'MHC-I-opathy'-unified concept for spondyloarthritis and Behcet disease
'MHC-I-opathy'-unified concept for spondyloarthritis and Behcet disease
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DOI：
10.1038/nrrheum.2015.147
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发表时间：
2015-12-01
影响因子：
33.7
通讯作者：
Direskeneli, Haner
中科院分区：
文献类型：
--
作者：
McGonagle, Dennis;Aydin, Sibel Zehra;Direskeneli, Haner
脊柱关节病包括强直性脊柱炎（AS）、反应性关节炎、银屑病关节炎（PsA）和与炎症性肠病相关的关节炎。在这篇前瞻性文章中，我们描述了白维特病和几种临床上不同的脊柱关节病-所有与MHC I类（MHC-I）等位基因，如HLA-B*51，HLA-C*0602和HLA-B*27和上位ERAP-1相互作用-有一个共同的免疫发病基础。作为一个统一的概念，我们提出，在环境暴露的器官，如皮肤，和异常的先天性免疫反应在机械应力的网站，往往可以触发二次适应性免疫CD 8 + T细胞反应与突出的嗜酸性炎症，最终在这些疾病的恶化和复发。值得注意的是，这些“MHC-I-病”显示出不同的免疫病理学，可能反映了靶组织内的抗原差异：HLA-B*51与眼部和皮肤粘膜疾病有关，但与肠道无关，HLA-C*0602与I型银屑病有关，但与头皮或指甲疾病无关。
The spondyloarthropathies comprise ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis (PsA) and arthritis associated with inflammatory bowel disease. In this Perspectives article, we describe how Behvet disease and several clinically distinct spondyloarthropathies-all associated with MHC class I (MHC-I) alleles such as HLA-B*51, HLA-C*0602 and HLA-B*27 and epistatic ERAP-1 interactions-have a shared immunopathogenetic basis. As a unifying concept, we propose that barrier dysfunction in environmentally exposed organs such as the skin, and aberrant innate immune reactions at sites of mechanical stress, can often trigger secondary adaptive immune CD8+ T-cell responses with prominent neutrophilic inflammation that culminate in exacerbation and recurrence of these diseases. Of note, these 'MHC-I-opathies' show a differential immunopathology, probably reflecting antigenic differences within target tissues: HLA-B*51 is linked to ocular and mucocutaneous disease but not gut involvement, and HLA-C*0602 is linked to type I psoriasis but not scalp or nail disease.