Centre of Experimental Rheumatology, University Hospital Zurich, Wagistrasse 14, CH-8952 Schlieren, Zurich, Switzerland.
Nat Rev Rheumatol. 2017 Jul;13(7):433-442. doi: 10.1038/nrrheum.2017.96. Epub 2017 Jun 15.
Rheumatic diseases follow a characteristic anatomical pattern of joint and organ involvement. This Review explores three interconnected mechanisms that might be involved in the predilection of specific joints for developing specific forms of arthritis: site-specific local cell types that drive disease; systemic triggers that affect local cell types; and site-specific exogenous factors, such as focal mechanical stress, that activate cells locally. The embryonic development of limbs and joints is also relevant to the propensity of certain joints to develop arthritis. Additionally, location-specific homeostasis and disease occurs in skin and blood vessels, thereby extending the concept of site-specificity in human diseases beyond rheumatology. Acknowledging the importance of site-specific parameters increases the complexity of current disease paradigms and brings us closer to understanding why particular disease processes manifest at a particular location.
风湿性疾病具有特征性的关节和器官受累解剖模式。这篇综述探讨了三种相互关联的机制，这些机制可能与特定关节发生特定类型关节炎的倾向性有关：驱动疾病的特定部位局部细胞类型；影响局部细胞类型的系统性触发因素；以及局部激活细胞的特定部位外源性因素，如局部机械应力。四肢和关节的胚胎发育也与某些关节易发生关节炎有关。此外，皮肤和血管中也存在特定部位的稳态和疾病，从而将特定部位疾病的概念扩展到风湿病学之外。认识到特定部位参数的重要性增加了当前疾病模式的复杂性，并使我们更接近于理解为什么特定的疾病过程会在特定的部位表现出来。
