Enteropathic arthritis

Holden, Wendy; Orchard, Tim; Wordsworth, P

doi:10.1016/s0889-857x(03)00043-7

Cited by 87 publications

(38 citation statements)

References 90 publications

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“…Whereas the clinical features of AS with IBD are largely indistinguishable from those of AS without IBD, the prevalence of B27 in patients with AS and IBD is only 50-70%, compared with Ͼ90% in those with AS alone. Moreover, the prevalence of B27 is Յ15% in patients with IBD and peripheral arthritis or with IBD alone, compared with ϳ7% in healthy control populations (6). The NOD2/CARD15 alleles that are associated with Crohn's disease show no significant association with AS, although they may be associated with radiographic sacroiliitis in patients with Crohn's disease (7) and with the intestinal inflammation found in patients with spondylarthritis (8).…”

mentioning

confidence: 99%

Additional human β₂‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Tran¹,

Dorris²,

Satumtira³

et al. 2006

Arthritis & Rheumatism

158

150

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Objective. Ankylosing spondylitis and related spondylarthritides are associated with HLA-B27, and also with intestinal inflammation, by unknown mechanisms. The folded HLA-B27 molecule is a trimer of heavy chain, ␤ 2 -microglobulin (␤ 2 m), and short peptide. However, B27 heavy chain has an unusual propensity to misfold and trigger the unfolded protein response (UPR). This study was initiated to test the hypothesis that B27 misfolding plays a role in the pathogenesis of spondylarthritis.Methods. Rats with high transgene copy numbers of HLA-B27 heavy chain together with human ␤ 2 m (Hu␤ 2 m) spontaneously develop colitis, peripheral arthritis, and occasional spondylitis, and those with lower transgene copy numbers remain healthy. We crossed disease-prone and healthy HLA-B27/Hu␤ 2 mtransgenic rat lines with a healthy line, 283-2, carrying only the Hu␤ 2 m transgene. HLA-B27 assembly was assessed by pulse-chase analysis of B27 molecules, and UPR triggering was assessed by measuring BiP/Grp78 messenger RNA (mRNA) in splenic concanavalin A blasts. Surface expression of B27 and Hu␤ 2 m was determined by flow cytometry. Disease manifestations were identified by clinical observation, histology, and measurement of cytokine mRNA.Results. The extra Hu␤ 2 m from the 283-2 line significantly reduced B27 misfolding and UPR triggering. Unexpectedly, however, F 1 male offspring of the healthy 21-3 line crossed with the 283-2 line showed a high prevalence, severity, and duration of arthritis and spondylitis, in the absence of colitis. The arthropathy showed many features characteristic of human spondylarthritis.Conclusion. These results suggest that B27 misfolding is associated with intestinal inflammation, but that neither B27 misfolding nor intestinal inflammation is critical to the development of B27-associated arthropathy.The spondylarthritides are a group of inflammatory rheumatic diseases characterized by axial and peripheral arthropathy and a variety of extraarticular lesions (1). In the prototype of these disorders, ankylosing spondylitis (AS), there is inflammation in the spinal and sacroiliac joints and in ligamentous attachments that, in severe cases, leads to bony fusion. The pathogenesis of spondylarthritis is poorly understood. Two factors strongly associated with these conditions are intestinal inflammation and the major histocompatibility complex (MHC) class I gene HLA-B27.With regard to the association with intestinal inflammation, the prevalence of inflammatory bowel disease (IBD) (both Crohn's disease and ulcerative colitis) is increased in individuals with AS. An even higher prevalence of IBD is found in individuals with other forms of spondylarthritis (2), and endoscopic studies with biopsy have shown a prevalence of microscopic inflammatory bowel lesions in 60-70% of patients

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confidence: 99%

Additional human β₂‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Tran¹,

Dorris²,

Satumtira³

et al. 2006

Arthritis & Rheumatism

158

150

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“…O primeiro seria uma forma de artrite periférica chamada artrite enteropática. O segundo padrão, denominado axial, seria a sacroiliíte com ou sem espondilite (24,(42)(43)(44) . Além disso, podem ocorrer manifestações periarticulares como entesite, tendinite e periostite.…”

Section: Introductionunclassified

“…Enquanto o envolvimento axial pode preceder o início da doença intestinal em anos, isso é raro na forma de artrite periférica. O curso da espondilopatia não está relacionado à atividade da doença intestinal, enquanto episódios de artrite periférica refletem períodos de atividade inflamatória da doença intestinal (4,44) .…”

Section: Introductionunclassified

“…A espondilite idiopática é mais comum em homens (2-4:1). Naquela associada à DC e à RCU, entretanto, a relação entre os sexos é 1:1 (44) . Radiograficamente, a EA associada à DC e à RCU não pode ser diferenciada dos achados da forma idiopática da doença.…”

Section: Introductionunclassified

“…Radiograficamente, a EA associada à DC e à RCU não pode ser diferenciada dos achados da forma idiopática da doença. Além disso, a EA da DC e da RCU tem associação com o HLA B27, o que não ocorre com a artrite periférica (4,29,44) . Raramente a EA ocorre na ausência de artrite ou sacroiliíte.…”

Section: Introductionunclassified

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Manifestações articulares em pacientes com doença de Crohn e retocolite ulcerativa

Lanna¹,

Ferrari²,

Carvalho³

et al. 2006

Rev. Bras. Reumatol.

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RESUMOOs sintomas articulares constituem a manifestação extra-intestinal mais comum em pacientes com doença de Crohn e com retocolite ulcerativa. Reconhecida como artrite colítica, e mais recentemente, artrite enteropática, está classificada como uma das doenças do grupo das espondiloartropatias. Reconhecidamente, há dois padrões de acometimento articular: 1) periférico, habitualmente, associado aos períodos de atividade da doença intestinal e sem associação com o antígeno HLA B27, e 2) axial, caracterizado por espondilite e sacroiliíte, com curso clínico e radiográfico independente da doença intestinal e associado ao HLA B27. Palavras ABSTRACTJoint involvement is the most commom extraintestinal manifestation in patients with Crohn's disease and ulcerative colitis. The colitic arthritis, lately called enteropathic arthritis, is classified as one of the diseases of the spondyloarthropathies group. There are two patterns of joint involvement: 1) peripheral arthritis, usually coincides with exacerbations of the inflammatory bowel disease and is not associated with the HLA B27 antigen; and 2) axial involvement, characterized by spondylitis and sacroiliitis, which the clinical course is independent of the intestinal disease, and has an association with HLA B27.Keywords: ar thritis, inflammator y bowel disease, spondyloarthropathy, Crohn's disease, ulcerative colitis. INTRODUÇÃONa sua conceituação mais ampla, a doença inflamatória intestinal (DII) corresponde a qualquer processo inflamatório envolvendo o trato gastrintestinal, seja ele agudo ou crônico. A doença de Crohn (DC) e a retocolite ulcerativa (RCU) representam as duas principais formas de apresentação da DII, de causa desconhecida (1) . A despeito de constituírem doenças distintas, compartilham aspectos clínicos e epidemiológicos, sugerindo a possibilidade de fatores etiológicos comuns. O curso clínico, cujas manifestações principais são diarréia, dor abdominal e sangramento retal, caracteriza-se por períodos de remissão e exacerbação, e apresenta complicações as mais diversas. Associam-se, com certa freqüência, manifestações extra-intestinais tais como articulares, cutâneas, oculares, hepatobiliares e vasculares, que podem preceder, acompanhar ou suceder a doença intestinal. A etiopatogenia da DII é multifatorial, com a participação de fatores genéticos, intraluminais, alterações na barreira do epitélio intestinal e resposta imunológica anormal da mucosa. Estes fenômenos determinam a ativação da cascata imunoinflamatória, que resulta em lesão continuada da mucosa do intestino (2,3) . Os sintomas articulares constituem a manifestação extra-intestinal mais comum em pacientes com RCU e DC. Apesar do conhecimento da existência de uma poliartrite em associação às duas enfermidades por décadas, até 1959, acreditava-se que isto refletia a co-existência delas com a artrite reumatóide(AR) (4) . Nesta época, o quadro ficou mais bem definido, quando Wright e Watkinson (5) , estudando 108 pacientes com RCU, identificaram em 15,7% deles um tipo de artrite com caracterí...

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Musculoskeletal Disorders

and¹,

Thelin²

2016

Agricultural Medicine

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Enteropathic arthritis

Cited by 87 publications

References 90 publications

Additional human β₂‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Additional human β₂‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Manifestações articulares em pacientes com doença de Crohn e retocolite ulcerativa

Musculoskeletal Disorders

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Enteropathic arthritis

Cited by 87 publications

References 90 publications

Additional human β2‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Additional human β2‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Manifestações articulares em pacientes com doença de Crohn e retocolite ulcerativa

Musculoskeletal Disorders

Contact Info

Product

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About

Additional human β₂‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats

Additional human β₂‐microglobulin curbs HLA–B27 misfolding and promotes arthritis and spondylitis without colitis in male HLA–B27–transgenic rats