Journal
CURRENT RHEUMATOLOGY REPORTS
Volume 23, Issue 6, Pages -Publisher
SPRINGER
DOI: 10.1007/s11926-021-01005-x
Keywords
Psoriatic arthritis; Spondyloarthritis; Interleukin-17; Synovial fluid; Innate immunity
Categories
Funding
- Medical Research Council clinical training fellowship [MR/P018904/1]
- King's College London
- National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust
- MRC [MR/P018904/1] Funding Source: UKRI
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The production of IL-17 by both unconventional and conventional lymphocytes in psoriatic arthritis and ankylosing spondylitis may lead to new pathogenic pathways. These cells significantly contribute to IL-17-mediated pathology and have implications for potential therapeutic mechanisms.
Purpose of Review The recognition that IL-17 is produced by many lymphoid-like cells other than CD4+ T helper (Th17) cells raises the potential for new pathogenic pathways in IBD/psoriasis/SpA. We review recent knowledge concerning the role of unconventional and conventional lymphocytes expressing IL-17 in human PsA and axSpA. Recent Findings Innate-like lymphoid cells, namely gamma delta (gamma delta) T-cells, invariant natural killer T (iNKT) cells and mucosal-associated invariant T (MAIT) cells, together with innate lymphoid cells (ILCs) are found at sites of disease in PsA/SpA. These cells are often skewed to Type-17 profiles and may significantly contribute to IL-17 production. Non-IL-23 dependent IL-17 production pathways, utilising cytokines such as IL-7 and IL-9, also characterise these cells. Both conventional CD4 and CD8 lymphocytes show pathogenic phenotypes at sites of disease. A variety of innate-like lymphoid cells and conventional lymphocytes contribute towards IL-17-mediated pathology in PsA/SpA. The responses of these cells to non-conventional immune and non-immune stimuli may explain characteristic clinical features of these diseases and potential therapeutic mechanisms of therapies such as Jak inhibitors.
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