• Login
    JavaScript is disabled for your browser. Some features of this site may not work without it.
    The clinical and immunological significance of ectopic lymphoneogenesis in the rehumatoid synovial membrane 
    •   QMRO Home
    • Queen Mary University of London Theses
    • Theses
    • The clinical and immunological significance of ectopic lymphoneogenesis in the rehumatoid synovial membrane
    •   QMRO Home
    • Queen Mary University of London Theses
    • Theses
    • The clinical and immunological significance of ectopic lymphoneogenesis in the rehumatoid synovial membrane
    ‌
    ‌

    Browse

    All of QMROCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    ‌
    ‌

    Administrators only

    Login
    ‌
    ‌

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    The clinical and immunological significance of ectopic lymphoneogenesis in the rehumatoid synovial membrane

    View/Open
    Humby, Francis PhD 2010.pdf (34.08Mb)
    Publisher
    Queen Mary University of London
    Metadata
    Show full item record
    Abstract
    Despite the development of new biomarkers predicting prognosis in rheumatoid arthritis (RA) remains challenging and targeting of powerful biologics difficult. The presence of ectopic germinal centres (GC) within synovium has long been recognised (ectopic lymphoneogenesis [ELN]) and data have suggested that they manufacture antibody (Ab). High affinity class switched Ab production occurs through class switch recombination (CSR) and somatic hypermutation (SHM) both critically dependent on activation induced cytidine deaminase (AID). However, whether ectopic GCs express AID has not been known. Nonetheless data associating ELN with disease severity suggest a role for ELN in RA pathogenesis and as a potential biomarker. A classification system for RA synovium, based on the concept of ELN has been proposed as: (i) aggregate, (ii) aggregate GC+ and, (iii) an unorganised infiltrate. However whether these distinct pathotypes and/or degree of aggregation equate to disease severity is unclear. Thus my first aim was to develop and validate a pathological scoring system for rheumatoid synovium capable of quantifying the degree of ELN. My second aim was to investigate whether the presence and/or degree of ELN within the synovial membrane correlated with both clinical phenotype and predicted erosive damage. I demonstrate that the aggregational score developed is highly reliable and that ELN within synovial tissue associates with a higher level of synovial inflammation but is not predictive of damage. My third aim was to investigate whether GCs within RA synovium were functional. I provide evidence of functionality by demonstrating that ectopic GCs invariably express AID, are surrounded by anti-CCP+ plasma cells, support ongoing CSR and the manufacture of anti-CCP Abs. My final aim was to characterise a cohort of synovial B cells consistently found surrounding ectopic GCs. I identify a novel B cell subset within RA synovium, interfollicular large B cells, (5)(5)(5) and demonstrate that interfollicular large B cells in lymph node express a somatically mutated IgH.
    Authors
    Humby, Frances Claire
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/28086
    Collections
    • Theses [3366]
    Licence information
    The copyright of this thesis rests with the author and no quotation from it or information derived from it may be published without the prior written consent of the author
    Twitter iconFollow QMUL on Twitter
    Twitter iconFollow QM Research
    Online on twitter
    Facebook iconLike us on Facebook
    • Site Map
    • Privacy and cookies
    • Disclaimer
    • Accessibility
    • Contacts
    • Intranet
    • Current students

    Modern Slavery Statement

    Queen Mary University of London
    Mile End Road
    London E1 4NS
    Tel: +44 (0)20 7882 5555

    © Queen Mary University of London.