Ankylosing spondylitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ankylosing spondylitis (AS), a spondyloarthropathy, is a chronic, multisystem inflammatory disorder involving primarily the sacroiliac (SI) joints and the axial skeleton. The outcome in patients with a spondyloarthropathy, including AS, is generally compared with that in patients with a disease such as rheumatoid arthritis.Mostly the joints where the spine joins the pelvis are also affected.Back pain is one of the most prominent symptoms of the ankylosing spondylitis (AS) which is intermittent in nature. Stiffness in the affected joints gets worse.It is believed that both the combination of genetic and environmental factors play an important role in the pathogenesis of ankylosing spondylitis (AS) and the underlying etiology is believed to be autoimmune or autoinflammatory.
Pathophysiology
Pathogenesis[1]
- It is understood that ankylosing spondylitis (AS) is the result of genetic and environmental factors.
- Ankylosing spondylitis (AS) is a chronic inflammatory disease that can affect sacroiliac joints and axial skeleton and cause significant functional and structural implications of the affected joints.
- Ankylosing spondylitis (AS) has a familial associations particularly among the patients who are positive for human leukocyte antigen (HLA)–B27 .
Genetics
- Genes involved in the pathogenesis of ankylosing spondylitis (AS) include Human Leukocyte Antigen–B27(HLA-B27).
- The expression of HLA-B27 is more in the antigen presenting cells.
- HLA-B27 binds to b2 microglobulin after translation and tertiary folding and then loaded with an oligopeptide.
- The complex now passes via Golgi apparatus to the cell surface where the antigenic peptide is presented to either CD8+ lymphocytes or NK cells.
- 90% of the time HLA B27 shows strong genetic association with AS, But only 5% of the patients who are positive for HLA B27 are going to develop ankylosing spondylitis (AS).
References
- ↑ Shamji, Mohammed F.; Bafaquh, Mohammed; Tsai, Eve (2008). "The pathogenesis of ankylosing spondylitis". Neurosurgical Focus. 24 (1): E3. doi:10.3171/FOC/2008/24/1/E3. ISSN 1092-0684.