Unit Molecular Immunology and Inflammation, Inflammation Research Institute VIB-Ghent University.
Department of Rheumatology, Universitair Ziekenhuis Gent, University of Gent, Ghent, Belgium.
Curr Opin Rheumatol. 2019 Jan;31(1):62-69. doi: 10.1097/BOR.0000000000000569.
This article aims to review recent literature linking epithelial barrier inflammation and arthritis in spondyloarthritis (SpA), with a critical view on how they are bound by genetic, immunological and environmental ties.
The epithelia-joint axis has become an intense area of both basic and clinical SpA research. The penultimate goal is to understand the immunopathologic links between epithelial inflammation and arthritis in SpA. Inflammatory bowel disease (IBD) and psoriasis (PsO) have strong links to SpA at several levels. Clinically, there is a strong association of IBD, PsO and SpA. Genetically, there are many shared risk factors; however, there are also distinct differences in the genetics of the respective diseases. Immunologically, type 3 immunity, especially interleukin (IL)-17 and IL-23 dysregulation, has been shown to play a central role in IBD, PsO and SpA. Environmentally, a microbial dysbiosis has been noted in each of these diseases, but whether the microbial signature is similar between diseases is not clear, nor is the effect of dysbiosis on the immune response known.
It will be crucial to determine whether the relationship between epithelia inflammation and SpA is truly causal for both the understanding of pathogenesis and for future treatment strategies.
本文旨在回顾近期有关连接脊柱关节炎（SpA）中上皮屏障炎症与关节炎的文献，重点关注它们在遗传、免疫和环境联系下是如何联系在一起的。
上皮-关节轴已成为 SpA 基础和临床研究的热点领域。最终目标是了解 SpA 中上皮炎症与关节炎之间的免疫病理联系。炎症性肠病（IBD）和银屑病（PsO）在多个层面与 SpA 有很强的关联。临床上，IBD、PsO 和 SpA 之间存在很强的关联。在遗传学上，存在许多共同的风险因素；然而，各自疾病的遗传也存在明显差异。在免疫学上，已证实 3 型免疫，特别是白细胞介素（IL）-17 和 IL-23 的失调，在 IBD、PsO 和 SpA 中发挥着核心作用。在环境方面，这些疾病中都存在微生物失调，但尚不清楚这些疾病之间的微生物特征是否相似，也不知道微生物失调对免疫反应的影响。
确定上皮炎症与 SpA 之间的关系是否对发病机制的理解和未来的治疗策略都具有真正的因果关系至关重要。
