Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Data that are relevant to the general understanding of the juvenile-onset spondyloarthropathies are reviewed here. Seronegative enthesopathy and arthropathy syndrome is considered the earliest recognizable form of juvenile-onset spondyloarthropathy, from which other syndromes and diseases emerge. The group also includes juvenile-onset ankylosing spondylitis, a disease defined in adult-based terms when definite changes have occurred in the axial joints; ankylosing tarsitis, a complex disorder in which foot problems resemble those of the spine in ankylosing spondylitis; Crohn's disease and ulcerative colitis-related peripheral and, especially, HLA-B27 axial disease; reactive arthritis and Reiter's syndrome, which might be further classified according to its cause; and juvenile psoriatic arthritis, a disease that resembles juvenile rheumatoid arthritis more than does juvenile-onset spondyloarthropathy.
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PMID:Spondyloarthropathies and psoriatic arthritis in children. 839 12

The aim of the study was to compare the spondyloarthropathy of ankylosing spondylitis (AS) to that of psoriatic arthritis (PsA). Forty patients with AS and 66 patients with PsA underwent a complete assessment according to a standard protocol, including radiographic evaluation and HLA typing. A logistic regression analysis was performed controlling for age, arthritis duration, and sex. A higher frequency of inflammatory neck and back pain and stiffness (p < 0.0002), limitation of back movements (p < 0.0006), grade 4 sacroiliitis (p = 0.007), and syndesmophytes (p = 0.005) was noted in AS, while peripheral arthritis was more common and more severe in patients with PsA (p = 0.002). A lower frequency of HLA B17 (p = 0.02), and a higher frequency of HLA B27 (p = 0.0001), and Cw2 (p < 0.01) was found in AS compared to PsA. Thus, there are clinical, radiologic, and genetic differences in disease expression of the SA of AS and PsA, supporting their classification as distinct entities.
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PMID:Differences in the expression of spondyloarthropathy: a comparison between ankylosing spondylitis and psoriatic arthritis. 846 76

Three-hundred-and-thirteen back pain sufferers completed a screening questionnaire for inflammatory back pain. This was positive in 46 (15%), who were invited for a further examination. Only two of these patients had definite ankylosing spondylitis. Eighteen of them (39%) had other features associated with spondyloarthropathy. It is suggested that up to 5% of back pain sufferers may have a mild form of ankylosing spondylitis that may never progress to definite ankylosis, but for whom treatment as if they had ankylosing spondylitis may be of benefit.
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PMID:Inflammatory back pain in primary care. 854 11

Abdominal scintigraphy with technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO)-labelled leucocytes is an excellent tool for evaluating disease extent and activity of intestinal lesions in patients with inflammatory bowel disease (IBD). In some cases of seronegative spondylarthropathies (SSp), IBD may remain subclinical. The aim of this study was to evaluate the presence of positive abdominal scintigraphy in patients with SSp and without clinical symptoms or signs of IBD. To this end we studied 32 patients with active SSp (European Spondylarthropathy Study Group 1991 criteria) without clinical evidence of IBD (eight had ankylosing spondylitis, four psoriatic arthritis, three reactive arthritis an 17 undifferentiated SSp) and 11 controls without SSp. All SSp and control patients received similar doses of non-steroidal anti-inflammatory drugs (NSAIDs). Abdominal scintigraphic images were obtained at 30 and 120 min after re-injection of 99mTc-HMPAO-labelled leucocytes. The 99mTc-HMPAO-labelled leucocyte scan was positive in 17 patients with SSp (53.1%) (six with ankylosing spondylitis, three with psoriatic arthritis, two with reactive arthritis and six with undifferentiated SSp). Fourteen patients scored from 2 to 4 on the intensity of uptake scale. The colon and terminal ileum were predominantly involved. Axial involvement was more frequent in patients with a positive scan than in patients with negative results (P<0.05) (64.7% vs 26.6%; odds ratio: 5). No control patient showed a positive scan. It is concluded that 99mTc-HMPAO-labelled leucocyte scan shows increased uptake among patients with SSp without evidence of IBD. These findings provide new evidence linking SSp with intestinal inflammation and suggest that in some cases a bowel-related process could contribute to the development of SSp. Long-term follow-up studies with more patients are necessary to evaluate the diagnostic and therapeutic implications of these results.
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PMID:Abdominal scintigraphy using 99mTc-HMPAO-labelled leucocytes in patients with seronegative spondylarthropathies without clinical evidence of inflammatory bowel disease. 859 54

The cases of 2 women with pyoderma gangrenosum (PG) and undifferentiated seronegative spondylarthropathy (SpA) are described. These 2 cases, together with the recently reported case of PG and B27-positive psoriatic spondylarthropathy, suggest that PG may also occur in association with forms of seronegative SpA that are different from primary ankylosing spondylitis (AS) and AS associated with inflammatory bowel disease.
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PMID:Pyoderma gangrenosum in association with undifferentiated seronegative spondylarthropathy. 865 72

In the past decade the concept of spondyloarthropathy has become well established, and appropriate classification criteria have been developed. Now it is time to better define the terms in common use in order to facilitate scientific communication. Recently, new therapeutic approaches have been tested, but the design of some of these studies is weak. Clearly, the outcome of ankylosing spondylitis and spondyloarthritis is multidimensional. A number of new instruments for the assessment of ankylosing spondylitis are now available, but there is a need for core sets of outcome measures appropriate for the different settings in which assessment is done. Although criteria intended for use in epidemiologic studies might be useful in daily clinical practice to establish a diagnosis, improved recognition of the different elements of ankylosing spondylitis and spondyloarthritis requires more "problem orientation" and less "disease orientation."
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PMID:Clinical and epidemiologic aspects of ankylosing spondylitis and spondyloarthropathies. 886 77

The term spondyloarthropathy (SpA) describes and defines a group of related inflammatory joint disease that share characteristic clinical features and a unique association with the major histocompatibility complex class I molecule HLA-B27. Five subgroups can be differentiated: ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated SpA. The sacroiliac joints are centrally involved in the SpA, most clearly and pathognomonic in ankylosing spondylitis, in which most patients are affected early in the disease. Overcoming some of the diagnostic difficulties of early sacroiliitis, dynamic magnetic resonance imaging was shown to visualize both acute and chronic changes in the sacroiliac joints. The inflammation in the sacroiliac joints in patients with SpA was recently examined in more detail; using immunohistology and in situ hybridrization, T cells, macrophages, and various cytokines were found in infiltrates. Biopsy specimens were obtained under guided computed tomography, and in the same study, intra-articular corticosteroid treatment was successfully undertaken. Further investigation of such biopsy specimens showed the absence of DNA of reactive arthritis-associated bacteria. The pathogenesis of the SpA and the reason for the tropism for the sacroiliac joints is still obscure. The nature of the relation of the genetic background of SpA to initially triggering bacterial infections remains to be established. In chronic disease, autoimmune mechanisms might be more important.
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PMID:The sacroiliac joint in the spondyloarthropathies. 886 78

B*2704 and B*2706 are closely related HLA-B27 subtypes of which the former but not the latter is associated to ankylosing spondylitis. Their peptide specificity relative to other disease-associated subtypes was analyzed by testing binding of self-peptides naturally presented by B*2705 or B*2702, and synthetic analogs, to B*2704, B*2706, and site-specific mutants mimicking their changes. Peptides with basic, aliphatic or aromatic C-terminal residues bound to B*2705 with similar affinity. In B*2704 C-terminal aliphatic/ aromatic residues were preferred. B*2706 discriminated drastically between polar and nonpolar C-terminal residues, showing strong preference for Leu and Phe, and less than B*2704 for basic and Tyr residues. Loss of single acidic charges (D > S77, D > Y116) increased preference for C-terminal Leu and Phe, but allowed efficient binding of peptides with basic residues or Tyr. Their gain (V > E152, H > D114) maintained wide C-terminal specificity, but severely impaired binding, presumably by disrupting interactions with internal peptide residues. This was compensated by Y116 in the double D114Y116 mutant. The specificity of B*2704 and B*2706 was explained only partially by the separate effects of single mutations, indicating that novel properties arise from concomitant changes at various positions. For instance, specificity of B*2706 for nonpolar C-terminal residues required simultaneous removal of Asp77 and Asp116. B*2706 differed from B*2705, B*2702, and B*2704 in its lower suitability for C-terminal Tyr, suggesting that this feature might be relevant for HLA-B27 association to spondyloarthropathy.
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PMID:Binding of peptides naturally presented by HLA-B27 to the differentially disease-associated B*2704 and B*2706 subtypes, and to mutants mimicking their polymorphism. 898 33

B*2704 and B*2706 are two closely related HLA-B27 subtypes, which differ from the common B*2705 by the Asp > Ser77, Val > Glu152, and Ala > Gly211 amino acid changes. In addition, B*2706 differs from B*2704 by the His > Asp114 and Asp > Tyr116 changes. In spite of their similarity B*2704, but not B*2706, was associated to ankylosing spondylitis in a same population. We have carried out pool sequence analyses of the peptides naturally bound to each of these subtypes, and of several individual peptide ligands. B*2704 and B*2706 shared with B*2705, among other features, their selectivity for Arg2 and their allowance for some aliphatic and aromatic C-terminal residues in their bound peptides. The main features that distinguished both subtypes from B*2705 were: 1) their failure to present peptides with C-terminal basic residues, and 2) their allowance for both polar and nonpolar residues at peptide position 3. A major difference between B*2704 and B*2706 was that C-terminal Tyr was prominent among the peptides bound to B*2704, but was not detected among those from B*2706. The use of Tyr as a C-terminal anchor motif is the only functional feature shared by the disease-associated B*2705, B*2702, and B*2704 subtypes that is absent in B*2706. This suggests that the ability of HLA-B27 to present peptides with C-terminal Tyr might be critical for its association to spondyloarthropathy.
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PMID:Lack of carboxyl-terminal tyrosine distinguishes the B*2706-bound peptide repertoire from those of B*2704 and other HLA-B27 subtypes associated with ankylosing spondylitis. 909 27

Seronegative and HLA B27-associated spondyloarthropathy (SpA) is a heterogeneous disease, so far without a clear origin. The term comprises five clinically defined subcategories: ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), inflammatory bowel disease-associated arthritis and undifferentiated spondyloarthropathy (uSpA). Sacroiliitis, an inflammatory involvement of one or both sacroiliac joints, is the key symptom of all spondyloarthropathies. Sacroiliitis is often associated with inflammatory back pain, manifest as deep nocturnal back pain that is improved by exercise. The pathogenesis of SpA and the reason for the tropism for the sacroiliac joints is still obscure. A genetic background of an initially bacterial triggered infection seems to be most likely.
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PMID:[Sacroiliitis: the key symptom of spondylathropathies. 1. The clinical aspects]. 911 65


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