van den Broek M F, van den Berg W B, Arntz O J, van de Putte L B
Department of Rheumatology, University Hospital St Radboud, Nijmegen, The Netherlands.
Clin Exp Immunol. 1988 Apr;72(1):9-14.
Although different models for rheumatoid arthritis have been studied, the pathogenesis in humans remains unknown. A possible mechanism is the crossreactivity between bacterial components and the target-tissue, the cartilage. The existence of this crossreactivity is supported by various data from clinical and experimental studies. Here we provide direct evidence that priming in vivo with cell wall fragments of Streptococcus pyogenes or Escherichia coli can induce a cellular and humoral anti-cartilage response in Balb/c mice in vitro. T cells isolated from these mice can be stimulated in vitro to proliferate by a variety of antigens among which are the priming bacterium, an unrelated bacterium, small bacterial components and diverse antigens of cartilagenous origin. In bacterium-primed mice antibodies were also detected that displayed a reactivity to cartilage extract besides the reactivity to bacteria. A crossreactive response occurred in vivo in certain circumstances: a delayed type hypersensitivity reaction could be elicited in cell-wall-primed mice by challenge with cartilage extract. For the expression of this crossreactive response in vivo however, it was obligatory to attenuate the mouse's suppressor-circuit. In this paper we would suggest a mechanism for the pathology of chronic arthritis, based on repeated challenges with different bacterial stimuli.
尽管已经对类风湿性关节炎的不同模型进行了研究,但人类的发病机制仍然未知。一种可能的机制是细菌成分与靶组织(软骨)之间的交叉反应性。临床和实验研究的各种数据支持了这种交叉反应性的存在。在这里,我们提供了直接证据,即体内用化脓性链球菌或大肠杆菌的细胞壁片段进行预刺激可以在体外诱导Balb/c小鼠产生细胞和体液抗软骨反应。从这些小鼠中分离出的T细胞在体外可以被多种抗原刺激增殖,其中包括预刺激细菌、无关细菌、小细菌成分和多种软骨来源的抗原。在细菌预刺激的小鼠中也检测到了抗体,这些抗体除了对细菌有反应外,还对软骨提取物有反应。在某些情况下,体内会发生交叉反应:用软骨提取物攻击细胞壁预刺激的小鼠可引发迟发型超敏反应。然而,对于这种交叉反应在体内的表达,必须减弱小鼠的抑制回路。在本文中,我们将基于不同细菌刺激的反复攻击,提出一种慢性关节炎病理的机制。