Department of Medicine, Center for Immunity, Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, Virginia, USA.
Immunol Rev. 2023 Oct;319(1):142-150. doi: 10.1111/imr.13256. Epub 2023 Jul 28.
Rheumatoid arthritis (RA) is a chronic inflammatory disease of the synovial joints that affects ~1% of the human population. Joint swelling and bone erosion, hallmarks of RA, contribute to disability and, sometimes, loss of life. Mechanistically, disease is driven by immune dysregulation characterized by circulating autoantibodies, inflammatory mediators, tissue degradative enzymes, and metabolic dysfunction of resident stromal and recruited immune cells. Cell death by apoptosis has been therapeutically explored in animal models of RA due to the comparisons drawn between synovial hyperplasia and paucity of apoptosis in RA with the malignant transformation of cancer cells. Several efforts to induce cell death have shown benefits in reducing the development and/or severity of the disease. Apoptotic cells are cleared by phagocytes in a process known as efferocytosis, which differs from microbial phagocytosis in its "immuno-silent," or anti-inflammatory, nature. Failures in efferocytosis have been linked to autoimmune disease, whereas administration of apoptotic cells in RA models effectively inhibits inflammatory indices, likely though efferocytosis-mediated resolution-promoting mechanisms. However, the nature of signaling pathways elicited and the molecular identity of clearance mediators in RA are understudied. Furthermore, canonical efferocytosis machinery elements also play important non-canonical functions in homeostasis and pathology. Here, we discuss the roles of efferocytosis machinery components in models of RA and discuss their potential involvement in disease pathophysiology.
类风湿关节炎(RA)是一种慢性炎症性疾病,影响滑膜关节,约占人类的 1%。关节肿胀和骨质侵蚀是 RA 的特征,导致残疾,有时甚至导致死亡。从机制上讲,疾病是由免疫失调驱动的,其特征是循环自身抗体、炎症介质、组织降解酶以及驻留基质细胞和募集免疫细胞的代谢功能障碍。由于滑膜增生与 RA 中凋亡缺乏之间的比较,以及癌细胞的恶性转化,细胞凋亡已在 RA 的动物模型中进行了治疗探索。几种诱导细胞死亡的方法已显示出在减少疾病的发展和/或严重程度方面的益处。凋亡细胞被吞噬细胞清除,这一过程称为吞噬作用,与微生物吞噬作用不同,它具有“免疫沉默”或抗炎性质。吞噬作用的失败与自身免疫性疾病有关,而在 RA 模型中给予凋亡细胞可有效抑制炎症指标,可能是通过吞噬作用介导的促进解决的机制。然而,RA 中引发的信号通路的性质和清除介质的分子特征仍研究不足。此外,经典的吞噬作用机制元件在稳态和病理中也发挥着重要的非经典功能。在这里,我们讨论了吞噬作用机制元件在 RA 模型中的作用,并讨论了它们在疾病病理生理学中的潜在参与。
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