[Reactive arthritis: from pathogenesis to novel strategies].
Reactive arthritis (ReA) was first described 100 years ago. It is defined as a sterile joint inflammation following a primary, extra-articular infection often in the form of urethritis or enteritis and less frequently respiratory infection and is characterized by the presence of bacterial antigens or non-culturable bacteria in the joint,. The prevalence is estimated to be 40/100,000 adults, while the incidence is 4-5/100,000. The classic HLA-B27-associated form with asymmetric involvement of the lower extremities and/or the spine is part of the spondyloarthritis concept. The phenomenon of persistence, which will be discussed in detail herein, plays an important role in the pathogenesis of ReA. Up to 30% of patients develop chronic symptoms posing a therapeutic challenge. Combination antibiotic treatment showing a response in up to 63% of patients has recently been proposed. Biologics could represent an alternative therapeutic option for patients showing a severe and highly active disease course.
Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Strasse 1, Hannover, Germany. Rihl.Markus@mh-hannover.de
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D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D001688:Biological Products / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000150:complications / Q000188:drug therapy; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005759:Gastroenteritis / Q000150:complications / Q000188:drug therapy; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D000091402:Prohibitins; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy; D025241:Spondylarthritis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014526:Urethritis / Q000150:complications / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D001688:Biological Products; D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins