CAJ | 학술논문

类风湿性关节炎(Rheumatoid Arthritis,RA)是一类以人体肢端关节滑膜中炎症细胞浸润为主要表现的自身免疫性疾病,其病因至今尚未真正明确.从免疫学角度研究发现:除了免疫复合物(炎性沉淀物)在关节囊液中起着一定的作用外,其患者体内的自身抗体与RA存在着密切关联.尽管目前仍有较为明确的证据表明RA是以T细胞--特别是Th1介导为主:这是由于依赖于胶原诱导关节炎(CIA,Collagen-induced arthritis)小鼠模型研究所得的结论.然而,新近的实验研究和临床免疫干预的进展使人们重新认识到B细胞是如何受自身抗原的诱导、激活、增殖和分泌自身抗体导致了RA发病以及这些自身抗体所累及的患者临床病理变化的本质,无疑将类风湿性关节炎与自身反应性B细胞的关联性重新提到一新的重要地位.毫无疑问:患者体内自身反应性B细胞和其产生的自身抗体在RA的发病中起到关键作用.患者关节滑液中浸润着高表达IL-13受体的B细胞,它们所分泌的一系列细胞因子发挥着特殊作用.值得特别注意的是IL-13可以作用于B细胞(诱导B细胞高表达CD23,促进幼稚B细胞的增殖和分化直至这种自身反应性B细胞克隆的异常扩增),越发突显自身反应性B细胞协同自身反应性T细胞介导RA发病的重要性,同时人们将更加关注其独特的免疫病理学机制对RA的诊断、进展和疾病预后的重要意义.本文将着重综述和讨论类风湿性关节炎与自身反应性B细胞的关联性的最新进展,旨在重新评估自身反应性B细胞和其分泌的自身抗体,包括一些细胞因子特别是IL-13介导的免疫失衡在类风湿性关节炎中的重要作用.
류풍습성관절염(Rheumatoid Arthritis,RA)시일류이인체지단관절활막중염증세포침윤위주요표현적자신면역성질병,기병인지금상미진정명학.종면역학각도연구발현:제료면역복합물(염성침정물)재관절낭액중기착일정적작용외,기환자체내적자신항체여RA존재착밀절관련.진관목전잉유교위명학적증거표명RA시이T세포--특별시Th1개도위주:저시유우의뢰우효원유도관절염(CIA,Collagen-induced arthritis)소서모형연구소득적결론.연이,신근적실험연구화림상면역간예적진전사인문중신인식도B세포시여하수자신항원적유도、격활、증식화분비자신항체도치료RA발병이급저사자신항체소루급적환자림상병리변화적본질,무의장류풍습성관절염여자신반응성B세포적관련성중신제도일신적중요지위.호무의문:환자체내자신반응성B세포화기산생적자신항체재RA적발병중기도관건작용.환자관절활액중침윤착고표체IL-13수체적B세포,타문소분비적일계렬세포인자발휘착특수작용.치득특별주의적시IL-13가이작용우B세포(유도B세포고표체CD23,촉진유치B세포적증식화분화직지저충자신반응성B세포극륭적이상확증),월발돌현자신반응성B세포협동자신반응성T세포개도RA발병적중요성,동시인문장경가관주기독특적면역병이학궤제대RA적진단、진전화질병예후적중요의의.본문장착중종술화토론류풍습성관절염여자신반응성B세포적관련성적최신진전,지재중신평고자신반응성B세포화기분비적자신항체,포괄일사세포인자특별시IL-13개도적면역실형재류풍습성관절염중적중요작용.
Rheumatoid arthritis (RA) is an autoimmune disease characterized by the accumulation and proliferation of inflammatory cells in the synovial (joint) lining.By investigating RA pathologic processes and also through experimental models where immune complexes (inflammatory sediments) play a fundamental role.Many other autoantibodies have then come to our knowledge to be associated with the disease.Though it remains unknown the autoimmune pathology of B cells and why the clones of autoreactive B cells survive and proliferate in RA patients,but no doubt these autoantibodies represent a very useful tool in both diagnostic and prognostic terms.In joint synovial fulid,B cells also secrete cytokines,which can be interacted with other cells.B cells express IL-13 receptor a1 (IL-13Ra1),IL-13 can induce CD23 expression on B cells and promote proliferation of naive B cells. In addition,IL-13 is a cytokine which is produced mainly by activated T helper cell 2 (Th2 cells),it can inhibit the production of pro-inflammatory factor and chemokines,and has a certain relationship with the differentiation of B cells. Therefore,it is necessary to summarize the mechanims of RA pathogenesis related with B cells and IL-13,which has great significance in the diagnosis,treatment and basic immunology research of autoimmune diseases such as RA.