The immunology of rheumatoid arthritis.

Abstract:

:The immunopathogenesis of rheumatoid arthritis (RA) spans decades, beginning with the production of autoantibodies against post-translationally modified proteins (checkpoint 1). After years of asymptomatic autoimmunity and progressive immune system remodeling, tissue tolerance erodes and joint inflammation ensues as tissue-invasive effector T cells emerge and protective joint-resident macrophages fail (checkpoint 2). The transition of synovial stromal cells into autoaggressive effector cells converts synovitis from acute to chronic destructive (checkpoint 3). The loss of T cell tolerance derives from defective DNA repair, causing abnormal cell cycle dynamics, telomere fragility and instability of mitochondrial DNA. Mitochondrial and lysosomal anomalies culminate in the generation of short-lived tissue-invasive effector T cells. This differentiation defect builds on a metabolic platform that shunts glucose away from energy generation toward the cell building and motility programs. The next frontier in RA is the development of curative interventions, for example, reprogramming T cell defects during the period of asymptomatic autoimmunity.

journal_name

Nat Immunol

journal_title

Nature immunology

authors

Weyand CM,Goronzy JJ

doi

10.1038/s41590-020-00816-x

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

10-18

issue

1

eissn

1529-2908

issn

1529-2916

pii

10.1038/s41590-020-00816-x

journal_volume

22

pub_type

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