By Stefan Siebert, Raj Sengupta, Alexander Tsoukas
Axial spondyloarthritis is the most typical inflammatory arthritis affecting the backbone. regularly first proposing to various basic and secondary care execs, the excessive international illness burden of this has created a necessity for elevated expertise of this situation throughout more than a few rheumatology specialties.
A pocketbook aimed toward the non-specialist reader Axial Spondyloarthritis is the basic consultant to this universal situation. targeting the sensible implications of advancements in category, prognosis and remedy, this simply obtainable textual content absolutely covers the wider spectrum of the disease.
Concise and completely illustrated, this addition to the Oxford Rheumatology Library covers the background and pathophysiology of axial spondylitis, along distinct sections on remedies, issues and manifestations of the . With each one part supported via a convenient key issues part, Axial Spondyloarthritis is an invaluable and optimistic source for any practitioner or trainee encountering this condition.
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Additional resources for Axial spondyloarthritis
Pathophysiology and immunology The development of culture- independent high- throughput microbial DNA sequencing has led to an exponential advance in the understanding of mucosal immunity, and the bidirectional interaction between microbes and their human hosts. It is now appreciated that the intestinal microbiome helps shape the human immune system, leading to homeostasis in health states or inflammation when dysfunction of the microbiome (dysbiosis) occurs. Dysbiosis has subsequently been implicated in the pathogenesis of a variety of inflammatory rheumatic conditions, with SpA conditions at the forefront due to the clinically evident links with mucosal inflammation.
Subsequently, several other genes whose products may influence IL-23 and Th17 development have been identified in association with AS, including TYK2, STAT3, IL12B, and IL6R. The gene IL12B encodes IL-12p40, the common subunit of IL-12 and IL-23, which is targeted by the monoclonal antibody ustekinumab used in clinic for the treatment of psoriasis, psoriatic arthritis, and IBD, and which is currently undergoing trials in AS. The convergence of these gene products in the IL-23/IL-17 axis strongly implicates this pathway in the pathogenesis of AS and SpA conditions.
Adapted from Rudwaleit et al. Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum. 2006;54(2):569–78 and Sieper et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009b;68(Suppl II):ii1–44 ASAS IBP according to experts criteria (2009) The subsequent Assessment of SpondyloArthritis international Society (ASAS) IBP criteria developed from a workshop of international experts convened to develop new classification criteria for spondyloarthritis (Sieper, 2009a).
Axial spondyloarthritis by Stefan Siebert, Raj Sengupta, Alexander Tsoukas