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14-7-第七节 对类风湿炎发病机制的认识和研究新进展
对有关免疫球蛋白的糖基化异常和类风湿关节炎的关系,包括其糖链结构、分子构象、基因表达等基础研究,发病机制,临床发病和病情的相关性,以及其糖链特点可能在临床诊断中的应用等,已经进行了持续多年的研究。大量很有说服力的资料说明,IgG糖链结构与RA密切相关。但因类风湿关节炎的病因复杂,还缺乏确切反映人体RA的动物模型,其发病机制仍需进一步深入研究。近年,还观察到某些RA免疫球蛋白的糖链核心部位的岩藻糖化明显增加,但其临床意义还待阐明。最近,将K/BxN转基因小鼠的动物模型和人类的RA联系,通过对其关节滑膜的组织化学分析,观察到RA滑膜表面衬里细胞有高浓度的GPI(糖基化磷脂酰肌醇)沉积,说明GPI抗体可能参与关节的疾病。研究者认为这种动物模型中的现象也可能见于人类 RA,并对发展新型的关节介入治疗提供了思路。此外,有关RA的免疫学研究也十分活跃,尤其观察到CD4+T细胞与RA的炎症的发生和发展密切相关后,细胞免疫在RA中的病理作用目前受到很大关注,免疫球蛋白分子的糖基化改变与细胞免疫是否有关可能也应予以进一步探讨。
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