Τίτλος:
Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Spondyloarthropathies (SpA) include many different forms of inflammatory arthritis and can affect the spine (axial SpA) and/or peripheral joints (peripheral SpA) with Ankylosing spondylitis (AS) being the prototype of the former. Extraarticular manifestations, like uveitis, psoriasis and inflammatory bowel disease (IBD) are frequently observed in the setting of SpA and are, in fact, part of the SpA classification criteria. Bowel involvement seems to be the most common of these manifestations. Clinically evident IBD is observed in 6%-14% of AS patients, which is significantly more frequent compared to the general population. Besides, it seems that silent microscopic gut inflammation, is evident in around 60% in AS patients. Interestingly, occurrence of IBD has been associated with AS disease activity. For peripheral SpA, two different forms have been proposed with diverse characteristics. Of note, SpA (axial or peripheral) is more commonly observed in Crohn's disease than in ulcerative colitis. The common pathogenetic mechanisms that explain the link between IBD and SpA are still ill-defined. The role of dysregulated microbiome along with migration of T lymphocytes and other cells from gut to the joint ("gut-joint" axis) has been recognized, in the context of a genetic background including associations with alleles inside or outside the human leukocyte antigen system. Various therapeutic modalities are available with monoclonal antibodies against tumour necrosis factor, interleukin-23 and interleukin-17, being the most effective. Both gastroenterologists and rheumatologists should be alert to identify the coexistence of these conditions and ideally follow-up these patients in combined clinics. © 2019 Baishideng Publishing Group Inc. All rights reserved.
Συγγραφείς:
Fragoulis, G.E.
Liava, C.
Daoussis, D.
Akriviadis, E.
Garyfallos, A.
Dimitroulas, T.
Περιοδικό:
World Journal of Gastroenterology
Εκδότης:
Baishideng Publishing Group Co
Λέξεις-κλειδιά:
adalimumab; calgranulin; etanercept; filgotinib; HLA antigen; infliximab; interleukin 17; interleukin 23; methotrexate; monoclonal antibody; nonsteroid antiinflammatory agent; risankizumab; salazosulfapyridine; secukinumab; steroid; tofacitinib; tumor necrosis factor; upadacitinib; ustekinumab; vedolizumab; immunosuppressive agent, allele; Article; cell migration; Crohn disease; disease association; follow up; genetic background; genetic predisposition; human; inflammatory bowel disease; intestine; joint; microbiome; nonhuman; pathogenesis; pathophysiology; prevalence; protein function; spondyloarthropathy; T lymphocyte; ulcerative colitis; complication; drug effect; immunology; inflammatory bowel disease; innate immunity; intestine flora; spondyloarthropathy, Gastrointestinal Microbiome; Humans; Immunity, Innate; Immunosuppressive Agents; Inflammatory Bowel Diseases; Spondylarthropathies; T-Lymphocytes
DOI:
10.3748/wjg.v25.i18.2162
