Fisher Corinne, Ciurtin Coziana, Leandro Maria, Sen Debajit, Wedderburn Lucy R
Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.
Department of Adolescent Rheumatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Front Med (Lausanne). 2021 May 31;8:681621. doi: 10.3389/fmed.2021.681621. eCollection 2021.
Spondyloarthritis (SpA) encompasses a broad spectrum of conditions occurring from childhood to middle age. Key features of SpA include axial and peripheral arthritis, enthesitis, extra-articular manifestations, and a strong association with HLA-B27. These features are common across the ages but there are important differences between juvenile and adult onset disease. Juvenile SpA predominantly affects the peripheral joints and the incidence of axial arthritis increases with age. Enthesitis is important in early disease. This review article highlights the similarities and differences between juvenile and adult SpA including classification, pathogenesis, clinical features, imaging, therapeutic strategies, and disease outcomes. In addition, the impact of the biological transition from childhood to adulthood is explored including the importance of musculoskeletal and immunological maturation. We discuss how the changes associated with adolescence may be important in explaining age-related differences in the clinical phenotype between juvenile and adult SpA and their implications for the treatment of juvenile SpA.
脊柱关节炎（SpA）涵盖了从儿童期到中年期出现的一系列广泛病症。SpA的关键特征包括中轴和外周关节炎、附着点炎、关节外表现，以及与HLA - B27的强关联。这些特征在各年龄段都很常见，但青少年发病型和成人发病型疾病之间存在重要差异。青少年SpA主要影响外周关节，中轴关节炎的发病率随年龄增长而增加。附着点炎在疾病早期很重要。这篇综述文章强调了青少年和成人SpA之间的异同，包括分类、发病机制、临床特征、影像学、治疗策略和疾病转归。此外，还探讨了从儿童期到成年期的生物学转变的影响，包括肌肉骨骼和免疫成熟的重要性。我们讨论了与青春期相关的变化如何在解释青少年和成人SpA临床表型的年龄相关差异及其对青少年SpA治疗的影响方面可能具有重要意义。
