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Activated immune cells produce pro-inflammatory cytokines, such as Interleukin-1beta (IL-1), Tumor necrosis factor alpha (TNF-), and Interleukin-6 (IL-6), which are highly expressed in the synovium and promote inflammatory responses leading to cartilage degradation

Following antigenic binding to the T-cell receptor, the strength of the immune response depends on the expression and interaction of costimulatory surface molecules on antigen presenting cells with those on T cells (68, 69)

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