Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Rheumatology Reports
Published in: Current Rheumatology Reports 5/2011

01-10-2011

Pathophysiology of Spondyloarthritis

Authors: Monika Ronneberger, Georg Schett

Published in: Current Rheumatology Reports | Issue 5/2011

Login to get access

Abstract

Spondyloarthritis (SpA) is characterized by inflammation and new bone formation in the spine and entheses. The disease is the result of a complex interplay among susceptibility genes, microbial triggers, inflammation of bone marrow, and the enthesial structures and new bone formation. This article gives a conceptual overview of the major insights into the pathophysiology of SpA and discusses the main genes associated with SpA, as well as other factors that are involved in the onset of inflammation. It also addresses the nature of inflammation in SpA and the mechanisms of ankylosis.
Literature
1.
Brewerton DA, Hart FD, Nicholls A, et al. Ankylosing spondylitis and HL-A 27. Lancet. 1973;1(7809):904–7.PubMedCrossRef
2.
Schlosstein L, Terasaki PI, Bluestone R, et al. High association of an HL-A antigen, W 27, with ankylosing spondylitis. N Engl J Med. 1973;288(14):704–6.PubMedCrossRef
3.
Lau CS, Burgos-Vargas R, Louthrenoo W, et al. Features of spondyloarthritis around the world. Rheum Dis Clin North Am. 1998;24(4):753–70.PubMedCrossRef
4.
5.
Gonzalez-Roces S, Alvarez MV, Gonzalez S, et al. HLA-B27 and worldwide susceptibility to ankylosing spondylitis. Tissue Antigens. 1997;49(2):116–23. Erratum in: Tissue Antigens 1997 Sep;50(3):315.PubMedCrossRef
6.
Bjorkman PJ, Saper MA, Samraoui B, et al. The foreign antigen binding site and T cell recognition regions of class I histocompatibility antigens. Nature. 1987;329:512.PubMedCrossRef
7.
Madden DR, Gorga JC, Strominger JL, et al. The three-dimensional structure of HLA-B27 at 2.1 A resolution suggests a general mechanism for tight peptide binding to MHC. Cell. 1992;70(6):1035–48.PubMedCrossRef
8.
Kim TH, Uhm WS, Inman RD. Pathogenesis of ankylosing spondylitis and reactive arthritis. Curr Opin Rheumatol. 2005;17(4):400–5.PubMedCrossRef
9.
10.
D’Amato M, Fiorillo MT, Carcassi C, et al. Relevance of residue 116 of HLA-B27 in determining susceptibility to ankylosing spondylitis. Eur J Immunol. 1995;25(11):3199–201.PubMedCrossRef
11.
Wucherpfennig KW. Presentation of a self-peptide in two distinct conformations by a disease-associated HLA-B27 subtype. J Exp Med. 2004;199(2):151–4.PubMedCrossRef
12.
Atagunduz P, Appel H, Kuon W, et al. HLA-B27-restricted CD8+ T cell response to cartilage-derived self peptides in ankylosing spondylitis. Arthritis Rheum. 2005;52(3):892–901.PubMedCrossRef
13.
Fiorillo MT, Maragno M, Butler R, et al. CD8(+) T-cell autoreactivity to an HLA-B27-restricted self-epitope correlates with ankylosing spondylitis. J Clin Invest. 2000;106(1):47–53.PubMedCrossRef
14.
Laitio P, Virtala M, Salmi M, et al. HLA-B27 modulates intracellular survival of Salmonella enteritidis in human monocytic cells. Eur J Immunol. 1997;27:133119.CrossRef
15.
Australo-Anglo-American Spondyloarthritis Consortium (TASC), Reveille JD, Sims AM, Danoy P, et al. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci. Nat Genet. 2010;42(2):123–7. Epub 2010 Jan 10.PubMedCrossRef
16.
• Wellcome Trust Case Control Consortium; Australo-Anglo-American Spondylitis Consortium (TASC), Burton PR, Clayton DG, Cardon LR, et al. Association scan of 14,500 nonsynonymous SNPs in four diseases identifies autoimmunity variants. Nat Genet. 2007 Nov;39(11):1329–37. ARTS1 and IL23R are two new loci related to AS and, moreover, IL23R probably is a common susceptibility factor for the “seronegative” disease. PubMedCrossRef
17.
Cawley MI, Chalmers TM, Kellgren JH, et al. Destructive lesions of vertebral bodies in ankylosing spondylitis. Ann Rheum Dis. 1972;31:345.PubMedCrossRef
18.
Appel H, Rudwaleit M, Sieper J. Relevance of osteoproliferation as an outcome parameter in ankylosing spondylitis. Nat Clin Pract Rheumatol. 2008;4(11):578.PubMedCrossRef
19.
Rauner M, Stupphann D, Haas M, et al. The HLA-B27 transgenic rat, a model of spondyloarthritis, has decreased bone mineral density and increased RANKL to osteoprotegerin mRNA ratio. J Rheumatol. 2009;36(1):120–6.PubMed
20.
Maksymowych WP. MRI in ankylosing spondylitis. Curr Opin Rheumatol. 2005;17:413.CrossRef
21.
Oostveen J, Prevo R, de Boer J, et al. Early detection of sacroiliitis on magnetic resonance imaging and subsequent development of sacroiliitis on plain radiography. A prospective, longitudinal study. J Rheumatol. 1999;26:1953.PubMed
22.
Schett G, Stolina M, Dwyer D, et al. Tumor necrosis factor alpha and RANKL blockade cannot halt bony spur formation in experimental inflammatory arthritis. Arthritis Rheum. 2009;60:2644–54.PubMedCrossRef
23.
Lories RJ, Luyten FP, de Vlam K. Progress in spondylarthritis. Mechanisms of new bone formation in spondyloarthritis. Arthritis Res Ther. 2009;11:221.PubMedCrossRef
24.
Benjamin M, Toumi H, Suzuki D, et al. Evidence for a distinctive pattern of bone formation in enthesophytes. Ann Rheum Dis. 2008;14.
25.
Samoto H, Shimizu E, Matsuda-Honjyo Y, et al. Prostaglandin E2 stimulates bone sialoprotein (BSP) expression through cAMP and fibroblast growth factor 2 response elements in the proximal promoter of the rat BSP gene. J Biol Chem. 2003;278(31):28659.PubMedCrossRef
26.
Zhang X, Schwarz EM, Young DA, Puzas JE, Rosier RN, O’Keefe RJ. Cyclooxygenase-2 regulates mesenchymal cell differentiation into the osteoblast lineage and is critically involved in bone repair. J Clin Invest. 2002;109(11):1405–15.PubMed
27.
28.
Lories RJ, Daans M, Derese I, Matthys P, Kasran A, Tylzanowski P, et al. Noggin haploinsufficiency differentially affects tissue responses in destructive and remodeling arthritis. Arthritis Rheum. 2006;54:1736–46.PubMedCrossRef
29.
Baron R, Rawadi G. Minireview: targeting the Wnt/beta-catenin pathway to regulate bone formation in the adult skeleton. Endocrinology. 2007;148:2635–43.PubMedCrossRef
30.
• Diarra D, Stolina M, Polzer K, et al. Dickkopf-1 is a master regulator of joint remodeling. Nat Med. 2007;13:156–63. Inhibiting Dickkopf-1 in the Wnt pathway results in formation of osteophytes in a murine model. PubMedCrossRef
31.
Uderhardt S, Diarra D, Katzenbeisser J, et al. Blockade of Dickkopf-1 induces fusion of sacroiliac joints. Ann Rheum Dis. 2009 Mar 26.
32.
Appel H, Ruiz-Heiland G, Listing J, et al. Altered skeletal expression of sclerostin and its link to radiographic progression in ankylosing spondylitis. Arthritis Rheum. 2009;60(11):3257.PubMedCrossRef
33.
Semënov M, Tamai K, He X. SOST is a ligand for LRP5/LRP6 and a Wnt signalling inhibitor. J Biol Chem. 2005;280:26770–5.PubMedCrossRef
34.
•• van der Heijde D, Landewe R, Baraliakos X, et al. Radiographic findings following two years of infliximab therapy in patients with ankylosing spondylitis. Arthritis Rheum. 2008;58:3063. Two years of infliximab therapy do not prevent progression of spinal damage in patients with AS. PubMedCrossRef
35.
van der Heijde D, Landewe R, Einstein S, et al. Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept. Arthritis Rheum. 2008;58:1324.PubMedCrossRef
36.
van der Heijde D, Salonen D, Weissman BN, et al. Assessment of radiographic progression in the spines of patients with ankylosing spondylitis treated with adalimumab for up to 2 years. Arthritis Res Ther. 2009;11:R127.PubMedCrossRef
Metadata
Title
Pathophysiology of Spondyloarthritis
Authors
Monika Ronneberger
Georg Schett
Publication date
01-10-2011
Publisher
Current Science Inc.
Published in
Current Rheumatology Reports / Issue 5/2011
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-011-0202-x

Other articles of this Issue 5/2011

Current Rheumatology Reports 5/2011 Go to the issue

ReviewPaper

Advances in Rheumatoid Arthritis Animal Models

ReviewPaper

Mucosal Inflammation in Spondylarthritides: Past, Present, and Future

ReviewPaper

Antibodies to Citrullinated Protein Antigens (ACPAs): Clinical and Pathophysiologic Significance

Clinical Trial Report

JAK Inhibition in Rheumatoid Arthritis

ReviewPaper

Diagnostic Utility of MRI in Early Spondyloarthritis

Clinical Trial Report

Inhibition of Spleen Tyrosine Kinase for Rheumatoid Arthritis
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits