Exploring T Cells as a Promising Therapeutic Target in Axial Spondyloarthritis

To investigate the role of T cells in the pathogenesis of axial spondyloarthritis (axSpA) and the potential for targeting them therapeutically.

Case Presentation: A 46-year-old man with a long-standing history of axSpA seeks a second opinion on treatment after self-managing his condition.
Introduction to axSpA: axSpA is a chronic inflammatory disease affecting the spine and sacroiliac joints, characterized by significant back pain and potential extra-articular manifestations.
Role of T Cells: The review explores the involvement of conventional and unconventional T cells in axSpA and their potential as therapeutic targets.

T cells, particularly CD8+ and CD4+ T cells, play a critical role in the pathogenesis of axSpA.
HLA-B27 is strongly associated with axSpA, with 80% to 90% of patients carrying this genetic marker.
CD8+ T cells produce proinflammatory cytokines and exhibit altered phenotypes in patients with axSpA.
CD4+ T helper cells, especially Th17 cells, are significant in the initiation and progression of axSpA.

The complex pathogenesis of axSpA remains to be fully understood.
Some experimental findings challenge the assumption that CD8+ T cells are the main drivers of disease.