Ankylosing spondylitis and bowel disease
Ankylosing spondylitis and bowel disease
复制标题
DOI：
10.1053/berh.2002.0249
复制
发表时间：
2002-09-01
影响因子：
5.2
通讯作者：
Veys, EM
中科院分区：
文献类型：
--
作者：
Baeten, D;De Keyser, F;Veys, EM
临床研究表明，肠道炎症在强直性脊柱炎和其他脊柱关节病中的重要作用，因此必须考虑两个不同的方面。首先，肠道炎症在临床和组织学上与克罗恩病密切相关。最近亚临床免疫改变的数据证实了这种关系，并表明脊柱关节病是一个独特的人类模型，研究早期克罗恩病。其次，肠道和外周关节炎症在临床、组织学和发病机制上是相关的。这些观察结果最重要的临床意义是，克罗恩病的靶向治疗对脊柱关节病的肠道和肠外疾病表现也有效，最近的TNF-α阻断研究证明了这一点。解开脊柱关节病的肠-滑膜轴也有助于识别新的治疗靶点。最后，通过组织学、血清学和遗传学评估临床下肠道炎症有助于将个体患者分层为对特定治疗干预有最佳反应的亚组。
Clinical studies indicate an important role for bowel inflammation in ankylosing spondylitis and other spondyloarthropathies whereby two different aspects have to be considered. First, the gut inflammation is clinically and histologically closely related to Crohn's disease. Recent data on subclinical immune alterations confirm this relationship and suggest that spondyloarthropathy is a unique human model for studying early Crohn's disease. Second, bowel and peripheral joint inflammation are clinically, histologically and pathogenetically linked. The most important clinical implication of these observations is that targeted therapies for Crohn's disease could also be effective for intestinal as well as extra-intestinal disease manifestations in spondyloarthropathy, as evidenced by the recent studies on TNF-alpha blockade. Unravelling the gut-synovium axis in spondyloarthopathy could also contribute to the identification of new therapeutic targets. Finally, assessment of subdinical gut inflammation by histology, serology and genetics could contribute to the stratification of individual patients in subgroups with an optimal response to specific therapeutic interventions.