Joint together: The etiology and pathogenesis of ankylosing spondylitis

Abstract

Spondyloarthritis (SpA) refers to a group of diseases with inflammation in joints and spines. In this family, ankylosing spondylitis (AS) is a rare but classic form that mainly involves the spine and sacroiliac joint, leading to the loss of flexibility and fusion of the spine. Compared to other diseases in SpA, AS has a very distinct hereditary disposition and pattern of involvement, and several hypotheses about its etiopathogenesis have been proposed. In spite of significant advances made in Th17 dynamics and AS treatment, the underlying mechanism remains concealed. To this end, we covered several topics, including the nature of the immune response, the microenvironment in the articulation that is behind the disease’s progression, and the split between the hypotheses and the evidence on how the intestine affects arthritis. In this review, we describe the current findings of AS and SpA, with the aim of providing an integrated view of the initiation of inflammation and the development of the disease.

Differentially expressed protein‐coding genes in ankylosing spondylitis: Emerging insights into pathogenesis and therapeutic approaches

“…Although the etiology and pathogenesis of AS have not been fully clarified, some studies have identified that the symptomatic feature described as the “bamboo‐like spine” is a characteristic of the classical autoimmune disorder AS, which typically begins with an inflammation in the sacroiliac joint. This disorder is a member of the SpA family of maladies, which cause inflammation to flare up in the spine, limb joints, ligaments, and tendons 111 . Although the pathogenic mechanism of AS is, as yet, undetermined, multiple theories on the triggering process have been put forward.…”

“…Endoplasmic reticulum stress, which triggers the unfolded protein response and induces necrotic death and cytokine production, could be generated by an error‐prone folding process of certain HLA‐B27 alleles. Via the intrinsic HLA monitoring receptor, surface‐expressed HLA‐B27 molecules with an unusual shape could encourage the immune system to react in an improper way 111 …”

“…This disorder is a member of the SpA family of maladies, which cause inflammation to flare up in the spine, limb joints, ligaments, and tendons. 111 Although the pathogenic mechanism of AS is, as yet, undetermined, multiple theories on the triggering process have been put forward. It was reported that one of most essential risk genes, HLA-B27, which is associated with a high frequency of genetic variations in AS patients, is conformationally plastic.…”

“…Via the intrinsic HLA monitoring receptor, surface-expressed HLA-B27 molecules with an unusual shape could encourage the immune system to react in an improper way. 111 Rapid innovations in bioinformatics have helped the advancement of molecular biology research. Molecular biology pathways can be explored using bioinformatics, and certain unique biological indicators can be discovered and exploited as targets for disease detection and treatment.…”

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

“…The term spondyloarthritis covers a heterogeneous set of conditions that can involve a variety of tissue ( Sharip and Kunz, 2020 ) including joints and the spine, specifically the sacroiliac joints ( Brown et al, 2020 ; Xiong et al, 2022 ). These inflammatory immune-mediated conditions can affect spinal tissues especially support tissues such as ligaments and their entheses of the axial skeleton ( Alber et al, 2022 ; Li et al, 2022 ).…”