- Dedication
- Preface
- List of contributors
- Symbols and abbreviations
- Chapter 1 Spondyloarthritis in antiquity and in history
- Chapter 2 Epidemiology of axial spondyloarthritis
- Chapter 3 Diagnosis and classification of axial spondyloarthritis
- Chapter 4 Diagnosis, classification, and management of peripheral spondyloarthritis
- Chapter 5 Genetics of spondyloarthritis
- Chapter 6 Immune mechanisms: HLA-B27
- Chapter 7 Immune mechanisms: innate immunity
- Chapter 8 Immune mechanisms: adaptive immunity
- Chapter 9 Infection and spondyloarthritis
- Chapter 10 Pathology: bone
- Chapter 11 Clinical features
- Chapter 12 Clinical outcomes
- Chapter 13 Imaging: sacroiliac joints
- Chapter 14 Imaging: spine
- Chapter 15 Juvenile-onset spondyloarthritis
- Chapter 16 Extra-articular manifestations: uveitis
- Chapter 17 Extra-articular manifestations: inflammatory bowel disease
- Chapter 18 Extra-articular manifestations: psoriasis
- Chapter 19 Non-pharmacological management in axial spondyloarthritis
- Chapter 20 Treatment: NSAIDs
- Chapter 21 Treatment: DMARDs
- Chapter 22 Treatment: biologics
- Chapter 23 Treatment: spinal surgery
- Chapter 24 Patient registries
- Chapter 25 Cost-of-illness and economic evaluations in axial spondyloarthritis
- Chapter 26 Physical functioning and work ability
- Chapter 27 Patient support and advocacy
- Chapter 28 Axial spondyloarthritis in Asia
- Chapter 29 Axial spondyloarthritis in Latin America
- Chapter 30 Axial spondyloarthritis in India
- Index
(p. 63) Immune mechanisms: adaptive immunity
- Chapter:
- (p. 63) Immune mechanisms: adaptive immunity
- Author(s):
Maxime Breban
and Hill Gaston
- DOI:
- 10.1093/med/9780198734444.003.0008
The role of adaptive immunity (i.e. the involvement of B and T lymphocytes) in the pathogenesis of axial spondyloarthritis has been investigated in both human disease and relevant animal models. Studies of B cell responses have not generally implicated an autoantibody in the disease, but there are abnormalities of antibody responses, particularly increased titres of antibodies to various gut bacteria. T cells are critical to the disease in animal models other than those where overexpression of a cytokine is engineered, suggesting that they are the drivers of the inflammatory response. There is convergent evidence from animal models, genetics in humans, and direct observation of human peripheral blood and joints to implicate T cells producing IL-17 under the influence of IL-23. These in turn may be responding to bacteria either in the gut or on the skin.
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- Dedication
- Preface
- List of contributors
- Symbols and abbreviations
- Chapter 1 Spondyloarthritis in antiquity and in history
- Chapter 2 Epidemiology of axial spondyloarthritis
- Chapter 3 Diagnosis and classification of axial spondyloarthritis
- Chapter 4 Diagnosis, classification, and management of peripheral spondyloarthritis
- Chapter 5 Genetics of spondyloarthritis
- Chapter 6 Immune mechanisms: HLA-B27
- Chapter 7 Immune mechanisms: innate immunity
- Chapter 8 Immune mechanisms: adaptive immunity
- Chapter 9 Infection and spondyloarthritis
- Chapter 10 Pathology: bone
- Chapter 11 Clinical features
- Chapter 12 Clinical outcomes
- Chapter 13 Imaging: sacroiliac joints
- Chapter 14 Imaging: spine
- Chapter 15 Juvenile-onset spondyloarthritis
- Chapter 16 Extra-articular manifestations: uveitis
- Chapter 17 Extra-articular manifestations: inflammatory bowel disease
- Chapter 18 Extra-articular manifestations: psoriasis
- Chapter 19 Non-pharmacological management in axial spondyloarthritis
- Chapter 20 Treatment: NSAIDs
- Chapter 21 Treatment: DMARDs
- Chapter 22 Treatment: biologics
- Chapter 23 Treatment: spinal surgery
- Chapter 24 Patient registries
- Chapter 25 Cost-of-illness and economic evaluations in axial spondyloarthritis
- Chapter 26 Physical functioning and work ability
- Chapter 27 Patient support and advocacy
- Chapter 28 Axial spondyloarthritis in Asia
- Chapter 29 Axial spondyloarthritis in Latin America
- Chapter 30 Axial spondyloarthritis in India
- Index