Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany.
Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany.
Bone. 2022 Sep;162:116468. doi: 10.1016/j.bone.2022.116468. Epub 2022 Jun 8.
The term osteoimmunology describes an interdisciplinary research field that links the investigation of osteology (bone cells) with immunology. The crosstalk between innate and adaptive immune cells and cells involved in bone remodeling, mainly bone-resorbing osteoclasts and bone-forming osteoblasts, becomes particularly obvious in the inflammatory autoimmune disease rheumatoid arthritis (RA). Besides striking inflammation of the joints, RA causes bone loss, leading to joint damage and disabilities as well as generalized osteoporosis. Mechanistically, RA-associated immune cells (macrophages, T cells, B cells etc.) produce high levels of pro-inflammatory cytokines, receptor activator of nuclear factor κB ligand (RANKL) and autoantibodies that promote bone degradation and at the same time counteract new bone formation. Today, antirheumatic therapy effectively ceases joint inflammation and arrests bone erosion. However, the repair of established bone lesions still presents a challenging task and requires improved treatment options. In this review, we outline the knowledge gained over the past years about the immunopathogenesis of RA and the impact of a dysregulated immune system on bone metabolism.
骨免疫学描述了一个跨学科的研究领域，它将骨骼学（骨细胞）的研究与免疫学联系起来。先天免疫和适应性免疫细胞与参与骨重塑的细胞（主要是骨吸收破骨细胞和骨形成成骨细胞）之间的相互作用在炎症性自身免疫性疾病类风湿关节炎（RA）中尤为明显。除了关节炎症外，RA 还会导致骨质流失，导致关节损伤和残疾以及全身性骨质疏松症。从机制上讲，与 RA 相关的免疫细胞（巨噬细胞、T 细胞、B 细胞等）会产生高水平的促炎细胞因子、核因子κB 配体受体激活剂（RANKL）和自身抗体，促进骨降解，同时抑制新骨形成。如今，抗风湿疗法能有效抑制关节炎症和阻止骨质侵蚀。然而，对于已建立的骨损伤的修复仍然是一个具有挑战性的任务，需要改进的治疗选择。在这篇综述中，我们概述了近年来关于 RA 免疫发病机制以及免疫系统失调对骨代谢影响的研究进展。
