The role of autoantibodies in the pathophysiology of rheumatoid arthritis.
The role of autoantibodies in the pathophysiology of rheumatoid arthritis.
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自身抗体在类风湿关节炎病理生理学中的作用
DOI：
10.1007/s00281-017-0627-z
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发表时间：
2017-06
影响因子：
9
通讯作者：
van der Woude D
中科院分区：
文献类型：
--
作者：
Derksen VFAM;Huizinga TWJ;van der Woude D
类风湿性关节炎（RA）是一种以关节炎症为特征的自身免疫性疾病。RA患者血清中自身抗体的存在为潜在疾病的病理生理学提供了许多线索。基于几种自身抗体如类风湿因子（RF）、抗瓜氨酸化蛋白抗体（ACPA）、抗氨基甲酰化蛋白抗体（anti-CarP）和最近的抗乙酰化蛋白抗体的存在，RA可细分为血清阳性和血清阴性疾病。这些自身抗体的形成与类风湿关节炎的遗传和环境危险因素有关，如特异性人类白细胞抗原（HLA）等位基因和吸烟。自身抗体可以在一部分患者发病多年前检测到，提示在易感宿主中产生第一个自身抗体，随后发生炎症反应导致临床明显的关节炎。研究这些自身抗体的特性和效应功能可能为了解风湿性关节炎的病理生理过程提供更多信息。最近的数据表明，ACPA可能在炎症发生后持续发挥作用。此外，已经发现的病理生理机制支持ACPA的存在与RA患者骨侵蚀和疼痛之间的直接联系。总之，研究自身抗体可能的致病潜力可能有助于提高对类风湿关节炎潜在病理生理过程的理解。
Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation. The presence of autoantibodies in the sera of RA patients has provided many clues to the underlying disease pathophysiology. Based on the presence of several autoantibodies like rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), anti-carbamylated protein antibodies (anti-CarP), and more recently anti-acetylated protein antibodies RA can be subdivided into seropositive and seronegative disease. The formation of these autoantibodies is associated with both genetic and environmental risk factors for RA, like specific human leukocyte antigen (HLA) alleles and smoking. Autoantibodies can be detected many years before disease onset in a subset of patients, suggesting a sequence of events in which the first autoantibodies develop in predisposed hosts, before an inflammatory response ensues leading to clinically apparent arthritis. Research on the characteristics and effector functions of these autoantibodies might provide more insight in pathophysiological processes underlying arthritis in RA. Recent data suggests that ACPA might play a role in perpetuating inflammation once it has developed. Furthermore, pathophysiological mechanisms have been discovered supporting a direct link between the presence of ACPA and both bone erosions and pain in RA patients. In conclusion, investigating the possible pathogenic potential of autoantibodies might lead to improved understanding of the underlying pathophysiological processes in rheumatoid arthritis.