Chin Athena, Small Annabelle, Wong Soon Wei, Wechalekar Mihir D
Department of Rheumatology, Flinders Medical Centre, Adelaide, SA, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Curr Rheumatol Rep. 2025 Jan 25;27(1):14. doi: 10.1007/s11926-025-01180-1.
Rheumatoid arthritis (RA) is a complex autoimmune disease characterized by chronic inflammation of the synovial tissue, where T cells play a central role in pathogenesis. Recent research has identified T peripheral helper (Tph) cells as critical mediators of local B cell activation in inflamed tissues. This review synthesizes the latest advancements in our understanding the of the role of T cells in RA, from initiation to established disease.
We explore recent advances regarding the genetic and epigenetic factors that predispose individuals to RA, the mechanisms of T cell activation and differentiation, and the interactions between T cells and other immune and stromal cells within the synovial microenvironment. The emergence of Tph cells as key drivers of RA pathobiology is highlighted, along with their potential as therapeutic targets. We also discuss the heterogeneity of T cell responses and their interplay with synovial cells, while addressing critical research gaps such as the drivers of T cell recruitment and the plasticity of synovial phenotypes. A deeper understanding of T cell dynamics in RA will provide valuable insights for developing targeted therapies to modulate T cell-mediated inflammation and improve patient outcomes.
类风湿关节炎（RA）是一种复杂的自身免疫性疾病，其特征为滑膜组织的慢性炎症，T细胞在发病机制中起核心作用。最近的研究已确定外周辅助性T（Tph）细胞是炎症组织中局部B细胞活化的关键介质。本综述综合了我们对T细胞在RA中从发病起始到疾病确立过程中作用的最新认识进展。
我们探讨了关于使个体易患RA的遗传和表观遗传因素、T细胞活化和分化机制以及滑膜微环境中T细胞与其他免疫和基质细胞之间相互作用的最新进展。强调了Tph细胞作为RA病理生物学关键驱动因素的出现及其作为治疗靶点的潜力。我们还讨论了T细胞反应的异质性及其与滑膜细胞的相互作用，同时解决关键的研究空白，如T细胞募集的驱动因素和滑膜表型的可塑性。对RA中T细胞动态的更深入理解将为开发靶向疗法以调节T细胞介导的炎症并改善患者预后提供有价值的见解。
