"SAPHO syndrome and infections"

Area of Science:

• Rheumatology
• Dermatology
• Infectious Diseases

Background:

• The synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome presents with diverse skin manifestations and bone lesions, often affecting the anterior chest wall.
• The exact causes and classification of SAPHO syndrome remain unclear, though Propionibacterium acnes (P. acnes) is implicated.

Purpose of the Study:

• To explore the potential role of Propionibacterium acnes in the pathogenesis of SAPHO syndrome.
• To investigate the immunological response triggered by P. acnes in SAPHO syndrome.
• To clarify whether osteoarticular changes in SAPHO syndrome are due to direct infection or inflammatory reactions.

Main Methods:

• Review of existing literature on SAPHO syndrome and Propionibacterium acnes.
• Analysis of proposed etiological mechanisms, including immune system stimulation by P. acnes.
• Discussion of the debate surrounding infectious versus inflammatory origins of bone lesions.

Main Results:

• Propionibacterium acnes may stimulate both innate and T-cell-mediated immune responses.
• The immune response to P. acnes could lead to inflammation perpetuation.
• The hypothesis of SAPHO syndrome as a reactive infectious osteitis in genetically predisposed individuals is considered but not yet proven.

Conclusions:

• The precise role of Propionibacterium acnes in SAPHO syndrome requires further investigation.
• Understanding the interplay between infection and inflammation is crucial for defining SAPHO syndrome.
• Further studies are needed to validate the concept of SAPHO syndrome as a reactive infectious osteitis.