T-cell studies in the spondyloarthropathies.
A growing body of evidence suggests that T lymphocytes play an important role in initiating and maintaining the inflammatory process characteristic of the human leukocyte antigen (HLA)-B27-associated spondyloarthropathies. T cells seem to be involved in the primary defense reaction against arthritis-triggering gram-negative bacteria at the site of extra-articular infection, in determining the systemic cytokine pattern, in the recirculation process between gut mucosa and the joint, and in mediating secondary autoimmune joint inflammation. The factors involved in disease chronicity (namely in ankylosing spondylitis and psoriatic arthritis) are still unknown. Autoreactive T cells may contribute to this process by recognition of cross-reactive self-epitopes (ie, molecular mimicry between bacterial and self-antigens). Autoreactive T cells may as well be inappropriately upregulated by bacterial superantigens, or by local inflammatory reactions leading to the uncovering of former cryptic self-epitopes. In this paper, we review recent studies on peripheral blood and synovial T cells in patients with reactive arthritis, enteropathic spondyloarthropathy, psoriatic arthritis, and ankylosing spondylitis.
Märker-Hermann
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Department of Internal Medicine, Johannes Gutenberg-University of Mainz, Langenbeckstr. 1, D - 55101 Mainz, Germany. emaerker@mail.uni-mainz.de
Schwab
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D015535:Arthritis, Psoriatic / Q000276:immunology; D016918:Arthritis, Reactive / Q000276:immunology; D015704:CD4 Antigens / Q000276:immunology; D016827:CD8 Antigens / Q000276:immunology; D003429:Cross Reactions; D000939:Epitopes; D015796:HLA-B27 Antigen / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000150:complications; D025242:Spondylarthropathies / Q000209:etiology / Q000276:immunology*; D013167:Spondylitis, Ankylosing / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*
D015704:CD4 Antigens; D016827:CD8 Antigens; D000939:Epitopes; D015796:HLA-B27 Antigen