Papel patogénico de las interacciones entre linfocitos b y sinoviocitos tipo fibroblasto en la artritis reumatoide

The success of rituximab in the treatment of patients with RA has led investigators to reassess the role of B cells in RA pathogenesis. In the RA synovium there is B-lymphocyte accumulation and clonal expansion, formation of ectopic germinal centers, plasma cell accumulation, and deposits of immune complexes, suggesting that B cells and their products participate in disease progression. Moreover, a recently described animal model that simulates RA demonstrates a critical need for B cells in the transition of T-cell autoreactivity to immunoglobulin-mediated joint destruction. Prior in vitro studies of requirements for B-cell survival in the synovial membrane and local differentiation into plasma cells concluded that cell contact between synovial fibroblasts and B cells is essential.