Enteropathic arthritis: how do the joints talk with the gut?
Enteropathic arthritis is a label for conditions in which gut pathology is believed to be of pathogenic importance for the developing joint disease. Impaired barrier function, as well as immunogenetic mechanism, are implicated. Recent publications have highlighted strong new support for the homing of lymphocytes from the gut mucosa to joint tissue, persistence of antigen- and cytokine-based immune deficiency. A convincing argument was made for the interesting observation that two distinct types of joint involvement with different class II HLA backgrounds occur in patients with inflammatory bowel disease. A new mechanism implicating dimeric HLA-B27 heavy chains in the pathogenesis of enteropathic arthritis is also presented. Despite evidence for persisting antigen presence, antimicrobial therapy seems ineffective in reactive arthritis.
Wollheim
F A
FA
Department of Rheumatology, Lund University Hospital, University of Lund, Lund, Sweden. Frank.Wollheim@reum.lu.se
D001168:Arthritis / Q000276:immunology* / Q000503:physiopathology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000276:immunology* / Q000503:physiopathology*