轴向型脊柱关节炎的骨形成：疾病缓解是否可能？
Bone formation in axial spondyloarthritis: Is disease modification possible?
机构信息
The Arthritis Program, Toronto Western Hospital, 399 Bathurst Street, Toronto, M5T 2S8, ON, Canada; Division of Genetics and Development, Krembil Research Institute, University Health Network, 60 Leonard Avenue, Toronto, ON, M5T 0S8, Canada; Division of Rheumatology, Department of Medicine, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada; Institute of Medical Science, University of Toronto, ON, Canada.
The Arthritis Program, Toronto Western Hospital, 399 Bathurst Street, Toronto, M5T 2S8, ON, Canada; Division of Genetics and Development, Krembil Research Institute, University Health Network, 60 Leonard Avenue, Toronto, ON, M5T 0S8, Canada.
出版信息
Best Pract Res Clin Rheumatol. 2019 Dec;33(6):101491. doi: 10.1016/j.berh.2020.101491. Epub 2020 Apr 15.
Axial spondyloarthritis (SpA) is a chronic disease characterised by new bone formation (NBF) in the axial skeleton as well as at peripheral entheseal sites. NBF is thought to arise in areas of previous inflammation or osteitis visualised on MRI, with mechanical stress playing a role in disease pathogenesis. The interface between bone and immune cells is complex with the RANKL-OPG system being key to NBF. The IL-17/23 axis and other cytokines such as TNFα and MIF are thought to play a central role. The transition from inflammation to NBF is mediated via the Wnt, BMP and Hedgehog signalling pathways. An altered microbiome has been reported in SpA, which is a potential trigger of NBF in SpA. There is now data to show that treatment with TNF inhibitors prevents NBF and hence modifies disease progression. More research into identifying newer targets for disease modification is needed to alter the course of the disease.
中轴型脊柱关节炎（SpA）是一种慢性疾病，其特征是轴向骨骼和外周附着点出现新骨形成（NBF）。据认为，NBF 出现在 MRI 上可见的先前炎症或骨炎区域，机械应力在疾病发病机制中起作用。骨与免疫细胞之间的界面很复杂，RANKL-OPG 系统是 NBF 的关键。IL-17/23 轴和其他细胞因子，如 TNFα 和 MIF，被认为起核心作用。从炎症到 NBF 的转变是通过 Wnt、BMP 和 Hedgehog 信号通路介导的。据报道，SpA 中存在微生物组改变，这可能是 SpA 中 NBF 的潜在触发因素。现在有数据表明，使用 TNF 抑制剂可预防 NBF，从而改变疾病进展。需要更多的研究来确定针对疾病修饰的新靶点，以改变疾病进程。
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