Tay Shi Huan, Yeo Joo Guan, Leong Jing Yao, Albani Salvatore, Arkachaisri Thaschawee
SingHealth Duke-National University of Singapore Academic Medical Centre, Translational Immunology Institute, Singapore, Singapore.
Duke-National University of Singapore Medical School, Singapore, Singapore.
Front Med (Lausanne). 2021 May 20;8:666772. doi: 10.3389/fmed.2021.666772. eCollection 2021.
Juvenile spondyloarthritis (JSpA) refers to a diverse spectrum of immune-mediated inflammatory arthritides whose onset occurs in late childhood and adolescence. Like its adult counterpart, JSpA is typified by a strong association with human leukocyte antigen-B27 (HLA-B27) and potential axial involvement, while lacking rheumatoid factor (RF) and distinguishing autoantibodies. A characteristic manifestation of JSpA is enthesitis (inflammation of insertion sites of tendons, ligaments, joint capsules or fascia to bone), which is commonly accompanied by bone resorption and new bone formation at affected sites. In this Review, advances in the role of HLA-B27, enthesitis and its associated osteoproliferation in JSpA pathophysiology and treatment options will be discussed. A deeper appreciation of how these elements contribute to the JSpA disease mechanism will better inform diagnosis, prognosis and therapy, which in turn translates to an improved quality of life for patients.
青少年脊柱关节炎（JSpA）是指一系列免疫介导的炎性关节炎，其发病于儿童晚期和青少年期。与成人脊柱关节炎一样，JSpA的典型特征是与人类白细胞抗原B27（HLA - B27）密切相关且有潜在的中轴受累，同时缺乏类风湿因子（RF）和特异性自身抗体。JSpA的一个特征性表现是附着点炎（肌腱、韧带、关节囊或筋膜与骨的附着部位的炎症），受累部位通常伴有骨吸收和新骨形成。在本综述中，将讨论HLA - B27、附着点炎及其相关的骨质增生在JSpA病理生理学和治疗选择中的作用进展。深入了解这些因素如何促成JSpA疾病机制将有助于更好地进行诊断、预后评估和治疗，进而改善患者的生活质量。
