Related Experiment Video
Updated: Jun 20, 2026
04:47
Du-Moxibustion in a Mouse Model of Ankylosing Spondylitis
Published on: October 27, 2023
Therapy of spondyloarthritides
1Rheumazentrum Ruhrgebiet, Herne, Germany. verwaltung@rheumazentrum-ruhrgebiet.de
Advances in Experimental Medicine and Biology
|September 8, 2009
Summary
Ankylosing spondylitis (AS) is a major spondyloarthritis (SpA) subtype characterized by inflammatory back pain and joint involvement. Early diagnosis, aided by HLA B27 testing and imaging, is crucial for effective management with NSAIDs, sulfasalazine, anti-TNF agents, and physiotherapy.
Area of Science:
- Rheumatology
- Immunogenetics
- Clinical Medicine
Background:
- Ankylosing spondylitis (AS) is a primary subtype of spondyloarthritides (SpA), a group of rheumatic diseases.
- Key features include inflammatory back pain, peripheral arthritis, enthesitis, and potential organ involvement like uveitis, psoriasis, and inflammatory bowel disease.
Purpose of the Study:
- To outline the clinical features, classification, genetics, diagnosis, and management of Ankylosing Spondylitis (AS).
- To highlight the challenges in early diagnosis and the importance of specific diagnostic markers and therapeutic strategies.
Main Methods:
- Review of clinical features, diagnostic criteria, and genetic associations of AS and SpA.
- Analysis of diagnostic delays and factors influencing early detection.
- Summary of current international management recommendations, including pharmacotherapy and physiotherapy.
Main Results:
- AS typically begins in the sacroiliac joints around age 26, with potential progression to the spine, characterized by osteoproliferative changes like syndesmophytes and ankylosis.
- Diagnostic delays average 5-10 years due to non-specific back pain, with HLA B27 and sacroiliac joint imaging being key for early diagnosis.
- Effective treatments include NSAIDs, sulfasalazine for peripheral arthritis, anti-TNF agents for persistent disease, and essential physiotherapy.
Conclusions:
- Ankylosing spondylitis (AS) is a significant spondyloarthritis (SpA) with diverse clinical manifestations and a strong genetic link to HLA B27.
- Improving early diagnosis through awareness of symptoms, genetic markers, and imaging is critical.
- Comprehensive management involving pharmacotherapy and physiotherapy is vital for patient outcomes.
Related Concept Videos
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
01:29Drugs for Treatment of Ulcerative Colitis in IBD
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation.
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
01:21Rheumatic Heart Disease III: Medical Management
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...