Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBRTNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10−8 in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10−6 overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27–positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides.
This paper describes the structure and function of the normal synovium including the cellular content, nerve and vascular supply and how normal synovium maintains homeostasis within the joint. It is important to understand normal synovium before appreciating the changes that occur in the synovial membrane which leads to the pathology seen in inflammatory arthritides such as Rheumatoid Arthritis.
Objective. Macrophage migration inhibitory factor (MIF) isConclusion. These data represent the first demonstration of the cytokine MIF in human autoimmune disease and suggest MIF as a potential therapeutic target in RA.Macrophage migration inhibitory factor (MIF) is increasingly recognized as an important regulator of immune and inflammatory responses. It is released by activated T lymphocytes and macrophages and upregulates the proinflammatory activity of these cells (1-4). While its original description focused on its ability to prevent the random migration of macrophages in culture, evidence of a broad range of proinflammatory actions continues to emerge. Of note, MIF induces macrophage secretion of tumor necrosis factor ␣ (TNF␣) and promotes interferon-␥ (IFN␥)-induced production of nitric oxide by mouse macrophages (5-7).
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