Pathophysiology and immunolgical basis of axial spondyloarthritis

IF 4.5 2区医学 Q1 RHEUMATOLOGY Best Practice & Research in Clinical Rheumatology Pub Date : 2023-09-01 DOI:10.1016/j.berh.2023.101897

Marleen G.H. van de Sande , Dirk Elewaut

引用次数: 0

Abstract

Over the recent years the wider availability and application of state-of-the-art immunological technologies greatly advanced the insight into the mechanisms that play an important role in axial spondyloarthritis (axSpA) pathophysiology. This increased understanding has facilitated the development of novel treatments that target disease relevant pathways, hereby improving outcome for axSpA patients.

In axSpA pathophysiology genetic and environmental factors as well as immune activation by mechanical or bacterial stress resulting in a chronic inflammatory response have a central role. The TNF and IL-23/IL-17 immune pathways play a pivotal role in these disease mechanisms.

This review provides an outline of the immunological basis of axSpA with a focus on key genetic risk factors and their link to activation of the pathological immune response, as well as on the role of the gut and entheses in the initiation of inflammation with subsequent new bone formation in axSpA.

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轴性脊柱炎的病理生理学和免疫学基础。

近年来，最先进的免疫学技术的广泛应用和应用，极大地促进了对在轴性脊柱炎(axSpA)病理生理中起重要作用的机制的了解。这种认识的增加促进了针对疾病相关途径的新治疗方法的发展，从而改善了axSpA患者的预后。在axSpA的病理生理学中，遗传和环境因素以及由机械或细菌应激引起的免疫激活导致慢性炎症反应起着核心作用。TNF和IL-23/IL-17免疫通路在这些疾病机制中起关键作用。这篇综述概述了axSpA的免疫学基础，重点介绍了关键的遗传危险因素及其与病理性免疫反应激活的联系，以及肠道和肠道在炎症启动和axSpA随后的新骨形成中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.