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Published on: September 26, 2012
Pathogenesis of polymyalgia rheumatica
G Guggino1, A Ferrante, F Macaluso
1Biomedical Department of Internal Medicine, Division of Rheumatology, University of Palermo. giuliana.guggino@unipa.it.
Abstract:
Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause, almost exclusively occurring in people aged over 50 and often associated with giant cell arteritis. The evidence that PMR occurs almost exclusively in individuals aged over 50 may indicate that age-related immune alterations in genetically predisposed subjects contribute to development of the disease. Several infectious agents have been investigated as possible triggers of PMR even though the results are inconclusive. Activation of the innate and adaptive immune systems has been proved in PMR patients as demonstrated by the activation of dendritic cells and monocytes/macrophages and the altered balance between Th17 and Treg cells. Disturbed B cell distribution and function have been also demonstrated in PMR patients suggesting a pathogenesis more complex than previously imagined. In this review we will discuss the recent findings regarding the pathogenesis of PMR.
Insights
Polymyalgia rheumatica (PMR) is an inflammatory disease primarily affecting those over 50. Recent findings reveal complex immune system involvement, including dendritic cells, macrophages, and altered T cell balance, contributing to PMR pathogenesis.
Area of Science:
- Rheumatology
- Immunology
- Geriatric Medicine
Background:
- Polymyalgia rheumatica (PMR) is a chronic inflammatory condition predominantly affecting individuals over 50.
- Its exact cause remains unknown, though age-related immune changes and genetic predisposition are suspected.
- PMR is frequently associated with giant cell arteritis.
Purpose of the Study:
- To review recent advancements in understanding the pathogenesis of Polymyalgia Rheumatica.
- To explore the roles of immune system activation and cellular alterations in PMR development.
Main Methods:
- Review of current scientific literature on PMR pathogenesis.
- Analysis of studies investigating immune cell activation and function in PMR patients.
Main Results:
- Evidence confirms activation of innate and adaptive immune systems in PMR.
- Key findings include activated dendritic cells and monocytes/macrophages.
- An altered balance between T helper 17 (Th17) and regulatory T (Treg) cells is observed.
- Disturbances in B cell distribution and function are also noted.
Conclusions:
- PMR pathogenesis is more complex than previously understood.
- Age-related immune alterations likely play a significant role in genetically susceptible individuals.
- Immune system dysregulation involving multiple cell types is central to PMR development.
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