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Windows Games
The site is best viewed on a new device and we recommend you upgrade to a new and improved version of your browser. While Internet Explorer remains a compatible browser, we recommend updating to versiones and pro-inflammatory immune cells (neutrophils) into inflamed joints. In the CS, these macrophages, neutrophils and T cells form a reactive stroma that is surrounded by (activated) synovial fibroblasts and chondrocytes.[@R55] This is crucial for pannus growth. Notably, there is a direct feedback loop between the synovium and the articular cartilage surface, that is mediated by CS-derived cytokines.[@R56] Therefore, the secretome of the synovial stroma is of great importance to sustain pannus formation and to control inflammation.
Loss of the anti-inflammatory M2 macrophages has been shown to result in excessive cartilage damage in a mouse OA model.[@R57] In humans, infrapatellar fat pad-derived M2 macrophages are associated with a low-grade inflammation, whereas high-grade inflammation is induced by M1 macrophages.[@R58] Although M2 macrophages are not considered the main source of pro-inflammatory cytokines,[@R59] studies have shown that they are of great importance in OA.[@R59] A recent study revealed that the synovial lining has a constant population of M2-like macrophages that are induced by tissue remodelling and remodelling-associated cytokines. In addition, these macrophages have an important role in maintaining the joint homeostasis.[@R60] Additional research is needed to unravel the molecular function of these macrophages.
Chondrocytes {#s5-3}
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Chondrocytes undergo a process known as endochondral ossification during growth. This process requires the breakdown of the extracellular matrix, followed by migration and differentiation of mesenchymal progenitor cells into chondrocytes, their proliferation and differentiation into mature chondrocytes. Endochondral ossification is thought to be involved in subchondral bone formation. It can also be seen in OA, where it is referred to as’secondary osteophyte formation’.[@R61] In OA, endochondral ossification
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