physician Herophilus, recognised as the pioneer of the Scientific Method, was known to have systematically and scientifically performed dissections on human cadavers in an effort to advance the field of pathology. [6] This was at a time when dissections were banned in most places, except in Alexandria. Herophilus often conducted his dissections in front of large audiences so that he could describe the procedure to the fascinated group of onlookers. Together with his contemporary Erasistratus, he is believed to have founded the great medical school of Alexandria, which is said to have attracted people from all over the ancient world, mainly due to Herophilus' fame. [7] 


The next significant pathologist was another Greek  called Claudius Galen, who is known to have often quoted the pathological findings of Herophilus, [8] though he was also critical of the approach used by his predecessor.7 Indeed, for some of the documented accounts of scientists like Herophilus, Galen's descriptions of their work are the only proof of their existence. Galen specialised in a wide-ranging number of scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology.

<b>Avenzoar and Ibn-al-Nafis</b>

The scene now shifts to the Middle East where noteworthy contributions were made by Muslim physicians in the Middle Ages. Previous to this it was believed that God could provide a cure for all illnesses. [9] However, in the Ninth Century AD, a paradigm shift took place and scientific analysis became the accepted norm. [10] The first known post-mortem dissections were performed by the Arabian physician Avenzoar. He proved that the skin disease, scabies was caused by a parasite. Around the 13th Century AD, Ibn-al-Nafis, used dissections to discover pathological abnormalities of pulmonary (lung) circulation. [11] Â 

<b>Antonio Beniveni and Giovanni Morgagni</b> In the 15th century, Antonio Beniveni often used dissections to determine the root cause of death. [12] One of the earliest known gross pathologists of that time was Giovanni Morgagni. While anatomical study was popular by this time, Morgagni's detailed treatise on the subject was perhaps the first recordings on the relationship between anatomy findings and disease. [13] 

<b>Rudolph Carl Virchow</b>

In the latter part of the nineteenth century, Virchow, another German pathologist, came to be known for his advancement of public health. Often referred to as the "father of modern pathology" he is also acknowledged as one of those who founded social medicine. He is known for being the first to have recognised leukaemia. Several initiatives in medicine have been credited to Virchow, prominent among them being the developing of a standard method of autopsy procedure and for establishing the medical fields of cellular pathology and comparative pathology (comparison of diseases common to humans and animals). He developed the microscope and was known to constantly urge his students to "think microscopically." [14] 

<b>Julius Cohnheim</b>

One of the earliest experimental pathologists in the late 19th century, Cohnheim, a student of Virchow, was one of the first to study inflammation, a common symptom of arthritis. He also introduced the use of frozen section procedure, which is widely practised by modern-day pathologists to provide clinical information without operations. [15] 

<b>Other Scientists who Influence Pathology</b>

With the advent of new techniques such as the electronic microscopy and molecular biology, the role of investigative pathologists has begun to blur. However, the role of a few eminent pathologists of the last few centuries must be recognised. Prominent amongst these are James Ewing, whose research activities on experimental cancer are well-known and Lauren Vedder Ackerman, a prestigious American physician and pathologist, who introduced the field of surgical pathology in the mid-twentieth century. [16] 

<a>Well-Know Physiologists</a>

<b>The Roots</b>

The history of physiology runs almost parallel to that of pathology with its beginnings with Hippocrates, as early as 3rd century BC. In Ancient Greece, the early development of physiology was heralded by Aristotle's critical study of the human structure's design in relationship to its functions.


In the beginning of the 2nd century AD, Claudius Galen founded experimental physiology to understand the significance of nutrition, health and hygiene, and measures to prevent, control and treat diseases. Galen's study on the human circulatory system is considered his foremost contribution to medicine. [17] Through his various experiments, Galen was first to make out the distinction between the venous (dark) and arterial (bright) blood. He conducted several experiments on animal models to get a more complete understanding of the human circulatory, nervous and respiratory systems. Although, the range of experiments he conducted influenced later-day scientists, it was subsequently proved that some of his thinking was inaccurate. [18] 

<b>Vesalius and Harvey</b>

Galen's thinking had a bearing on medical thinking for several centuries. In fact, it was only around the sixteenth century that physiologist Andreas Vesalius, and William Harvey, a physician from England, made as noteworthy a mark in the world of physiology. Vesalius and Harvey sought to disprove several of Galen's theories. Vesalius's books on human anatomy and physiology are acknowledged as ones that most influenced the deeper understanding of human anatomy at that time. It is, therefore, no wonder that he was referred to as the "father of modern human anatomy." [19] Harvey was the first to give a detailed account of the systemic circulation, the heart as a pumping organ and the properties of the blood. [20] 


The Dutch physiologist Herman Boerhaave also made his mark in Europe as well as other parts of the world. He earned the title "the father of physiology" [21] mainly because of his commendable teaching methodology in the University in Leiden, which became a famous learning centre thanks to Boerhaave's work.

<b>Schleiden and Schwann</b>

The nineteenth century saw the rapid accumulation of physiological information, especially after Matthias Schleiden and Theodor Schwann along with Virchow, propounded the cell theory, which stated that all organisms consists of a unit of cells. Schleiden also recognised the significant role the nucleus played in the cell. He hypothesised that the nucleus was somehow connected to the division of cells. At a time when the world was sceptical about it, Schleiden accepted Darwin's Theory of Evolution. [22] Schwann is well-known for his observation that "all living things are composed on cells and cell products." This conjecture became the cornerstone of modern histology (the study dealing with microscopic tissues) and gave modern pathology a strong scientific footing.


Schmidt-Nielsen and Bartholomew In the twentieth century, contemporaries Knut Schmidt-Nielsen and George Bartholomew were responsible for very interesting work on new fields such as comparative physiology and ecophysiology, which compares how human beings and other organisms function. More recently, the study of evolutionary physiology has been gaining momentum.

<a>Pathology of Arthritis at the Molecular Level</a>

Before we understand the cause and symptoms of molecular arthritis, it may be useful to understand what are atoms and molecules and how they differ from each other.

<b>Atoms and Molecules</b>

Atoms are the basic building blocks of almost all matter that is present in the universe. All elements are made up of atoms and the smallest part into which an element can be divided is an atom. Combinations of atoms form molecules. Molecules are made up of two or more atoms held together in specific proportions by chemical bonds.

<b>Molecules Involved in the Pathology of Arthritis</b>

Pathologists are yet to get a clear understanding of what causes arthritis, besides natural occurrences like ageing and trauma. It is interesting to learn that a team of scientists from California and Japan have thrown fresh light on this debilitating condition. These scientists have discovered that naturally occurring molecules within the body can counteract the advancement of arthritis.


One such important molecule within the human body is the HLA (human leukocyte antigen) which was identified when organ transplants were, more often than not, being rejected by the recipient's body. These molecules are actually genes present on the human chromosomes and are closely associated with the human immune system. Some of these genes encode proteins, which are known as antigens. An antigen is essentially any substance that leads to the immune system producing antibodies against it. This came to light only as a result of studies which were done during organ transplants. An important role, attributed to this group of antigens, is that they encourage the growth and rapid reproduction of T-helper cells about which more details are given in the following paragraphs. [23] HLAs have several other functions within the human system. Important amongst these are the following:


They play an important role in disease defence.

They may be responsible for rejection during organ transplanting.

They may defend or, conversely, fail to defend (if they are down regulated by infection of any kind) the individual against cancers.

They may intervene in autoimmune diseases, such as in the system.


The types of HLA present within each person are inherited. Thus, people with certain HLA antigens are more susceptible to developing certain diseases than others.


CD 4+, also called T4, is a large glycoprotein molecules found on the surface of lymphocytes that serve as a receptor for HIV. Glycoproteins play a crucial role in the body. These are molecules which contain carbohydrates as well as proteins and in the immune system almost all the main molecules are glycoproteins. With advancement of medicine scientist have realised the vital role CD4+ plays in immune responses in human autoimmune diseases, including rheumatoid arthritis. As knowledge of CD4 + continues to expand, it will help scientists understand and explore effective step to arrest and cure this debilitating disease. [24] 

<b>TNF (Tumor Necrosis Factor)</b> Cytokines are small protein molecules secreted by numerous cells which seem to be useful for cell signalling, between one cell and another. TNF-  is one such cytokine which has a crucial part to play in the advancement of arthritis in humans and animals. Scientists hypothesise that if the TNF- molecule is removed from the joint, where there is inflammation, it may have an effect on the progression of arthritis. [25] 


Another group of enzyme molecules that are found in the human body are kinases. Over five hundred different kinases have been identified in the human body and of these the largest group are protein kinases. Their main function is to act on or, alter the activity of specific proteins within the body. The activity of the kinases are actually believed to modify around 30 per cent of all human proteins. [26] 


Scientists have identified Rho GTPases in the human body, the main function of which is to regulate cytoskelatal activities as well as several kinds of signalling pathways within the system. They may be described as a very small but significant family of G proteins that are known to regulate many aspects of intracellular dynamics. Scientist have been conducting experiments, particularly with three members of the RHO family- Cdc 42, Rac 1 and Rho A. [27] 

Rho GTPases were actually first identified back in the mid-1980s but they continue to be investigated even today. RhoA proteins have earned themselves a name for being "molecular switches" and are known to play an important part in cell multiplication, and several other common cellular features. They are recognized as pivotal coordinators of immune responses. A more complete understanding of the role played by Rho GTPases will show scientists the way forward towards the treatment of arthritis.


Interleukins are another group of cytokines which were first seen to be associated with the white blood cells. They are protein-secreting, signalling molecules. The term interleukin is derived from inter which is a "means of communication", and leukin, which is related to the fact that many of the proteins secreted by the interleukins are either produced by or act on leukocytes. The name, however, has proved to be a misnomer, because subsequent studies have revealed that interleukins are actually produced by several other body cells. [28] 

It has been established that the functioning of the immune system depends heavily on interleukins. A deficiency of number of them seems to result in autoimmune diseases or immune deficiency. There are several forms of interleukin each with its own significant role to play in the human immune system. For instance, Interleukin1 accelerates production of interferon and stimulates the growth of disease fighting cells. Interleukin-3 regulates the production of blood cells and interleukin-35 is believed to play a role in inflammation of the skin.

<a>Pathology of Arthritis at the Cell and Tissue Levels</a>

All living beings plants as well as animals are made up of cells. A cell can be described as the structural, functional and biological unit of all organisms. Cells are usually microscopic in structure and contain nuclear and cytoplasmic materials which are bound within a semi-permeable membrane. In plants, the cells are surrounded by an outer cell wall. Cells may exist alone or function together with other cells and work together in a group. Tissues are a collection of similar cells that group together to perform a specialised function. Tissue comes from the Middle English word tissue a rich kind of cloth. Organs are structures which are made up of at least two or more tissues which function together for a common purpose. The body is made up of several different organs (heart, liver and kidneys among others) and also skin. In fact, the skin, which covers every part of the body, is actually the largest organ. The skin is made up tissues such as 1) the outer epidermis which protects the body, 2) the connective tissue which contains the blood vessels which nourish the skin as well as nerves that give the skin its ability to feel and makes it sensitive to the touch, and 3) fat layers which provide cushioning to the skin.

<b>Introduction to Cells affected by Arthritis</b>

The parts mainly affected by rheumatoid arthritis are the joints, tendons, bone cells, and muscle cells. In some cases, rheumatoid arthritis is also known to affect the internal organs. Fresh insights into the possible causes of arthritis have been uncovered only in the last decade or so with over 100 different kinds of arthritis being identified. Scientists are yet to identify a single cause that could set off the cellular symptoms of rheumatoid arthritis, and , consequently, a single type of cell responsible for such a disease, let alone arthritis in general. While they continue to look for that cellular root cause of arthritis, valuable information is continuously being unravelled which helps medicine and science to understand how to diagnose and treat this disease. Rheumatoid arthritis is now recognised as autoimmune condition, which arguably relates to the fact that autoimmune conditions involve cells. [29] When a person develops symptoms of arthritis, the body begins to produce antibodies to its own tissues. To understand what causes the production of these antibodies, it is essential to understand the working of the immune system.


These are leukocytes, or white blood cells, that are part of the human body's defence mechanism. Macrophage originates from macro meaning "large," and "phage" which means "to eat." Macrophages are created in the bone marrow. When a foreign body such as bacteria, for instance, enters the blood stream and come across the macrophages, the macrophages engulf the bacteria (the foreign body) and thereby destroy it. [30] 

Researchers believe that macrophages play a significant role in rheumatoid arthritis because they appear abundantly in the site of inflamed arthritis-affected membrane and at the cartilage. Studies indicate that macrophages do not seem to be actually the root cause of rheumatoid arthritis, however, they do seem to possess the capacity to be inflammatory and destructive and active in all stages of arthritis. There is also ample evidence to prove that the abundance of macrophages at the site of the inflamed rheumatoid affected area directly correlates with the severity of the disease.

<b>Red Blood Cell</b>

Studies have conclusively shown that one of the common complications of rheumatoid arthritis is the abnormally low number of red blood cells in the blood stream. This leads to a condition called anaemia. Contrary to popular belief, all the problems associated with arthritis are not necessarily related to the bones and joints. Almost thirty to sixty percent of people with rheumatoid arthritis seem to suffer from anaemia. [31] Anaemia seems to become more acute in people who have contracted severe forms of arthritis, which involves a higher number of bones and joints and a greater degree of pain and disability. Arthritis, by way of cellular pathology, is by no means the only cause for anaemia; in fact, several other conditions can lead to anaemia. However, it is important to note that, in people suffering from rheumatoid arthritis, this condition can lead to acute fatigue and shortness of breath leading to an overall feeling of malaise.

The following two types of anaemia are associated with arthritis. (1) Iron deficiency anemia is primarily caused by loss of blood, which may include gastrointestinal bleeding in severe cases. Blood inevitably contains red blood cells. (2) Anaemia of chronic diseases is where the patient has both rheumatoid arthritis and anaemia. The abnormal chemical and proteins that inflame the joint also affect the cells which produce red blood cells in the bone marrow. Studies show that this form of anaemia inhibits or reduces the production of new red blood cells in spite of the fact that the body may have sufficient iron to produce new blood cells. [32] 

<b>B-Cells and T-Cells</b>

Another group of molecules called B cells are found in the lymphocytes (white blood cells). Scientists believe that lymphocytes play a major role in ensuring that the activities of the immune system continue. B cells (also called b-lymphocytes) develop from stem cells in the bone marrow and supply antibodies to the human system. Studies have revealed that any change in the development and function of B cells, may significantly affect rheumatic disorders. B-cell depletion therapy is being investigated actively by researchers today as a treatment for arthritis and many other immune-related diseases. [33] Two types of white blood cells are present in the immune system; these are B and T cells. Studies have revealed that the B and T cells distinguish between "self-molecules" belonging to the body and "non-self molecules" such as bacteria and viruses, which may have invaded the body. It is interesting to note that B cells produce antibodies which get attached only to non-self molecules. Each B cell seems to produce antibodies for only one type of non-self molecule, and this production of antibodies takes place only with the assistance of T cells, which first need to recognise parts of the same non-self molecule. It is believed that T cells actually direct antibody production. [34] 

Since T cells actually direct normal immunity, scientists theorise that sometimes T cells confuse self-molecules with non-self help molecules and begin directing the production of autoantibodies. This marks the beginning of autoimmunity, such as that which is related to arthritis, which once started goes on forever. This type of autoimmunity seems to be typical only to humans. A clear explanation for what causes most forms of autoimmunity to start up simply does not exist. There seems to be no evidence to support the thinking that influences from outside the body is "fooling" the T cells into mistaking self-help and non-self help molecules within the body. It seems clear, however, that hereditary factors make some people more susceptible to developing disease than others. It appears that even within families which are autoimmune, it is impossible to predict who will develop the disease and when. It is, therefore, reasonable to conclude that arthritic autoimmunity gets initiated by a chance incident within the immune system. This progresses into a non-ending and self-creating vicious cycle. This chance event is the production of an autoantibody that has the abnormal ability to reproduce itself in prolific amounts which causes damage to body tissues.

<a>Rare and Special Cells Related to Arthritis</a>

<b>Synovial Fibroblasts</b>

The synovial membrane is the soft tissue found between the joint and the joint cavity. The term synovium comes from the word synovia which means "synovial fluid" which is a clear, fluid secreted by the synovial membranes. The term may have originally been derived from the Latin word syn which means "with" and the Latin word "ovum" which means "egg" because the liquid secreted is very much like the white region of an egg. Synovial fibroblasts are mesenchymal cells known to be abundant in arthritis. Mesenchymal cells are rare cells found in the bone marrow which are capable of developing into connective tissues, lymphatic and blood vessels and blood. They are considered vital cells in the diagnosis and treatment of rheumatoid arthritis, due to their ability to replicate themselves and produce inflammatory cytokines as well as enzymes which destroy the matrix of the cells. However, since rheumatoid arthritis is considered an immune-related disease, scientists were not able to give a clear connection between the disease and immunity-related symptoms. One of the characteristic features of arthritis is the inflammation of the synovial joints. All kinds of cells such as macrophages, T cells and neutrophils migrate to the synovial tissues, become activated and produce the substances that cause inflammation and degradation of the joints and cartilages. [35] 

<b>Th-17 Cells</b>

Scientists have been on an elusive quest for years to identify some key factor that could activate and act as a trigger for the onset and progression of rheumatoid arthritis. So far, all studies have proved futile in as much as there does not seem to be a single organism or condition that can exclusively be held responsible for this debilitating disease. A fairly recent study has shown that IL-17 producing helper T cells (Th-17cells), have a significant influence on the initiation of immune response in arthritis. However, the connection between local chronic inflammation and immune response is still not evident. [36] 

Advances in the study of osteoimmunilogy have thrown new light on how bone destruction takes place in rheumatoid arthritis. Osteoclastogenesis or diseases of the bone have been shown to have advanced in the presence of Th 17 and related cytokines mainly through the conduit of synovial fibroblast. It is possible to conclude that mesenchymal cells influence the development of rheumatoid arthritis and there is a clear link between the immune response and the localised inflammation and destruction of joints and bones.

<a>Bones and Other Tissues Connected to Arthritis</a>

Bones, being specialised tissues composed of cells, have a central role to play in both the physiology and pathological status of arthritis patients. Besides giving all vertebrates their shape, they support and protect the body organs, produce red and white blood cells and store minerals. Bones are multifunctional and are shaped differently according to their position and function. They have a complex internal structure and the bone tissue consists of dense connective tissue. Osseous tissue, also called bone tissue, is one of the types of tissues that form the bones. This gives bones their rigidity and their three dimensional internal, coral-like structure. Bones are fairly hard and not too heavy. Other tissues found in the bones the bone marrow, endosteum, periosteum, nerves, blood vessels and cartilages. [37] 

<b>Bone Pathology and Arthritis</b>

Arthritis affects more than 10 per cent of humans, between the age of 30 and 60 [38] and it appears to affect women more than men. A person suffering from arthritis may have inflammation around the joints. This, in turn, releases enzymes that cause the surrounding bone and cartilage to wear away. If the condition becomes acute, secondary conditions sets in which may even affect surrounding tissues and organs, leads to bone loss and have a greater tendency to fracture. When the bone tissue becomes damaged, the body automatically replaces the damaged tissue with another tissue called scar tissue, which is somewhat like the scar tissue that forms over an injury on the outer surface of the body. Scar tissue forming on the bone leads to the normal spaces between the joint becoming narrower and some of the bones actually fuse together leading to further complications.

<b>Joint Tissue Pathology and Arthritis</b>

Arthritis leads to inflammation of the tissues of the joint lining (synovium) which is the body's automatic response to any kind of infection or foreign invasion. As synovitis, as the disease is called, causes pain and swelling and if not arrested in time, results in permanent damage of the affected joints and their surrounding blood vessels, nerves, ligaments, tendons and cartilages.

<b>Cartilage Pathology and Arthritis</b>

Cartilages are flexible connective tissues found in different areas in the bodies of humans and vertebrate animals. It is less hard and rigid than the bone, but not as flexible as the muscles. It is the cushioning agent between bones, ribs and is found in ears, nose, in the bronchial tube and between the numerous vertebrae of the spinal column. Cartilages do not contain blood vessels like other connective tissues do, with the result, the healing process of the arthritis affected area is relatively slow. On the whole, in comparison to other connective tissues, cartilage grows and repairs at a considerably slower pace. One of the pathological manifestations of arthritis is that the cartilage continues to wear off over a period of time. It may lead to a condition where the adjoining bones begin to rub against one other. As an automatic response, the bones start to regenerate at this point, causing the joint to become rough and uneven. As the condition worsens, ridges of bone are formed on the surface of the affected area making movement difficult and excruciating. Arthritis is the broad term applied when it concerns any part of the bone, joint, synovial membrane or even the ends of the bone. One of the consequences of arthritis is the deterioration or wasting away of muscles attached to and in the vicinity of the joint.

Cartilage is normally smooth and unblemished. When this is altered in anyway and its original appearance and characteristic change or become flawed, it said to be arthritic. When the cartilage in a joint is affected by arthritis it leads to other negative occurrences. Some of these have been described below.


Wear and tear: Cartilage attached to a joint can be compare to the rubber soles on shoes or to the treads on a new tyre. After constant or heavy use, the soles of the shoe or treads on the tyre becomes thinner and worn out and lose their original thickness and elasticity. Similarly, the cartilage becomes thinner with continuous usage. Importantly, studies have shown that the joint cartilage wears out much faster for heavy-built people.

Dryness: cartilage covering the joints, also called articular cartilage, is soft and smooth and also strong and long-lasting. The water content in the cartilage is very high; almost 60 percent. [39] One of the consequences of arthritis is that the persistent inflammation which is one of its manifestations can lead to reduction or loss of the ability to absorb and store water. If the problem persists, the cartilage becomes brittle and more likely to crack and flake and crumble.

Loss of cells: One of the greatest issues with cartilage is its inability to reproduce itself. Once pathologically damaged, there's no way with which it can get repaired or get regenerated. This is extremely worrying, because as more cartilage in the joint becomes worn out the bones below become visible and get stressed due to pressures from carrying weight. This can lead to acute strain and pain.

Traumatic rupture or detachment wherein the cartilage in the knee gets damaged, sometimes permanently

Costochondritis, when the inflammation of cartilage in the ribs results in chest pain

Spinal disc herniation, when the intervertebral disc becomes compressed unevenly causing rupture of the sac-like disc, which in turn leads a herniation of its soft content. This often compresses the adjacent nerves and causes back pain.

Relapsing polychondritis: This is probably an autoimmune condition of the cartilage, especially of the nose and ears, causing disfiguration. In extreme cases, death occurs by suffocation as the larynx loses its rigidity and collapses.



Great strides have been made in the world of medicine since its early beginnings but people would not be where they are today if not for the giants in science who dared to experiment, take risks while facing the wrath of narrow-minded and superstitious people of that period. Today gigantic strides are being made by scientists and yet, one should not forget that with each discovery, come new responsibilities. Today's lifestyles have brought with it a yet more diseases; some of which still defy scientific study. The quest to control these and find remedies for all kinds of ailments, including arthritis, continues unabated. Scientists are continuing to investigate the connection between chronic inflammation, bone destruction and immune response. A clear and complete understanding of this interaction will help them find strategies to treat and eradicate arthritis, in all its forms.