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Updates on ankylosing spondylitis: pathogenesis and therapeutic agents
1Division of Rheumatology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
Journal of Rheumatic Diseases
|September 22, 2023
Summary
Ankylosing spondylitis involves gut microbiota, HLA-B*27, and biomechanical stress triggering inflammation. Understanding these factors and immune responses is key to developing new biologics and biomarkers for this autoinflammatory disease.
Area of Science:
- Immunology
- Gastroenterology
- Rheumatology
Background:
- Ankylosing spondylitis (AS) is an autoinflammatory condition characterized by enthesitis.
- Key factors like gut microbiota, HLA-B*27, and biomechanical stress interact to initiate and perpetuate inflammation in AS.
Purpose of the Study:
- To critically analyze the complex pathogenesis of ankylosing spondylitis.
- To provide updates on immune system findings and new information on biologics and biomarkers for AS.
Main Methods:
- Review of current scientific literature on ankylosing spondylitis pathogenesis.
- Analysis of the interplay between gut dysbiosis, HLA-B*27, biomechanical stress, and immune responses.
- Evaluation of cytokine regulation, bone homeostasis, and autoimmune aspects in AS.
Main Results:
- Gut dysbiosis in HLA-B*27 positive individuals compromises the gut barrier.
- Biomechanical stress contributes to inflammation via resident or gut-origin immune cells.
- Cytokines regulate bone homeostasis, leading to new bone formation in inflamed areas.
Conclusions:
- Immune cells, influenced by gut microbiota and biomechanical factors, propagate inflammation in AS.
- Targeting cytokines and understanding autoimmune markers are crucial for developing novel therapeutic strategies.
- Further research into biologics and biomarkers is essential for managing AS progression.
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