Wei Yuxiao, Zhang Shuqiong, Shao Fenli, Sun Yang
State Key Laboratory of Pharmaceutical Biotechnology, Chemistry and Biomedicine Innovation Center (ChemBIC), School of Life Sciences, Nanjing University, 163 Xianlin Avenue, Nanjing 210023, Jiangsu, China.
State Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture, Nanjing University of Chinese Medicine, Nanjing 210023, China.
Int Immunopharmacol. 2025 Jan 3;145:113709. doi: 10.1016/j.intimp.2024.113709. Epub 2024 Dec 6.
Ankylosing spondylitis (AS) is an autoimmune rheumatic disease that primarily affects the axial joints, with its etiology complex and still not fully understood. The unknown pathogenesis of AS limits the development of treatment strategies, so keeping up-to-date with the current research on AS can help in searching for potential therapeutic targets. In addition to the classic HLA-B27 genetic susceptibility and Th17-related inflammatory signals, increasing research is focusing on the influence of autoantigen-centered autoimmune responses and bone stromal cells on the onset of AS. Autoantigens derived from gut microbiota and preferential TCR both exacerbate the autoimmune response in patients with AS. Furthermore, dysregulated bone metabolism also promotes pathological new bone formation in AS. Current treatments approved for AS almost focus on the management of inflammation with inconsistent treatment results due to the heterogeneity of patients. In this review, we systematically summarized various pathogenesis and management of AS, meanwhile discussed the underlying risk factors and potential therapeutic targets.
强直性脊柱炎（AS）是一种主要影响中轴关节的自身免疫性风湿性疾病，其病因复杂，尚未完全明确。AS未知的发病机制限制了治疗策略的发展，因此了解AS的当前研究进展有助于寻找潜在的治疗靶点。除了经典的HLA - B27基因易感性和Th17相关炎症信号外，越来越多的研究聚焦于以自身抗原为中心的自身免疫反应和骨基质细胞对AS发病的影响。来自肠道微生物群的自身抗原和优先TCR均会加剧AS患者的自身免疫反应。此外，骨代谢失调也促进了AS中病理性新骨形成。目前批准用于AS的治疗几乎都集中在炎症管理上，但由于患者的异质性，治疗结果并不一致。在本综述中，我们系统总结了AS的各种发病机制和管理方法，同时讨论了潜在的危险因素和潜在治疗靶点。
