Ankylosing spondylitis in women

Gran, Jan Tore; Husby, Gunnar

doi:10.1016/0049-0172(90)90053-i

Cited by 46 publications

(19 citation statements)

References 34 publications

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“…Most studies of gender-related clinical dierences in SpA have been carried out in ankylosing spondylitis (AS) [2,13], in which men tend to show more pronounced radiological changes and demonstrate radiological sacroiliitis earlier than women. Although axial disease is more severe in men with AS, the overall pattern of the SpA is similar in the two sexes [2,3,13]. Furthermore, in AS spinal symptoms, chest expansion, peripheral arthritis and extra-articular features do not dier signi®cantly between the sexes [13].…”

Section: Discussionmentioning

confidence: 99%

“…Although the HLA-B27 antigen is the strongest genetic risk factor for SpA, it is unclear whether these gender-related dierences regarding the sex distribution of these conditions are due entirely to the presence of this genetic marker [2,3]. On the other hand, disease expression in SpA may dier in men and women, although the ®ndings of several studies are con¯icting, and no consistent picture has yet emerged [3,4]. For example, studies in the ®eld of PsA suggest that, in psoriatic spondyloarthropathy (PsSpA), and irrespective of HLA status there are gender-related dierences in the expression of the disease [4].…”

Section: Introductionmentioning

confidence: 99%

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Comparative analysis of psoriatic spondyloarthropathy between men and women

Queiró

Sarasqueta²,

et al. 2001

Rheumatology International

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This study analyzed gender-related differences in a cohort of patients with psoriatic spondyloarthropathy (SpA) We performed a retrospective cross-sectional study of 100 patients (mean age 48 +/- 14 years; 63 men, 37 women), diagnosed as having psoriatic SpA on the basis of ESSG criteria. All patients were studied according to a standard protocol, and HLA-B27 and Cw status were analyzed in the study population and their frequencies compared to that of 177 healthy blood donors. The clinical features of PsSpA were compared between men and women by univariate analyses. Twenty-three patients showed isolated axial disease (M:F ratio 3.6:1), 36 had polyaxial disease (M:F ratio 1:1), and 41 showed oligoaxial pattern (M:F ratio 1.7:1). HLA-B27 was correlated with male sex (P=0.002) and isolated axial disease (P=0.016). Univariate analysis showed female sex to be correlated with lower complement levels (P < 0.05), erosive disease (P = 0.05), higher swelling joint count (P = 0.002), and higher scores on the Health Assessment Questionnaire-Specific for SpA (P < 0.05). The HLA-B27 antigen seems to be a defined genetic risk factor only in men with psoriatic SpA. The extent of the spondylitic process is quite similar between the two, although women show poorer functional performance and more aggressive peripheral disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative analysis of psoriatic spondyloarthropathy between men and women

Queiró

Sarasqueta²,

et al. 2001

Rheumatology International

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“…AS is distinctive among the SpA family of diseases, because it has a clear male dominance, with a male-to-female ratio of up to 3:1 (3,4). In addition, disease expression differs significantly between male and female patients.…”

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confidence: 99%

Sexual Dimorphism in the Th17 Signature of Ankylosing Spondylitis

Gracey

Yao

Green

et al. 2016

Arthritis & Rheumatology

144

101

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ObjectiveTo identify an immunologic basis for the male sex bias in ankylosing spondylitis (AS).MethodsCohorts of male and female patients with AS and age‐ and sex‐matched healthy control subjects were selected, and the levels of serum cytokines (interferon‐γ [IFNγ], tumor necrosis factor α, interleukin‐17A [IL‐17A], and IL‐6) were examined by enzyme‐linked immunosorbent assay, the frequencies of Th1 and Th17 cells were assessed by flow cytometry, and whole blood gene expression was analyzed using both microarray and NanoString approaches.ResultsThe frequency of IL‐17A and Th17 cells, both of which are key factors in the inflammatory Th17 axis, was elevated in male patients with AS but not in female patients with AS. In contrast, AS‐associated alterations in the Th1 axis, such as the frequency of IFNγ and Th1 cells in serum, were independent of a patient's sex. Results of microarray analysis supported an altered Th17 axis in male patients, with a specific increase in IL17RA. In addition, male and female patients with AS displayed shared gene expression patterns, while male patients with AS had additional alterations in gene expression that were not seen in female patients with AS. The differential sex‐related immune profiles were independent of HLA–B27 status, clinical disease activity (as measured by the Bath Ankylosing Spondylitis Disease Activity Index), or treatment (with nonsteroidal antiinflammatory drugs or biologic agents), implicating intrinsic sexual dimorphism in AS.ConclusionThe results of this study demonstrate distinct sexual dimorphism in the activation status of the immune system in patients with AS, particularly in the Th17 axis. This dimorphism could underlie sex‐related differences in the clinical features of AS and could provide a rationale for sex‐specific treatment of AS.

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“…Thus, it is very likely that asymp tomatic sacroiliitis demonstrated by x-ray is not a precursor of idiopathic ankylosing spon dylitis. Moreover, the authors found a female preponderance of sacroiliitis in UC which sharply contrasts with ankylosing spondylitis [122], A cautionary note should be added, however, because ankylosing spondylitis has for a long time been greatly underestimated among females [122], Uveitis is seen in about 25% of ankylosing spondylitis [2] and independently of this dis ease it is associated with HLA B27 [125], Thus, the finding in UC of an association between uveitis and ankylosing spondylitis and not between uveitis and radiological sa croiliitis [118] further suggests that the latter finding is not a manifestation of idiopathic ankylosing spondylitis. Further evidence strongly indicating etiopathogenetic differ ences between asymptomatic radiological sa croiliitis and ankylosing spondylitis in UC has been provided by the family study of UC conducted by Macrae and Wright [116], In the study, it was shown that the prevalence of ankylosing spondylitis in the relatives of pro bands with UC and ankylosing spondylitis was higher than among relatives of probands with UC exclusively.…”

Section: Severity Ami Extent O F Colitis and Ankylos Ing Spondylitismentioning

confidence: 99%

Joint Manifestations in Gastrointestinal Diseases

Gran¹,

Husby²

1992

Dig Dis

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The many unique structural and functional features of the intestine may offer explanations to the well-established association between arthritis and inflammatory bowel diseases (IBD). In ulcerative colitis (UC) and Crohn’s disease (CD) some 6-8% of cases develop peripheral joint disease which frequently correlates with the activity and extent of the underlying bowel disorder. Ankylosing spondylitis is also found rather frequently in UC and CD, but is apparently not related to the severity of colitis. The occurrence of rheumatic manifestations in these two IBD is reviewed in detail.

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Ankylosing spondylitis in women

Cited by 46 publications

References 34 publications

Comparative analysis of psoriatic spondyloarthropathy between men and women

Comparative analysis of psoriatic spondyloarthropathy between men and women

Sexual Dimorphism in the Th17 Signature of Ankylosing Spondylitis

Joint Manifestations in Gastrointestinal Diseases

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