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)

A 55-year-old man with ankylosing spondylitis was referred with left sided loin pain, loin mass, and painless macroscopic hematuria. Physical examination revealed a palpable loin mass, fixed flexion deformity of the lumbar and cervical spines, with severely restricted cervical movement and mouth opening. An ultrasound and computed tomography scan confirmed a 7-cm solid mass in the left kidney. Following a multidisciplinary meeting he elected to undergo radical laparoscopic nephrectomy. An anesthetic opinion was sought in view of the expected difficulties with intubation. Mouth opening was restricted to 3 fingers and he was Mallampati grade 3 on airway examination. As the degree of spinal flexion deformity and restricted spinal movement was significant, the patient was placed in a lateral decubitus position, and surgery was performed using a transperitoneal approach. A five-port technique was employed and was carried out successfully with no complication. Operative time was 240 minutes and estimated blood loss was 700 mL. His postoperative inpatient stay was 4.5 days. Surgical margins were clear and the patient was disease-free at 2-year follow-up. Laparoscopic nephrectomy in a patient with ankylosing spondylitis is technically challenging for both the surgeon and the anesthetist, however, with the right preoperative planning, potential morbidity can be limited to ensure a good outcome for the patient.
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PMID:Laparoscopic nephrectomy in a patient with ankylosing spondylitis: surgical and anesthetic challenges. 1748 53

A single amino acid exchange between the major histocompatibility complex molecules HLA-B(*)2705 and HLA-B(*)2709 (Asp-116/His) is responsible for the emergence of distinct HLA-B27-restricted T cell repertoires in individuals harboring either of these two subtypes and could correlate with their differential association with the autoimmune disease ankylosing spondylitis. By using fluorescence depolarization and pK(a) calculations, we investigated to what extent electrostatic interactions contribute to shape antigenic differences between these HLA molecules complexed with viral, self, and non-natural peptide ligands. In addition to the established main anchor of peptides binding to HLA-B27, arginine at position 2 (pArg-2), and the secondary anchors at the peptide termini, at least two further determinants contribute to stable peptide accommodation. 1) The interaction of Asp-116 with arginine at peptide position 5, as found in pLMP2 (RRRWRRLTV; viral) and pVIPR (RRKWRRWHL; self), and with lysine in pOmega, as found in gag (KRWIILGLNK; viral), additionally stabilizes the B(*)2705 complexes by approximately 5 and approximately 27 kJ/mol, respectively, in comparison with B(*)2709. 2) The protonation state of the key residues Glu-45 and Glu-63 in the B-pocket, which accommodates pArg-2, affects peptide binding strength in a peptide- and subtype-dependent manner. In B(*)2705/pLMP2, protonation of Glu-45/Glu-63 reduces the interaction energy of pArg-2 by approximately 24 kJ/mol as compared with B(*)2705/pVIPR. B(*)2705/pVIPR is stabilized by a deprotonated Glu-45/Glu-63 pair, evoked by allosteric interactions with pHis-8. The mutual electrostatic interactions of peptide and HLA molecule, including peptide- and subtype-dependent protonation of key residues, modulate complex stability and antigenic features of the respective HLA-B27 subtype.
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PMID:Molecular determinants of major histocompatibility complex class I complex stability: shaping antigenic features through short and long range electrostatic interactions. 1850 34

The authors report an unusual case of myelodysplastic syndrome (MDS) associated with ankylosing spondylitis (AS). A 40-year-old-man with MDS presented with chronic low back pain for 6 years. Four years ago, MDS was diagnosed during routine blood analysis for the work-up of his articular complaints. His initial articular complaints were attributed to extramedullary manifestations of MDS. Persistent low back pain with increasing intensity finally led the patient to seek medical attention. Radiograph of the pelvis showed bilateral asymmetric sacroiliitis. A diagnosis of AS was established on the basis of modified New York criteria. Although various autoimmune phenomena associated with MDS have been described, this is the first report of AS in the setting of MDS. Causal relationship between these two disorders is currently unknown. Increased risk of hematological diseases as well as AS in individuals with a positive HLA-B27 provides a feasible explanation for this rare observation.
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PMID:Ankylosing spondylitis in a patient with myelodysplastic syndrome: an association with HLA-B27 or coincidence? 1884 70

The objective is to report a case of atypical acute infectious mononucleosis in a juvenile ankylosing spondylitis patient who was treated with infliximab. A 20-year-old man was hospitalized for the evaluation of lymphadenopathy and systemic symptoms. His symptoms developed at the eighth week of the infliximab treatment and he required hospitalization. Lymph node biopsy was performed and he was diagnosed as atypical infectious mononucleosis (absence of fever, pharyngitis, lymphocytosis and negative atypical lymphocytosis on blood smear). Infections have become major concerns in patients treated with TNF-blocking agents. In theoretical base, it is not surprising as TNF-alpha has a crucial role in the body's defense against both bacterial and viral invasion. Blocking the action of TNF may also change the course of the disease and could lead to a delay in the diagnosis. TNF-alpha-blocking treatment may mask the typical symptoms of infectious mononucleosis and atypical cases should be included in the differential diagnosis of lymphadenopathy in patients receiving anti-TNF-alpha agents.
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PMID:Atypical infectious mononucleosis in a patient receiving tumor necrosis factor alpha inhibitory treatment. 1903 55

HLA-B27 confers susceptibility to ankylosing spondylitis but AS disease mechanisms remain unknown. We determined here the effect of polymorphism and tapasin dependence on the expression, intracellular maturation and homodimer formation among HLA-B27 subtypes. We found that B*2709 with a histidine at position 116 was strongly associated with the transporter associated with antigen processing complex, correlated with lower, non-conformational expression on the cell surface, delayed maturation rate and minimal conformational and non-conformational homodimer formation. In contrast, B*2705 showed a low dependence for transporter associated with antigen processing, faster intracellular maturation and increased levels of homodimeric forms. The absence of tapasin significantly influenced the rate of intracellular maturation of B*2709, showing faster transport out of the endoplasmic reticulum, but similar to that of B*2705. All B27 subtypes examined were unable to express conformational homodimeric forms in the absence of tapasin. This study suggests that HLA-B27 polymorphism drives the tapasin dependency, rates of intracellular maturation and expressions of homodimers.
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PMID:HLA-B27 polymorphism at position 116 critically influences the association with TAP/tapasin, intracellular trafficking and conformational homodimers formation. 1916 61

Alongside several important Russian scientists of the 18th century (G.I. Sokolski, S.P. Botkin), W.T. Talalajew - with his work on cardiac rheumatoid nodules - and W.M. Bechterew, the namesake of ankylosing spondylitis, made significant contributions to international rheumatology. While the Dutchman Jan van Breemen (1874-1961) was busy founding international rheumatology, Russian rheumatology played an at least equally important role in Europe, attracting much attention with the brilliant organisation of the 4th Congress of the International League Against Rheumatism (ILAR) in Moscow in 1934. The later institutionalised and perfectly organised rheumatological care in the giant empire is inextricably linked with the name of Anatoli Innokentjewitsch Nesterow. He founded a large institute in Moscow and, together with his many students, laid the foundations for a network of rheumatological dispensaries in Russia and the former Soviet Republic. Moreover, as the leading centre for the Working Group of Rheumatologists in socialist countries, he and his colleagues also gave specialist work in the GDR the impetus it needed. His life and work, as well as that of his congenial successor, W. A. Nassonova, are described, partially on the basis of personal encounters.
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PMID:[A.I. Nesterow (1895-1979) and Russian rheumatology]. 1935 57

We report a case of diffuse systemic sclerosis (skin, joints, esophagus, and Raynaud's phenomenon) in a 41-year-old Caucasian male with a 15-year history of ankylosing spondylitis and an episode of severe myocarditis of unknown origin. His HLA type included both the B27 allele conferring susceptibility to ankylosing spondylitis and the B35, DRB1 11, and DQB1 03 described as associated with systemic sclerosis. This case-report confirms that two inflammatory joint diseases may co-exist, particularly in patients carrying one or two susceptibility alleles to both diseases.
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PMID:Ankylosing spondylitis and systemic sclerosis: a rare combination. 1937 61

A 25-year-old man with a 3-year history of ankylosing spondylitis presented with a sudden onset of pain in his left thigh. His ankylosing spondylitis had been treated for 2 years with the tumour necrosis factor-alpha (TNF-alpha) antagonist infliximab. The initial diagnosis was a muscular tear, and non-steroidal anti-inflammatory drugs were prescribed. 40 days later, the patient had tender swelling with warmth and light redness on his left thigh. His knee function had decreased markedly. His C-reactive protein level was 320 mg/l and white cell count was 30.4 x10(9)/l, indicating severe infection. Magnetic resonance imaging revealed a loculated fluid collection in the quadriceps musculature measuring 30 cm. Hyperintensity seen on T1-weighted images was suggestive of infection. The infliximab therapy was stopped and repeated debridement and drainage performed, with about 2.5 litres of pus evacuated. Flucloxacillin was administered for 2 weeks. The wound was closed 9 days later. The patient was discharged 20 days after surgery. An alternative immunosuppressive therapy--abatacept--was introduced. At the 18-month follow-up, the patient reported only light discomfort in the thigh during exercise, with a mildly impaired range of knee movement. No infectious complications recurred.
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PMID:A life-threatening abscess in a patient treated with a tumour necrosis factor-alpha antagonist: a case report. 1972 Nov 59

A 45 year old trader presented with history of persistent productive cough, progressively increasing dyspnoea, malaise and fever of 6 months prior to presentations. He also complained of severe lower backache and stiffness that radiated to both legs of 5 years duration. Chest radiograph revealed left apical fibrosis, coarse, linear shadows with cavities. There was also super infection with aspergilloma in the left apical region. The sputum AAFB was negative. Despite the fact that the patient complained of lower backache and stiffness, the plain radiograph of the affected spine was not requested for by the attending physician. Rather, the patient was commenced on antituberculous therapy based on pulmonary changes on chest radiograph. But after completing the treatment (nine months regimen), there were no improvement in patient's clinical conditions and pulmonary changes on repeated chest radiograph. The plain radiographs of the lumbosacral spine, pelvis and both hips were suggested by the author (Radiologist) who reviewed the patient's chest radiographs. The radiographs of the lumbosacral spine, as well as pelvis and both hips showed features of ankylosing spondylitis with pulmonary complication. His treatment was later reviewed based on the above new findings. This report highlights the fact that pulmonary manifestation in ankylosing spondylitis, a rare entity in our environment can present the same pattern as pulmonary tuberculosis which is far more common in this environment. A high index of suspicion will enhance early proper diagnosis.
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PMID:Pulmonary manifestations of ankylosing spondylitis treated as pulmonary tuberculosis: a case report and review of literature. 2003 24

A patient with downbeat nystagmus subsequent to ankylosing spondylitis was studied. His nystagmus was found to exhibit both increasing- and decreasing-velocity exponential slow phases as well as the linear form more often reported. Alternation between waveforms sometimes occurred on a beat-to-beat or even intrabeat basis. Possible explanations for all three waveforms are presented in terms of short-term gain changes in cerebellar compensation for leaky brainstem neural integrators. A computer model was developed and its results are discussed.
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PMID:Variable waveforms in downbeat nystagmus imply short-term gain changes. 2250 87


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