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在风湿性关节炎发展轨迹中的自身免疫过程的时间序列:我们知道什么?

Judith W Heutz¹, René E M Toes², Annette H M van der Helm-van Mil^3,2

¹Department of Rheumatology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands j.heutz@erasmusmc.nl.

|May 9, 2025

概括

类风湿性关节炎 (RA) 的发展是一个长达十年的过程. 对ACPA阳性RA的自身免疫反应成熟发生在诊断前5年,而不是在症状阶段,指导新的预防策略.

科学领域:

免疫学免疫学免疫学
类风湿病学类风湿病学
疾病的病原发生疾病的病原发生

背景情况:

类风湿性关节炎 (RA) 的发展是一个复杂的,多步骤的过程,长达十年.
了解免疫事件的时间序列对于开发有效的预防策略至关重要.
目前的模型往往不准确地将自身免疫反应的成熟定位在疾病轨迹的晚期.

研究的目的:

阐明在RA发作之前的无症状和症状风险阶段免疫系统变化的精确时间.
批判性地评估现有文献,以获得关于RA发展过程中自身免疫过程的时间序列的强有力的证据.
基于全面的文献综述,提出RA病变的更新模型.

主要方法:

对有关RA发展的现有文献进行系统的审查和解释.
对有关免疫过程的时间主张的证据水平的评估.
对专注于ACPA阳性和ACPA阴性RA轨迹的研究进行分析.

主要成果:

对于ACPA阳性RA,全身自身免疫反应成熟发生在诊断前大约5年,在症状阶段保持稳定.
遗传和环境因素在无症状和症状风险阶段具有不同的影响.
对ACPA阴性RA的症状风险阶段较长,自身免疫成熟主要发生在无症状阶段.

结论:

确定的RA自身免疫发展时间表需要修订,关键成熟发生的时间比以前假设的更早.
这种对RA病变的修订理解可以为未来的预防试验选择治疗点提供信息.
区分ACPA阳性和ACPA阴性RA对于理解不同的发育轨迹至关重要.

关键词:

抗氨酸蛋白抗体抗氨酸蛋白抗体关节炎,类风湿性关节炎这是一种自身免疫力.细胞因子 (cytokines) 是一种细胞因子.

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