Pannus inflammation in sacroiliitis following immune pathological injury and radiological structural damage: a study of 193 patients with spondyloarthritis.
Pannus inflammation in sacroiliitis following immune pathological injury and radiological structural damage: a study of 193 patients with spondyloarthritis.
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免疫病理损伤和放射结构损伤后骶髂关节炎中的血管翳炎症：对 193 名脊柱关节炎患者的研究
DOI：
10.1186/s13075-018-1594-z
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发表时间：
2018-06-08
影响因子：
4.9
通讯作者：
Xiao ZY
中科院分区：
文献类型：
--
作者：
Wang DM;Lin L;Peng JH;Gong Y;Hou ZD;Chen SB;Xiao ZY
背景骶髂炎的发病机制尚不清楚；因此，我们旨在系统地研究轴向性脊柱炎（axSpA）患者骶髂炎的免疫病理学，探讨骶髂炎引起的鞘膜形成、炎症和结构损伤之间的关系。方法对193例axSpA患者行骶髂关节（SIJ）细针穿刺活检。在基线和随访期间收集临床、实验室和影像学资料。免疫组化检测CD34+微血管、CD68+破骨细胞/巨噬细胞、血管内皮生长因子（VEGF）、金属蛋白酶-3 （MMP-3）、肿瘤坏死因子-α (TNF-α)、caspase-3。尸检对象作为对照。结果早期骶髂炎（0 ~ 1级）可观察到所有病理特征，以软骨下膜形成最为常见。193例患者中，98例随访1 ~ 13年（平均3.6年）；63.3%在终点有放射学进展。多元回归分析显示，基线时软骨泛膜侵犯（OR 2.99，P= 0.010）和软骨内成骨（OR 3.97，P= 0.049）是影像学结构损伤的危险因素。与SIJ对照组相比，骶髂炎患者软骨下微血管密度、CD68+多核破骨细胞数量以及骨软骨界面表达的VEGF、caspase-3、MMP-3和TNF-α水平均显著升高。结论软骨下纤维血管组织形成是早期骶髂炎最重要的病理特征。基线时是否存在软骨泛膜侵犯或软骨内成骨可以预测随访期间的放射学结构损伤。
BackgroundThe pathogenesis of sacroiliitis is unclear; therefore, we aimed to systematically study the immunopathology of sacroiliitis in patients with axial spondyloarthritis (axSpA), and explore the relationship between pannus formation, inflammation, and the structural damage caused by sacroiliitis.MethodsFine needle aspiration biopsy of the sacroiliac joint (SIJ) was performed in 193 patients with axSpA. Clinical, laboratory, and imaging data were collected at baseline and during the follow up. Immunohistochemistry analysis was performed to detect CD34+ microvessels, CD68+ osteoclasts/macrophages, vascular endothelial growth factor (VEGF), metalloproteinase-3 (MMP-3), tumor necrosis factor-α (TNF-α), and caspase-3. Autopsy subjects were used as controls.ResultsIn early sacroiliitis (grade 0–1) all pathological features could be observed, with the most common being subchondral pannus formation. Among the 193 patients, 98 were followed up for 1–13 years (mean 3.6 years); 63.3% had radiological progression at the endpoint. Multiple regression analysis showed that cartilage pannus invasion (OR 2.99,P= 0.010) and endochondral ossification (OR 3.97,P= 0.049) at baseline were risk factors for radiological structural damage. Compared to SIJ controls, the subchondral microvessel density, number of CD68+ multinuclear osteoclasts, and the levels of VEGF, caspase-3, MMP-3, and TNF-α expressed at the interface of the bone and cartilage were significantly higher in patients with sacroiliitis.ConclusionsSubchondral fibrovascular tissue formation is the most important pathological feature in early sacroiliitis. The existence of cartilage pannus invasion or endochondral ossification at baseline can predict radiological structural damage during the follow up.
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影响因子：
3.1
作者：
Poole, AR
通讯作者：
Poole, AR
DOI：
10.1002/art.21445
发表时间：
2005-10-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Maksymowych, WP;Inman, RD;Lambert, RGW
通讯作者：
Lambert, RGW
影响因子：
27.4
作者：
ENGFELDT, B;ROMANUS, R;YDEN, S
通讯作者：
YDEN, S
影响因子：
27.4
作者：
CRUICKSHANK, B
通讯作者：
CRUICKSHANK, B
影响因子：
--
作者：
Gong, Yao;Zheng, Nan;Zeng, Qing-Yu
通讯作者：
Zeng, Qing-Yu