Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
Walaeus Library, Leiden University Medical Center, Leiden, the Netherlands.
Eur J Clin Invest. 2018 May;48(5):e12913. doi: 10.1111/eci.12913. Epub 2018 Mar 13.
Axial spondyloarthritis (axSpA) is a common inflammatory arthritis of the sacroiliac joints and the spine. The best-known and most studied form of axSpA is ankylosing spondylitis.
In this review, we provide a brief overview of the pathophysiology of axSpA. In addition, we performed a quantitative text analysis of reviews on the pathogenesis of axSpA published in the last 10 years to establish the current consensus in various fields of research into the pathogenesis of axSpA.
There appears to be broad consensus on genetic risk factors and the involvement of the immune system in the initiation phase of the disease although little consensus was found on which specific immune cells drive disease. Moreover, despite relatively little data available, alterations in the microbiome are commonly thought to be involved in disease. Abnormal bone formation is the most prominent pathogenic factor thought to be involved in disease progression.
So, although the pathophysiology of axSpA remains incompletely understood, the progress in recent years in several fields of research in axSpA including genetics, diagnosis, imaging and therapeutics, hold great promise for the future.
中轴型脊柱关节炎（axSpA）是一种常见的累及骶髂关节和脊柱的炎性关节炎。在 axSpA 中，最广为人知和研究最多的形式是强直性脊柱炎。
在这篇综述中，我们简要概述了 axSpA 的发病机制。此外，我们对过去 10 年中发表的关于 axSpA 发病机制的综述进行了定量文本分析，以确立 axSpA 发病机制各个研究领域的当前共识。
尽管在哪些特定的免疫细胞驱动疾病方面尚未达成共识，但似乎在遗传风险因素和免疫系统参与疾病的起始阶段存在广泛共识。此外，尽管可用的数据相对较少，但微生物组的改变通常被认为与疾病有关。异常的骨形成被认为是参与疾病进展的最主要的致病因素。
因此，尽管 axSpA 的发病机制仍不完全清楚，但近年来在 axSpA 的几个研究领域（包括遗传学、诊断、影像学和治疗学）取得的进展，为未来带来了巨大的希望。
