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The Role of the IL-23/TH17 Immune Pathway in the Pathogenesis of Arthritis

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TH17 Cells in Health and Disease

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Abstract

Studies with IL-23-deficient mice revealed the critical role of IL-23 and in particular IL-17-producing cells, including TH17 cells, in the initiation of experimental auto-immune arthritis. Interestingly, the recognition of TH17 cells and TH17 cytokines at the very early stage of rheumatoid arthritis (RA) fits with the concept that the IL-23/TH17 immune pathway is important in the development of this auto-immune disease. However, the exact biological role of this immune pathway in the development of RA and other arthropathies needs further examination. The first data from clinical trials using anti-IL-17A antibody treatment in psoriatic arthritis and RA is promising. Whether the regulation of TH17 cell activity or specific combinations of TH17 cytokines will have additional value compared to neutralizing IL-17A activity or TNF needs to be elucidated. However, first evidence from in vitro studies showed that the inhibition of the TH17 pathway in addition to anti-TNF suppressed the pro-inflammatory feedback loop between TH17 cells and synovial fibroblasts of patients with early RA. This approach may help to reach the ultimate goal of permanent remission or even prevent the development of this crippling disease. In addition, further understanding of the plasticity of T cell subsets in the pathogenesis of chronic destructive arthritis especially at different stages of the disease will be essential to understanding the T cell biology in RA. Moreover, understanding T cell plasticity due to different therapies may further improve treatment of patients with chronic destructive arthritis.

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Acknowledgement

I would like to acknowledge all members of the Lubberts lab for their excellent input and discussions.

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Authors and Affiliations

  1. Department of Rheumatology, Erasmus MC, University Medical Center, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Erik Lubberts

  2. Department of Immunology, Erasmus MC, University Medical Center, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Erik Lubberts

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  1. Erik Lubberts
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Correspondence to Erik Lubberts .

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Editors and Affiliations

  1. King's College London, Department of Nephrology and Transplanta, Guy's Hospital, London, WC2R 2LS, United Kingdom

    Shuiping Jiang

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Lubberts, E. (2011). The Role of the IL-23/TH17 Immune Pathway in the Pathogenesis of Arthritis. In: Jiang, S. (eds) TH17 Cells in Health and Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9371-7_23

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