Koopman W J, Gay S
Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham.
Rheum Dis Clin North Am. 1993 Feb;19(1):107-22.
The association between elevated serum rheumatoid factor and rheumatoid arthritis (RA) has been confirmed repeatedly and interpreted as strong evidence for an immunologic basis for the disease. In recent years, considerable additional evidence supporting this view has been obtained, strongly suggesting a role for CD4+ T cells in the pathogenesis of RA. An alternative view has also gained support, however. Based on studies of animal models and of RA itself, several lines of evidence have emerged that indicate that nonimmunologic pathways are operative in established RA. These observations have fostered the hypothesis that the evolution of RA may be associated with the emergence of non-T-cell-dependent autonomous pathways that dominate the latter stages of the disease.
血清类风湿因子升高与类风湿关节炎（RA）之间的关联已被反复证实，并被视为该疾病存在免疫学基础的有力证据。近年来，又获得了大量支持这一观点的额外证据，强烈表明CD4 + T细胞在RA发病机制中发挥作用。然而，另一种观点也得到了支持。基于对动物模型和RA本身的研究，出现了几条证据表明非免疫途径在已确诊的RA中起作用。这些观察结果催生了一种假说，即RA的发展可能与非T细胞依赖性自主途径的出现有关，这些途径在疾病后期起主导作用。
