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Immunocompetent Cells and Their Role in Polymyalgia Rheumatica and Giant Cell Arteritis

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Polymyalgia Rheumatica and Giant Cell Arteritis

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Abstract

Giant cell arteritis (GCA) and polymyalgia reumatica (PMR) are two closely related syndromes affecting elderly people. General experience says that with age the capacity to generate protective immune response declines whereas reactivity to autoantigens increases. GCA and PMR is an inflammatory vasculopathy mediated by pathogenic condition of unknown aetiology.Β cells are extremely rare in the vascular lesions, which is consistent with the lack of antibody production and of immune complex deposition or hypergammaglobulinemia in GCA. The presence of high levels of autoantibodies in the serum of patients with GCA and PMR suggested the idea that there could be a B-cell activation in these patients. B cells not only produce antibodies, but also modulate T cell responses by secreting proinflammatory and antiinflammatory cytokines such as tumor necrosis factor α and interleukin-10, respectively. Furthermore,effector B (Beff) cells can potentiate T cell– mediated autoimmunity via secretion of IL-6. B cells from GCA patients with active disease had an enhanced capacity for IL- 6 production and B cell-activating factor was strongly associated with disease activity. However, much less is known about the role circulating Τ cells in patients with GCA and PMR. Besides Τ lymphocytes, macrophages are the second components of the vascular lesions. Their role in the inflammatory events in the arterial wall is unclear, although during the recent 10 years also involvement of vascular dendritic cells in the inflammatory process has been documented. Compared with noninflamed temporal arteries, inflamed specimens contain the T cell products IFN-γ and interleukin -2 and the CD68+ macrophage products IL-1 beta, IL-6 and transforming growth factor β (TGF-β ). TGF-β was most abundantly found and was produced in conjunction with, but also in the absence of IL-1 β and IL-6. Markedly elevated IL-6 and IL-1 receptor antagonist concentrations were found at the time of PMR diagnosis, thus prior to start of glucocorticoid therapy.The open is question about of number of circulating Τ cells and other subtypes in patients with PMR and GCA. Significantly reduced percentages and number of CD8+ cells have been found in 40% to 80% of patients with PMR and GCA and their role have not been fully clarified.The cellular players and their mediators in PMR and GCA are known, are needed but further studies to deepen the information on them, and it gives new hopes to treatment.

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Authors and Affiliations

  1. National Institute of Rheumatic Diseases, Piešťany, Slovakia

    Stanislava Blažíčková Ing., Ph.D. & Jozef Rovenský M.D., D.Sc., F.R.C.P.

  2. Department of Rheumatology, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia

    Jozef Rovenský M.D., D.Sc., F.R.C.P.

  3. Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia

    Richard Imrich M.D., Ph.D.

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  1. Stanislava Blažíčková Ing., Ph.D.
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  2. Jozef Rovenský M.D., D.Sc., F.R.C.P.
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  3. Richard Imrich M.D., Ph.D.
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Correspondence to Stanislava Blažíčková Ing., Ph.D. .

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Editors and Affiliations

  1. Department of Rheumatology, National Institute of Rheumatic Diseases, Piešťany, Slovakia

    Jozef Rovenský

  2. 2nd Department of Medicine, State Hospital of Stockerau, Stockerau, Austria

    Burkhard Leeb

  3. 2nd Internal Clinic Medical Faculty, Comenius University, Bratislava, Slovakia

    Viera Štvrtinová

  4. Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia

    Richard Imrich

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Blažíčková, S., Rovenský, J., Imrich, R. (2017). Immunocompetent Cells and Their Role in Polymyalgia Rheumatica and Giant Cell Arteritis. In: Rovenský, J., Leeb, B., Štvrtinová, V., Imrich, R. (eds) Polymyalgia Rheumatica and Giant Cell Arteritis. Springer, Cham. https://doi.org/10.1007/978-3-319-52222-7_5

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