Korean J Med.  2013 Sep;85(3):229-239. 10.3904/kjm.2013.85.3.229.

The Concept and Overview of Spondyloarthritis

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea. baekhj@gilhospital.com

Abstract

The spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases in association with HLA-B27. They share the clinical features including sacroiliitis, spondylitis, oligoarthritis, enthesitis and extra-articular involvement. Recently ASAS proposed new classification criteria sets of axial and peripheral SpA. They were designed to include non-radiographic SpA, thus can guide the early diagnosis of disease before the structural damage occurs. SpA has a strong genetic predisposition. Non-MHC genes, such as IL23R and ERAP1, as well as HLA-B27 were confirmed as susceptibility genes through several GWAS. Major pathology in SpA is entheseal inflammation and new bone formation. Intrinsic ability of HLA-B27 to trigger innate immune response and several proinflammtory cytokines may contribute to the inflammation in SpA. New bone formation could be explained by a mechanism, partly or completely independent of the inflammatory process.

Keyword

Spondyloarthritis; Ankylosing spondylitis; Inflammatory back pain; HLA-B27

MeSH Terms

Cytokines
Early Diagnosis
Genetic Predisposition to Disease
HLA-B27 Antigen
Immunity, Innate
Inflammation
Osteogenesis
Rheumatic Diseases
Sacroiliitis
Spondylitis
Spondylitis, Ankylosing
Cytokines
HLA-B27 Antigen
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