轴性脊椎关节炎
Joachim Sieper1, Denis Poddubnyy1
1Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany.
Lancet (London, England)
|January 24, 2017
概括
轴性关节炎,包括结性关节炎,涉及炎症和潜在的骨损伤. 早期识别和治疗,如TNF阻断剂和IL-17阻断,是治疗这种疾病的关键.
科学领域:
- 关节病学
- 免疫学
- 遗传学
背景情况:
- 轴性脊椎关节炎 (AxSpA) 包括放射性 (缩性脊椎炎) 和非放射性形式.
- 通常发生在第三个十年,男性与女性的比例有所不同.
- 高遗传率 (> 90%) 与HLA-B27有关,但其致病作用需要进一步阐明.
研究的目的:
- 审查轴性脊髓关节炎的发病,诊断和治疗.
- 突出关键细胞因子的作用和早期检测的重要性.
- 讨论当前和新兴的治疗策略.
主要方法:
- 临床试验和致病机制的文献综述.
- 基因关联的分析,特别是HLA-B27.
- 评估像MRI和治疗干预等诊断工具.
主要成果:
- 瘤死亡因子-α (TNF-α) 和中白素-17 (IL-17) 参与了AxSpA的发病.
- 除了MRI,新的分类和查标准有助于早期识别患者.
- 非类固醇抗炎药物 (NSAID) 和TNF抑制剂显示出有效性.
结论:
- 了解炎症与骨形成之间的相互作用对于预防长期损伤至关重要.
- 在AxSpA治疗中,IL-17阻断是一个显著的进步.
- 早期诊断和向治疗,包括IL-17阻断,可以改善患者的治疗结果.
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