The role of cytokines in the pathogenesis of rheumatoid arthritis – Practical and potential application of cytokines as biomarkers and targets of personalized therapy

• Disturbances in Th1/Th2/Th17 cytokines play important role in RA pathogenesis.
• Cytokine profile changes dependent on RA stage and activity.
• Measurement of any single cytokine is unlikely to be used as a biomarker in RA.
• Multiplex cytokine measurements have the diagnostic potential in RA.
• Most of bDMARDs currently available block TNF and IL-6.

Rheumatoid arthritis (RA), as a common chronic disease leading to severe disability, requires early diagnosis and introduction of proper treatment. Deregulation in the cytokine network plays an undoubtedly crucial role in the pathogenesis of RA. The understanding of the role of cytokines in RA can be used for patients’ benefit. Technological advances had already allowed introduction of the tailor-made cytokine-targeted therapies (so far anti-TNF, anti-IL-1 and anti-IL-6) into clinical practice. This type of treatment is currently developing very fast. Moreover, cytokines are considered to be potential powerful biomarkers of RA with roles predicted to grow in the future. Detailed understanding of the cytokine balance in RA may assist both the diagnostic process and therapy.