在轴性脊柱关节炎中是否存在疾病内型,我们如何定义它们?
Kevin D Deane1, Laura T Donlin2, Christopher T Ritchlin3
1K.D. Deane, MD, PhD, K.A. Kuhn, MD, PhD, Division of Rheumatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
The Journal of rheumatology
|October 24, 2024
概括
轴性脊椎关节炎 (axSpA) 可能由多种类型组成,但定义这些内型需要进一步研究. 将基于组织的病理与临床和成像数据的整合对于未来的axSpA分类至关重要.
科学领域:
- 风湿病学和免疫学
- 疾病分类和内型鉴定.
背景情况:
- 轴性脊柱关节炎 (axSpA) 在确定它是否代表一个单一实体或多个不同的亚型方面提出了挑战.
- 目前的分类依赖于临床,成像和遗传标记 (例如,HLA-B27),但基于放射状况和性别的疾病结果的区别表明潜在的异质性.
研究的目的:
- 探索内型的概念,以定义轴性脊柱关节炎 (axSpA) 中的亚型.
- 对其他疾病 (如类风湿性关节炎,喘和牛皮性关节炎) 的内型定义进行审查,以对axSpA.潜在的应用.
主要方法:
- 在相关的炎症条件下对内型定义的文献综述.
- 讨论将从类风湿性关节炎,喘和牛皮性关节炎中学到的经验教训应用于axSpA.
- 确定axSpA研究中的未满足需求,特别是关于组织可访问性的需求.
主要成果:
- 现有的数据显示,非放射性和放射性axSpA之间以及男性和女性患者之间的结果差异,表明异质性.
- 在其他疾病中的内型定义为基于功能性或病理生理学特征的axSpA亚型的理解提供了一个框架.
结论:
- 定义axSpA内型对于精确的分类和了解疾病机制至关重要.
- 对受影响组织的访问是调查病理机制和定义组织特异性内型的关键未满足的需求.
- 未来的axSpA分类标准应该将基于组织的特征与临床数据和成像进行整合.
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