总结当前对风湿性炎症性疾病、退行性疾病或机械应力引起的滑囊炎免疫病理学的见解，并确定该领域的知识差距。腱鞘炎病理学数据也被纳入比较。我们对 PubMed/MEDLINE 上所有发表的文献进行了电子数据库搜索，从最初到 2023 年 2 月 13 日，进行了系统综述，调查了炎症性风湿病患者法氏囊中发生的免疫学变化，退行性疾病或机械应力（例如撞击综合征）。三十二篇文章提供了有关法氏囊组织炎症免疫病理学的数据。组织学和免疫学扰动包括组织形态的改变、巨噬细胞和一些 T 细胞的浸润以及促炎细胞因子的表达增强，例如白细胞介素 (IL)-6、IL-1β 和肿瘤坏死因子 α (TNF-α)。尽管对与风湿性炎症性疾病相关的滑囊炎的研究很少，但对所有三个根本原因都描述了这些变化。在我们纳入的研究中，仅在由机械应力引起的肩峰下滑囊炎中报告了纤维化。目前对滑囊炎的认识已经过时，并且特别缺乏与风湿性炎症性疾病相关的滑囊炎的研究。无论根本原因如何，在滑囊炎中都发现 IL-6、IL-1β、TNF-α 和浸润性巨噬细胞的表达增强存在显着重叠。迫切需要对滑囊炎进行深入研究，例如高通量多组学，以指导疾病特异性治疗管理。版权所有 © 2024。由 Elsevier Inc. 出版。

To summarize current insights on the immune pathology of bursitis caused by rheumatic inflammatory diseases, degenerative conditions, or mechanical stress and identify knowledge gaps in this field. Data on tenosynovitis pathology was included for comparison.We performed a systematic review encompassing an electronic database search of all published literatures in PubMed/MEDLINE from inception to February 13, 2023, investigating the immunological changes occurring in the bursa of patients with inflammatory rheumatic diseases, degenerative conditions or mechanical stress (e.g., impingement syndrome).Thirty-two articles provided data on the immune pathology of bursal tissue inflammation were identified. Histological and immunological perturbations included alterations of tissue morphology, infiltration of macrophages and some T cells, and enhanced expression of proinflammatory cytokines, such as interleukin (IL)-6, IL-1β and tumor necrosis factor alpha (TNF-α). These changes were described for all three underlying causes, although studies on bursitis associated with rheumatic inflammatory diseases were rare. Fibrosis was only reported in subacromial bursitis caused by mechanical stress within our included studies.Current insights on bursitis were outdated and studies on bursitis associated with rheumatic inflammatory diseases are particularly lacking. Substantial overlap of enhanced expression of IL-6, IL-1β, TNF-α and infiltrating macrophages were found in bursitis irrespective of the underlying cause. In depth investigation on bursitis such as high throughput multi-omics are urgently needed to guide disease-specific therapeutic management.Copyright © 2024. Published by Elsevier Inc.