Division of Rheumatology, University of Colorado Denver, Aurora, CO, USA.
Denver Veterans Affairs Medical Center, Denver, CO, USA.
Immunol Rev. 2020 Mar;294(1):124-132. doi: 10.1111/imr.12842. Epub 2020 Feb 6.
The primary manifestation of rheumatoid arthritis (RA) is articular disease; however, extra-articular disease can also occur. In particular, pulmonary disease is a leading cause of morbidity and mortality in individuals with RA. Herein, we will review the types, prevalence, risk factors, and potential pathophysiology of lung disease in individuals with established RA. We will also discuss the emerging understanding of potential role of the lung in the generation of RA-related autoantibodies during a period of disease development termed "pre-RA." Finally, we will discuss a research agenda outlining the next steps to improve our understanding and management of lung inflammation and lung disease throughout the natural history of RA.
类风湿关节炎(RA)的主要表现为关节疾病;然而,也会发生关节外疾病。特别是,肺部疾病是导致 RA 患者发病率和死亡率的主要原因。在此,我们将回顾已确诊 RA 患者肺部疾病的类型、患病率、危险因素和潜在病理生理学。我们还将讨论在疾病发展过程中被称为“pre-RA”的时期中,肺部在产生 RA 相关自身抗体中的潜在作用的新认识。最后,我们将讨论一个研究议程,概述了在 RA 自然病史中提高我们对肺部炎症和肺部疾病的理解和管理的下一步措施。