Reumatizam, Vol. 62 No. 1, 2015.
Review article
PATHOGENESIS OF UNDIFFERENTIATED SPONDYLOARTHRITIS
Lovro Lamot
Mandica Vidović
Marija Perica
Lana Tambić Bukovac
Miroslav Harjaček
Abstract
Spondyloarthritis or spondyloarthropathy (SpA) is a multifactorial
disease in which a disturbed interplay occurs
between the immune system and environmental factors
on a predisposing genetic background, which leads to infl
ammation and structural damage of target tissue. Many
recent researches on development of SpA showed important
role of innate and adaptive immunity as well as of
prominent bone tissue remodeling which leads to osteoproliferation
and ankylosis. It is believed that possible sites
of infl ammation in SpA are entheses, sinovium and gut.
Current knowledge on infl ammation and tissue destruction
leads to conclusion that SpA is disease characterized
by disorders on diff erent levels. Disorder on the fi rst level is disturbed pathogen recognition and immune response
activation, on second level disturbed infl ammatory cells
migration and on third level disturbed immune response
regulation. As follows, disease progress depends on range
of disturbances: disease course can be short, as in reactive
arthritis, or long-lasting with substantial structural damage,
as in ankylosing spondylitis. Unfortunately, there are
still no confi dent markers of disease progression, so at the
mere beginning disease is oft en described as undiff erentiated.
Keywords
spondyloarthritis; enthesitis; synovitis; innate immunity; specifi c immunity; immune response
Hrčak ID:
182712
URI
Publication date:
9.3.2015.
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