Información del artículo
Resumen
El éxito del rituximab en el tratamiento de pacientes con artritis reumatoide (AR) ha favorecido la reevaluación del papel de los linfocitos B en la patogenia de esta enfermedad. En la membrana sinovial inflamada de pacientes con AR se observa una acumulación y expansión clonal de linfocitos B, formación ectópica de centros germinales, acumulación de células plasmáticas, producción local de autoanticuerpos y depósito de inmunocomplejos. Además, en modelos animals de artritis inflamatoria se ha demostrado que las células B son necesarias para que se produzca el daño mediado por linfocitos T. Todo ello indica que los linfocitos B son importantes en la patogenia de la AR. Varios estudios han demostrado que el contacto con fibroblastos sinoviales es esencial para la acumulación y la supervivencia de los linfocitos B en la articulación reumatoidea, así como para su diferenciación hacia células plasmáticas.
Palabras clave:
Artritis reumatoide
Linfocito B
inoviocito tipo fibroblasto
Abstract
The success of rituximab in the treatment of patients with RA has led investigators to reassess the role of B cells in RA pathogenesis. In the RA synovium there is B-lymphocyte accumulation and clonal expansion, formation of ectopic germinal centers, plasma cell accumulation, and deposits of immune complexes, suggesting that B cells and their products participate in disease progression. Moreover, a recently described animal model that simulates RA demonstrates a critical need for B cells in the transition of T-cell autoreactivity to immunoglobulin-mediated joint destruction. Prior in vitro studies of requirements for B-cell survival in the synovial membrane and local differentiation into plasma cells concluded that cell contact between synovial fibroblasts and B cells is essential.
Key words:
Rheumatoid arthritis
B lymphocyte
Fibroblastlike synoviocyte
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