Immunohistologic analysis of zygapophyseal joints in patients with ankylosing spondylitis
Immunohistologic analysis of zygapophyseal joints in patients with ankylosing spondylitis
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DOI：
10.1002/art.22060
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发表时间：
2006-09-01
影响因子：
--
通讯作者：
Loddenkemper, Christoph
中科院分区：
文献类型：
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作者：
Appel, Heiner;Kuhne, Maren;Loddenkemper, Christoph
Objective.强直性脊柱炎（AS）常累及脊柱关节突关节。在这项研究中，我们进行了系统的免疫组织学评估的免疫病理学的关节突关节在先进的AS患者。我们从16例接受多节段脊柱后凸矫正的AS患者和10例非AS对照（尸检）中获得了关节突关节。免疫组化分析骨髓浸润T细胞（CD 3、CD 4、CD 8）、B细胞（CD 20）、破骨细胞（CD 68）、骨髓巨噬细胞（CD 68）和微血管密度（CD 34）。16例AS患者中有6例的关节突关节出现2个或更多的CD3+ T细胞聚集，表明持续性炎症，而对照组无一例出现。间质性CD4+和CD8+ T细胞在AS患者中比非AS对照组显著更频繁（分别为P = 0.002和P = 0.049）。虽然与对照组相比，AS患者的CD 20 + B细胞数量总体上没有明显差异，但当将AS患者的持续性炎症关节与AS患者的无活动性炎症关节或对照组关节进行比较时，存在显著差异（均P = 0.03）。炎症活动性AS患者骨髓微血管密度明显高于对照组。结论。对关节突关节骨髓的免疫组织学研究表明，AS患者（包括长期患病者）的脊柱存在持续性炎症。T细胞和B细胞数量的增加以及新生血管的发现表明这些特征在AS的发病机制中起作用。
Objective. Zygapophyseal joints of the spine are often affected in ankylosing spondylitis (AS). In this study, we undertook a systematic immunohistologic evaluation of the immunopathology of the zygapophyseal joints in patients with advanced AS.Methods. We obtained zygapophyseal joints from 16 AS patients undergoing polysegmental correction of kyphosis and from 10 non-AS controls (at autopsy). Immunohistologic analysis of the bone marrow was performed by analyzing the number of infiltrating T cells (CD3, CD4, CD8), B cells (CD20), osteoclasts (CD68), bone marrow macrophages (CD68), and microvessel density (CD34) per high-power field.Results. Zygapophyseal joints from 6 of 16 AS patients, but from none of the controls, exhibited 2 or more CD3+ T cell aggregates, signifying persistent inflammation. Interstitial CD4+ and CD8+ T cells were significantly more frequent in AS patients compared with non-AS controls (P = 0.002 and P = 0.049, respectively). While there was no clear difference between the number of CD20+ B cells in AS patients overall compared with controls, there was a significant difference when persistently inflamed joints from patients with AS were compared with joints without active inflammation from patients with AS or joints from controls (both P = 0.03). Microvessel density in bone marrow from AS patients with active inflammation was significantly higher than that in bone marrow from controls.Conclusion. This immunohistologic study of bone marrow from zygapophyseal joints demonstrates persistent inflammation in the spine of patients with AS, including those with longstanding disease. The findings of increased numbers of T cells and B cells and neoangiogenesis suggest that these features play a role in the pathogenesis of AS.