title: The B cell, arthritis, and the sympathetic nervous system.
abstract: The pathogenesis of rheumatoid arthritis (RA) is still an unresolved puzzle. Many factors and inflammatory cells play together to initiate a chronic inflammatory process that, if untreated, leads to complete destruction of involved joints. Recent success in treating severe forms of RA with B cell-depleting or -modifying agents revived the concept that the B cell might play a pivotal role in the pathogenesis of some forms of arthritis. However, the rather unspecific treatment approach affecting all B cells, no matter if autoreactive or not, leads to potential harmful side-effects, e.g., severe infections. Therefore, finding regulatory systems that more specifically modulate B cell function is important to improve current treatment options. One such regulatory system is the sympathetic nervous system (SNS), which is known to modulate B cell function, but also profoundly influences arthritis development and severity. This review develops the hypothesis that the SNS via modulating B cell function influences arthritis development and progression. For this purpose data is presented that shows (1) how the SNS influences B cell function, (2) how the SNS influences arthritis development and severity, and (3) how B cells are involved in the disease process with an emphasis on possible contact points for SNS neuromodulation.
authors.affiliation: Laboratory of Experimental Rheumatology and Neuroendocrino-Immunology, Department of Internal Medicine I, University Hospital Regensburg, 93042 Regensburg, Germany. georg.pongratz@klinik.uni-regensburg.de
authors.forename: Georg
authors.initials: G
authors.lastname: Pongratz
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Straub
mesh_terms: D000818:Animals; D001168:Arthritis / Q000276:immunology / Q000503:physiopathology*; D001402:B-Lymphocytes / Q000276:immunology / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000276:immunology; D009411:Nerve Endings / Q000276:immunology; D018377:Neurotransmitter Agents / Q000502:physiology; D013564:Sympathetic Nervous System / Q000276:immunology / Q000502:physiology*; D013583:Synovial Membrane / Q000276:immunology / Q000473:pathology
chemical_list: D018377:Neurotransmitter Agents