Padula S J, Clark R B, Korn J H
Hum Pathol. 1986 Mar;17(3):254-63. doi: 10.1016/s0046-8177(83)80218-4.
Rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis are the three most common systemic rheumatic diseases in which disordered immune function is thought to play a pathogenetic role. Each disease has different and characteristic abnormalities of the cellular immune system. In rheumatoid arthritis the identified abnormalities of immunoregulation are largely limited to specific antigens: Epstein-Barr virus and collagen. Systemic lupus erythematosus is characterized by exuberant B-cell activity with exaggerated humoral response, a diversity of autoantibodies, non-antigen-specific loss of suppressor cell function, and general suppression of cell-mediated immunity. In systemic sclerosis systemic defects of cellular and humoral immune function are mild, but the release of lymphokines and monokines at sites of inflammatory lesions is thought to be important in the pathogenesis of the disease. Similar immune cell-connetive tissue cell interactions are probably important in the propagation of rheumatoid synovitis. Thus, despite the many shared clinical and serologic features of these diseases as well as the presence of many patients who have clinically overlapping features of more than one of these entities, the immune defects and the immunopathogenesis of these disorders appear to be distinct.
类风湿关节炎、系统性红斑狼疮和系统性硬化症是三种最常见的系统性风湿性疾病，人们认为免疫功能紊乱在其发病机制中起作用。每种疾病在细胞免疫系统方面都有不同的特征性异常。在类风湿关节炎中，已确定的免疫调节异常主要局限于特定抗原：爱泼斯坦-巴尔病毒和胶原蛋白。系统性红斑狼疮的特征是B细胞活性旺盛，伴有过度的体液反应、多种自身抗体、抑制细胞功能的非抗原特异性丧失以及细胞介导免疫的普遍抑制。在系统性硬化症中，细胞和体液免疫功能的系统性缺陷较轻，但炎症病变部位淋巴因子和单核因子的释放被认为在该疾病的发病机制中很重要。类似的免疫细胞与结缔组织细胞的相互作用可能在类风湿滑膜炎的发展中起重要作用。因此，尽管这些疾病有许多共同的临床和血清学特征，并且存在许多具有不止一种这些疾病临床重叠特征的患者，但这些疾病的免疫缺陷和免疫发病机制似乎是不同的。
