Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Int J Mol Sci. 2021 Dec 11;22(24):13325. doi: 10.3390/ijms222413325.
Extensive research into ankylosing spondylitis (AS) has suggested the major role of genetics, immune reactions, and the joint-gut axis in its etiology, although an ultimate consensus does not yet exist. The available evidence indicates that both autoinflammation and T-cell-mediated autoimmune processes are actively involved in the disease process of AS. So far, B cells have received relatively little attention in AS pathogenesis; this is largely due to a lack of conventional disease-defining autoantibodies. However, against prevailing dogma, there is a growing body of evidence suggestive of B cell involvement. This is illustrated by disturbances in circulating B cell populations and the formation of auto-reactive and non-autoreactive antibodies, along with B cell infiltrates within the axial skeleton of AS patients. Furthermore, the depletion of B cells, using rituximab, displayed beneficial results in a subgroup of patients with AS. This review provides an overview of our current knowledge of B cells in AS, and discusses their potential role in its pathogenesis. An overarching picture portrays increased B cell activation in AS, although it is unclear whether B cells directly affect pathogenesis, or are merely bystanders in the disease process.
对强直性脊柱炎（AS）的广泛研究表明，遗传、免疫反应和关节-肠道轴在其发病机制中起主要作用，尽管尚未达成最终共识。现有证据表明，自身炎症和 T 细胞介导的自身免疫过程都积极参与了 AS 的疾病过程。到目前为止，B 细胞在 AS 发病机制中的研究相对较少；这主要是由于缺乏传统的疾病定义性自身抗体。然而，与流行的观点相反，越来越多的证据表明 B 细胞参与其中。这体现在循环 B 细胞群的紊乱、自身反应性和非自身反应性抗体的形成，以及 AS 患者的轴性骨骼中的 B 细胞浸润。此外，使用利妥昔单抗清除 B 细胞在亚组 AS 患者中显示出有益的结果。这篇综述提供了我们目前对 AS 中 B 细胞的认识概述，并讨论了它们在发病机制中的潜在作用。一个总体的描述是，AS 中 B 细胞的激活增加，尽管尚不清楚 B 细胞是否直接影响发病机制，还是仅仅是疾病过程中的旁观者。
