T cells: pathogenic cells and therapeutic targets in rheumatoid arthritis

Semin Arthritis Rheum. 1999 Aug;29(1):27-35. doi: 10.1016/s0049-0172(99)80035-3.

Abstract

Objectives: To provide: 1) a brief review of current thought on the role of T cells in the pathogenesis of rheumatoid arthritis (RA); and 2) To provide an overview of RA therapies directed against T cells.

Methods: The following papers in relevant American and European medical journals were reviewed. Those related to: the role of T cells in the pathogenesis of RA; to biological therapy directed against cell surface markers specific to T cell populations implicated in RA; and to treatment of RA with cyclosporin A and leflunomide, pharmacological agents known to interfere with the T cell response to antigens.

Results: Although a variety of cell types are now recognized as contributors to the progressive joint destruction that is a hallmark of RA, T cell activation is still thought to be a central event in the initiation and progression of this disease. As a result, various therapeutic options directed against T cells have been developed. These include biological agents directed against specific populations of activated T cells and pharmacological agents that have specific T cell-modulatory actions.

Conclusions: Use of T cell-directed biological therapies for RA has been disappointing, as a result of both lack of efficacy and serious toxicity. Treatment of RA with pharmacological agents that interfere with antigen-driven T cell proliferation has been more successful.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antigens, CD / immunology
  • Arthritis, Rheumatoid / immunology*
  • Arthritis, Rheumatoid / therapy*
  • Clone Cells / immunology
  • Genetic Predisposition to Disease
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Immunotherapy
  • Isoxazoles / therapeutic use
  • Leflunomide
  • Lymphocyte Activation / immunology
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antigens, CD
  • Immunosuppressive Agents
  • Isoxazoles
  • Leflunomide