Schatteman L, Mielants H, Veys E M, Cuvelier C, De Vos M, Gyselbrecht L, Elewaut D, Goemaere S
Department of Rheumatology, University Hospital, Ghent, Belgium.
J Rheumatol. 1995 Apr;22(4):680-3.
Some forms of psoriatic arthritis (PsA) are classified as spondylarthropathy, and subclinical gut inflammation is found in spondylarthropathies. Our study was designed to determine if inflammatory gut lesions were also present in PsA, and if the prevalence of subclinical gut involvement was different in the subgroups of this disease. The relationship with HLA subtypes was also determined.
Ileocolonoscopy was performed on 64 patients with PsA (37 men, 27 women).
Inflammatory gut lesions were found in 10 of the 64 patients (16%): in 3 of the 15 patients (20%) with oligoarthritis and in 7 of the 23 patients (30%) with axial involvement. None of the 26 patients with polyarthritis showed these lesions. The prevalence of HLA-B27, Bw62, and B17 was significantly raised in our total group of patients with PsA. HLA-B27 and Bw62 were significantly more prevalent in patients with gut inflammation, 60 and 50%, respectively.
Gut inflammation is only present in PsA subgroups that belong to the spondylarthropathy concept. This suggests that the gut plays a role in the pathogenesis of locomotor inflammation in these subgroups. The prevalence of gut inflammation in psoriatic spondylarthropathy is significantly lower than in nonpsoriatic spondylarthropathies. Consequently, not only the gut but also the skin may be a portal of entry for causative antigens in PsA.
某些类型的银屑病关节炎（PsA）被归类为脊柱关节病，且在脊柱关节病中发现了亚临床肠道炎症。我们的研究旨在确定PsA中是否也存在炎症性肠道病变，以及该疾病各亚组中亚临床肠道受累的患病率是否不同。还确定了其与HLA亚型的关系。
对64例PsA患者（37例男性，27例女性）进行了回结肠镜检查。
64例患者中有10例（16%）发现炎症性肠道病变：15例寡关节炎患者中有3例（20%），23例轴向受累患者中有7例（30%）。26例多关节炎患者均未出现这些病变。在我们的PsA患者总组中，HLA - B27、Bw62和B17的患病率显著升高。HLA - B27和Bw62在肠道炎症患者中更为普遍，分别为60%和50%。
肠道炎症仅存在于属于脊柱关节病概念的PsA亚组中。这表明肠道在这些亚组中运动性炎症的发病机制中起作用。银屑病性脊柱关节病中肠道炎症的患病率显著低于非银屑病性脊柱关节病。因此，在PsA中，不仅肠道，皮肤也可能是致病抗原的进入门户。
