1.RHEUMATOIDARTHRITIS
BY
DRBASHIRAHMEDDAR
ASSOCIATEPROFESSORMEDICINE
SOPOREKASHMIR
EMAILdrbashir123@gmail.com

2. Dr Bashir and Dr yashodhoraleading group of medical studentsto meet noble prize winner in medicineat KL Malaysia
3. Dr Bashir at PBL Conference
4. Noble prize winner Prof Barry .J Marshall in recognition of his discovery Helicobacter pylori-most common cause for peptic ulcer
5. Precious moments with noble prize winner
6. 7. Rheumatoid arthritis isautoimmune disorder in which Immune system identifies the synovial membrane as "foreign" and begins attacking it.
Synovial membrane shown in picture
8. With long-term or intensive exposure to the antigen, normal antibodies become auto-antibodies that target self-antigens in the synovial membrane.
9. Once the antigen or immune complex reaches the synovial membrane .The antigen presenting cell deals with
Fibrous capsule of synovial joint.
10. Rheumatoid Arthritis
First, the APC usually a macrophage in synovium engulfs the antigen.
Enzymes (peroxides) inside the APC break down the antigen into smaller particles.
11. Rheumatoid Arthritis
The processed antigens are transported to the surface of the APC, where it binds with MHC (major histocompatibility complex)
12. This complex ie (part of a foreign substance and MHC) is now presented to T-cells (CD4 cells ie T-helper cell ) or CD8 (cytotoxic T cells) which the T-cell receptor (TCR) recognizes and binds to.
13. RHEUMATOID ARTHRITIS

Once the T-cell binds to the Antigen / MHC complex, the APC then secrete cytokines like

14. Interleukin-1 (IL-1) 15. Interferon-alpha (IFN-a) 16. Interferon-gamma (IFN-g) 17. Tumor necrosis factor (TNF) 18. And other factors that activate lymphocytes and other immune cells to respond to the antigens.