T cell subsets and their role in the pathogenesis of rheumatic disease

Curr Opin Rheumatol. 2014 Mar;26(2):204-10. doi: 10.1097/BOR.0000000000000036.


Purpose of review: T lymphocytes are critical to the pathogenesis of systemic rheumatic diseases. Understanding of the roles of T cells in disease has been enriched by the description of highly distinct effector subsets of CD4 T lymphocytes. The purpose of this review is to describe selected advances in the biology of T lymphocytes that are pertinent to the pathogenesis or treatment of rheumatic diseases.

Recent findings: Knowledge is expanding about not only pathogenic effector T cell subsets, such as the TH17 cells, but also of regulatory T cells (Treg), the functions of which are defective, but correctable, in several rheumatic diseases. Although the initial agent that demonstrated a role for T cells in rheumatoid arthritis was CTLA4-Ig (abatacept), use of this biologic is now expanding to other rheumatic diseases. Moreover, effects of other biologics are now understood to in part be mediated by effects on T cell subsets. Experimental model systems in rodents continue to be valuable testing grounds for future approaches to treatment of human disease. Meanwhile, the roles of effector T cell subsets are becoming clearer in conditions such as Sjogren's syndrome and scleroderma. Finally, rheumatic diseases, including rheumatoid arthritis and spondyloarthropathies, have been critical for identification of new innate-like T cell subsets.

Summary: Imbalances in the numbers and functions of specific T cell subsets are key pathogenic derangements in systemic rheumatic diseases, and these insights are leading to changes in clinical practice.

Publication types

  • Review

MeSH terms

  • Abatacept
  • Animals
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / etiology
  • Arthritis, Rheumatoid / therapy
  • Disease Models, Animal
  • Humans
  • Immunoconjugates / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Mice
  • Myositis / etiology
  • Myositis / therapy
  • Rheumatic Diseases / etiology*
  • Rheumatic Diseases / immunology
  • Rheumatic Diseases / therapy
  • Scleroderma, Systemic / etiology
  • Scleroderma, Systemic / therapy
  • Sjogren's Syndrome / etiology
  • Sjogren's Syndrome / therapy
  • Spondylitis, Ankylosing / therapy
  • T-Lymphocyte Subsets / immunology*
  • Vasculitis / etiology
  • Vasculitis / therapy


  • Antirheumatic Agents
  • Immunoconjugates
  • Immunosuppressive Agents
  • Abatacept