Syndesmophyte Growth in Ankylosing Spondylitis: from Laboratory to Bedside.
Michael M WardSovira TanPublished in: Current rheumatology reports (2023)
New genetic studies, including a genome-wide association study, provided only limited evidence of specific genetic associations with radiographic severity. Measures of inflammation, including vertebral osteitis and C-reactive protein level, were strongly associated with radiographic progression, while studies of adipokines had mixed results. Mesenchymal stem cells from HLA-B27 positive AS patients were found to promote vertebral ossification via a pathway of B27 misfolding, retinoic acid receptor-β activation, and increased bone alkaline phosphatase. Low vertebral trabecular bone density is associated with syndesmophyte growth, with reciprocal effects when bridged. Several observational studies suggested radiographic severity was reduced by treatment with tumor necrosis factor inhibitors, particularly when longer than 2 years. Syndesmophyte development in AS is the result of a complex, incompletely understood, interplay of inflammatory and mechanical factors.
Keyphrases
- bone mineral density
- ankylosing spondylitis
- postmenopausal women
- body composition
- genome wide association study
- end stage renal disease
- oxidative stress
- rheumatoid arthritis
- newly diagnosed
- ejection fraction
- stem cells
- genome wide
- peritoneal dialysis
- disease activity
- copy number
- prognostic factors
- dna methylation
- gene expression
- soft tissue
- systemic lupus erythematosus
- replacement therapy