Gut inflammation in the spondyloarthropathies.
In this paper, the ample experimental, clinical, genetic, histopathologic, and immunologic evidence for an important role of the gut in the pathogenesis of spondylarthropathy (SpA) and for an overlap between SpA and Crohn's disease is reviewed. These data suggest that SpA and Crohn's disease should be scientifically and clinically considered as distinct phenotypes of common immune-mediated inflammatory disease pathways rather than as separate disease entities. Classification, diagnosis, and therapy based on pathophysiologic insights is likely to become superior to an approach based exclusively on signs and symptoms, as evidenced by the recent evolution in treatment of SpA by tumor necrosis factor-a blockade.
Mielants
Herman
H
Department of Rheumatology, 0K12IB, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. herman.mielants@ugent.be
De Keyser
Filip
F
Baeten
Dominique
D
Van den Bosch
Filip
F
D000818:Animals; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D007413:Intestinal Mucosa / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D025242:Spondylarthropathies / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism
D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha