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胶原性自身免疫性关节炎

Collagen autoimmune arthritis.

作者信息

Stuart J M, Townes A S, Kang A H

出版信息

Annu Rev Immunol. 1984;2:199-218. doi: 10.1146/annurev.iy.02.040184.001215.

Abstract

The evidence is now fairly conclusive that collagen-induced arthritis in rodents is mediated by antitype II collagen autoimmunity. Arthritis is probably initiated by binding of antibodies to the surface of intact articular cartilage. Many of the major manifestations of arthritis, including synovial proliferation, pannus formation, marginal erosion of bone, and destruction of cartilage, can be duplicated by injection of isolated antitype II collagen antibodies. It is not known whether delayed hypersensitivity reactions to collagen can provoke similar lesions in the absence of antibody, but circumstantial evidence suggests they do not. Also clear is that not all anticollagen antibodies are capable of inducing arthritis. The minimal requirements for arthritogenic potential are currently under investigation but probably include the ability to bind native autologous type II collagen. Also IgM antibodies alone are either ineffective or are required in relatively higher concentrations than IgG for induction of arthritis. Autoimmunity to collagen is found in many spontaneous and induced rheumatic diseases other than collagen-induced arthritis. There is at present, however, no direct evidence that this autoimmunity actually contributes to the arthritic process. Nevertheless, the human disease most often associated with collagen autoimmunity is rheumatoid arthritis. In many respects the immune reactions detected in humans with rheumatoid arthritis parallel those of arthritis in rodents. That is, responsiveness is under the control of genes within or linked to the major histocompatibility locus. High responders are limited to only a few haplotypes. Cell-mediated reactions are most vigorous in response to denatured collagen and probably have limited specificity for the type of collagen recognized. Antibodies may be separated into at least two groups, one with broad specificity for denatured collagen and a second highly specific for conformation-dependent determinants on native type II collagen. The latter antibodies are of most interest to researchers because they may be like those that induce arthritis in rodents. There is also ample evidence that antibodies are deposited in the joints of rheumatoid arthritis patients, although the specificity of these antibodies is unknown. Generally, collagen-induced arthritis is a model of antibody-initiated autoimmunity arthritis. Specifically, it is a model of type II collagen autoimmune arthritis. In consideration of its extraarticular manifestations, it may justifiably be referred to as type II collagen autoimmune disease.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

现在有相当确凿的证据表明,啮齿动物的胶原诱导性关节炎是由抗II型胶原自身免疫介导的。关节炎可能是由抗体与完整关节软骨表面结合引发的。关节炎的许多主要表现,包括滑膜增生、血管翳形成、骨边缘侵蚀和软骨破坏,都可以通过注射分离的抗II型胶原抗体重现。在没有抗体的情况下,对胶原的迟发型超敏反应是否能引发类似病变尚不清楚,但间接证据表明它们不能。同样清楚的是,并非所有抗胶原抗体都能诱发关节炎。目前正在研究致关节炎潜力的最低要求,但可能包括结合天然自体II型胶原的能力。此外,单独的IgM抗体要么无效,要么在诱导关节炎时所需的浓度比IgG相对更高。除了胶原诱导性关节炎外,在许多自发性和诱发性风湿性疾病中都发现了对胶原的自身免疫。然而,目前没有直接证据表明这种自身免疫实际上促成了关节炎进程。尽管如此,最常与胶原自身免疫相关的人类疾病是类风湿性关节炎。在许多方面,类风湿性关节炎患者中检测到的免疫反应与啮齿动物关节炎的免疫反应相似。也就是说,反应性受主要组织相容性位点内或与之连锁的基因控制。高反应者仅限于少数单倍型。细胞介导的反应在对变性胶原的反应中最为强烈,并且对所识别的胶原类型的特异性可能有限。抗体可分为至少两组,一组对变性胶原有广泛特异性,另一组对天然II型胶原上依赖构象的决定簇高度特异性。后一种抗体是研究人员最感兴趣的,因为它们可能类似于在啮齿动物中诱发关节炎的抗体。也有充分证据表明抗体沉积在类风湿性关节炎患者的关节中,尽管这些抗体的特异性尚不清楚。一般来说,胶原诱导性关节炎是抗体引发的自身免疫性关节炎的模型。具体而言,它是II型胶原自身免疫性关节炎的模型。考虑到其关节外表现,它可以合理地被称为II型胶原自身免疫性疾病。(摘要截选至400字)

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