Rossana Scrivo, Salvatore D'Angelo, Antonio Carriero, Chiara Castellani, Fabio Massimo Perrotta, Fabrizio Conti, Matteo Vecellio, Carlo Selmi, Ennio Lubrano
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引用次数: 0
摘要
银屑病关节炎(PsA)是一种慢性炎症性疾病,以银屑病、滑膜炎、粘膜炎、脊柱炎为特征,并可能伴有其他关节外表现和合并症。它是一种多方面的全身性疾病,发病机制复杂,结合了自身炎症和自身免疫的各个方面。PsA 自身炎症的特点包括:生物力学压力在发病和/或病情加重中的作用;皮肤、外周血和滑膜组织中先天性免疫反应介质参与的证据;平等的性别分布;可能出现长期缓解期的临床病程以及与自身炎症综合征重叠的特征。相反,与 I 类主要组织相容性复合体等位基因相关、疾病的多关节模式(有时类似类风湿性关节炎)以及血清中自身抗体的存在,都会引起自身免疫的作用。遗传学也为 PsA 的发病机制提供了重要的见解,尤其是 I 类 HLA 与银屑病和 PsA 的相关性。在这篇综述中,我们对 PsA 的发病机制、遗传学和临床特征进行了全面的综述,这些综述证实了 PsA 是一种处于自身炎症和自身免疫交叉点的混合性疾病。
The Conundrum of Psoriatic Arthritis: a Pathogenetic and Clinical Pattern at the Midpoint of Autoinflammation and Autoimmunity.
Psoriatic arthritis (PsA) is a chronic inflammatory condition characterized by psoriasis, synovitis, enthesitis, spondylitis, and the possible association with other extra-articular manifestations and comorbidities. It is a multifaceted and systemic disorder sustained by complex pathogenesis, combining aspects of autoinflammation and autoimmunity. Features of PsA autoinflammation include the role of biomechanical stress in the onset and/or exacerbation of the disease; the evidence of involvement of the innate immune response mediators in the skin, peripheral blood and synovial tissue; an equal gender distribution; the clinical course which may encounter periods of prolonged remission and overlapping features with autoinflammatory syndromes. Conversely, the role of autoimmunity is evoked by the association with class I major histocompatibility complex alleles, the polyarticular pattern of the disease which sometimes resembles rheumatoid arthritis and the presence of serum autoantibodies. Genetics also provide important insights into the pathogenesis of PsA, particularly related to class I HLA being associated with psoriasis and PsA. In this review, we provide a comprehensive review of the pathogenesis, genetics and clinical features of PsA that endorse the mixed nature of a disorder at the crossroads of autoinflammation and autoimmunity.
期刊介绍:
Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership.
The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.