Current view on the role of neutrophils in rheumatoid arthritis. Still neutrophiles or maybe already microphages?

Our understanding of the role of neutrophils in inflammation has changed fundamentally over recent years. Neutrophils are short-lived polymorphonuclear phagocytes. Since, as a result of contact with pathogens, they undergo rapid activation, they are often called the body's first line of defence. Activated neutrophils are short-lived and rapidly undergo apoptosis (kamikaze cells). In rheumatoid arthritis, neutrophils can be phagocytosed by macrophages, creating characteristic Reiter cells. Current findings show that migration of neutrophils from circulation to the tissues extend their life span by inhibition of apoptosis; this may prolong the inflammatory reaction. It is now accepted that neutrophils are not only cells passively responding to external signals, but they also play an active role in the initiation and regulation of the inflammatory process by secreting proinflammatory cytokines, expression of MHC class II receptor, thus they are involved in the activation and control of the T cell activity. The importance of neutrophils in the pathogenesis of diseases such as chronic obstructive pulmonary disease, Behçet’s disease or arthritis has been demonstrated. These cells, in the context of this new knowledge, should become in the future an important target of the new treatment strategies in rheumatoid arthritis.