Treatment of spondyloarthropathies with antibodies against tumour necrosis factor α:: first clinical and laboratory experiences
Treatment of spondyloarthropathies with antibodies against tumour necrosis factor α:: first clinical and laboratory experiences
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DOI：
10.1136/ard.59.12.985
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发表时间：
2000-11-01
影响因子：
27.4
通讯作者：
Sieper, J
中科院分区：
文献类型：
--
作者：
Braun, J;Xiang, J;Sieper, J
脊椎关节病是最常见的炎症性风湿病之一。1除了强烈的遗传易感性（部分是由于HLA-B27）， 2 SpA3还有一些特征性的临床特征：炎性背痛通常是由骶髂炎和腰炎引起的，主要发生在各种明确的部位，主要是腿部，如跟腱、足底腱膜、膝关节、股骨粗隆区和几个骨盆部位。因此，脓包无处不在，导致相关病理表现的多样性。骶髂炎是SpA最常见的早期症状。骶髂炎症是否影响韧带和骨膜结构尚不完全清楚。为了回答一些最关键的问题，组织了一个关于鼻疽的专家研讨会：+为什么鼻疽相关结构被回避？+纤维软骨的存在是必要的吗？+我们是否需要改变enthesitis或enthesis的概念？更多的结构被反折，比传统的概念内嵌暗示。那么这些结构的血液供应呢？炎症是一种炎症过程吗？是由于免疫反应，创伤/机械压力，还是两者兼而有之？炎症从哪里开始？+新骨形成和强直本身是一种病理过程，还是仅仅是对严重和持续炎症的反应？
The spondyloarthropathies are among the most common inflammatory rheumatic diseases. 1 In addition to the strong genetic predisposition, partly due to HLA-B27, 2 there are characteristic clinical features of SpA3: inflammatory back pain often due to sacroiliitis4 and enthesitis occurring mostly at various well defined locations, predominantly of the legs, such as the Achilles tendon, the plantar aponeurosis, the knee, the trochanter regions of the femur, and several pelvic sites. 5 Thus entheses are ubiquitous, resulting in a diversity of associated pathological manifestations. Sacroiliitis is the most common early sign of SpA. 6 Whether or not ligamentous and entheseal structures are aVected in sacroiliac inflammation has not yet been entirely clarified. To answer some of the most critical questions an expert symposium on enthesitis was organised:+ Why are enthesis related structures aVected?+ Is the presence of fibrocartilage essential?+ Do we have to change the concept of enthesitis or that of enthesis? More structures are aVected than the conventional concept of enthesis implies. What about the blood supply of such structures?+ Is enthesitis an inflammatory process? Is it due to an immune response, trauma/mechanical stress, or both?+ Where does the inflammation start?+ Is the new bone formation and ankylosis a pathological process itself, or is it no more than a reaction to severe and persistent inflammation?