Ankylosing spondylitis risk factors: a systematic literature review

Hwang, Meeyul; Ridley, Lauren K.; Reveille, John D.

doi:10.1007/s10067-021-05679-7

Cited by 70 publications

(61 citation statements)

References 122 publications

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“…Furthermore, considering the differences in common occupation-related physical activities between the age groups, mechanical stress on the spine, which is linked with worsening disease progression, could be an important contributor to progression in specific age groups, although it is difficult to quantify excess mechanical load. 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study

Lee

Koo

Nam

et al. 2022

Therapeutic Advances in Musculoskeletal

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Objective: The objective of this study was to investigate spinal radiographic progression in specific age ranges of ankylosing spondylitis (AS) patients. Methods: Longitudinal data for 1125 AS patients at a single hospital from 2000 to 2018 were retrospectively reviewed. Radiographic intervals were obtained from patients with consecutive spinal radiographs. The radiographic progression rate was defined as the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) change per year within each interval. Using generalized estimating equations (GEEs), estimated marginal means were calculated for the mSASSS progression rate across age groups after adjusting for potential confounders. Results: We obtained 4016 radiographic intervals and stratified them into five groups based on patient age at the interval start: <20 ( n = 122); 20–29 ( n = 1124); 30–39 ( n = 1690); 40–49 ( n = 794); and ⩾50 years ( n = 286). The mean (SD) mSASSS progression rate for all the intervals was 0.8 (1.9). The GEE-estimated mean mSASSS progression rate increased with age, peaking in the 30–39 age group with a value of 1.15 [95% confidence interval (CI) 1.03, 1.27], and decreased slightly thereafter. In the presence of risk factors, rapid progression occurred at earlier ages: the GEE-estimated mean mSASSS progression rate in those with elevated C-reactive protein levels and preexisting syndesmophytes was 2.82 (95% CI 1.93, 3.71) in the 20–29 age group. Conclusion: Spinal structural damage in AS seems to progress most rapidly when patients are age 30–39 years. An awareness of the trends in radiographic progression with advancing age could improve understanding of the natural course of AS.

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Section: Discussionmentioning

confidence: 99%

Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study

Lee

Koo

Nam

et al. 2022

Therapeutic Advances in Musculoskeletal

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“…Other than genetic predisposition and gut microbiota, mechanical stress had been identified as another important risk factor in the etiology of axial spondyloarthritis. 18 It had been observed that the spinal involvement of axSpA usually developed in an ascending fashion, with SIJs as the most involved axial joints and the earliest to manifest, while lesions in lumbar and thoracic vertebrae ensued. 7,8 Numerous studies had linked the biomechanical stress to the development of axial 19 A study of the joint anatomy of SIJs suggested that proportions of atypical joints were significantly higher in axSpA patients than in controls, possibly due to the supra-physiological biomechanical stress exerted by atypical joint forms.…”

Section: Discussionmentioning

confidence: 99%

Distribution of Acute and Chronic Lesions in the Sacroiliac Joints of Patients with Axial Spondyloarthritis

Lin¹,

Liu²,

Liu³

et al. 2022

IJGM

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In this study, we aimed to investigate whether there was a pattern of distribution of acute and chronic lesions in the sacroiliac joints (SIJ) of patients with axial spondyloarthritis (axSpA). Methods: A total of 96 patients diagnosed as axSpA were retrospectively included in this study. The Spondyloarthritis Research Consortium of Canada sacroiliac joint inflammation score (SIS) and structural score (SSS) were used to evaluate the acute and chronic lesions in the SIJs. Scores representing the distribution of bone marrow edema, fatty lesions and erosions were extracted respectively. By dividing the SIJs into sacral or iliac sections, upper or lower sections, anterior and posterior levels, differences of scores representing acute and chronic lesions were analyzed by Kruskal Wallis' tests. Results: SIS scores were not significantly different in sacral or iliac sections, in upper or lower sections, on anterior or posterior levels. SSS scores were also not significantly different in different sections, except for higher occurrence rates of erosions in the iliac sections. Posthoc analysis showed that there was a higher erosion score in the left ilium than left sacrum, as well as in right ilium than left sacrum. Conclusion: There was no specific distribution pattern of acute or chronic lesions in the SIJs in patients with axSpA. A bigger study sample was needed to confirm the distribution of erosions in sacral or iliac sections.

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“…Although the exact etiology and pathogenesis of AS/r-AxSpA remain obscure, genetic predisposition by human leukocyte antigen (HLA)-B27 subtypes is known to have a strong association with the disease. However, other genetic loci of non-major histocompatibility complex (MHC) including endoplasmic reticulum aminopeptidase ( ERAP1 ) and interleukin 23 receptor ( IL-23R ), gut microbiome, local immune-metabolomics in gastrointestinal (GI) tract and joints, as well as T cell plasticity may also be implicated in its pathogenesis ( Voruganti and Bowness, 2020 ; Hwang et al, 2021 ). In addition to musculoskeletal manifestations, the extra-articular complications such as anterior uveitis (AU), interstitial pulmonary fibrosis, osteoporosis, syndesmophyte formation, and cardiovascular diseases (e.g., aortitis) may also occur ( El Maghraoui, 2011 ; Stolwijk et al, 2015 ; Redeker et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The Potential Role of Genetics, Environmental Factors, and Gut Dysbiosis in the Aberrant Non-Coding RNA Expression to Mediate Inflammation and Osteoclastogenic/Osteogenic Differentiation in Ankylosing Spondylitis

Liao

Tsai

Lai

et al. 2022

Front. Cell Dev. Biol.

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Ankylosing spondylitis (AS) or radiographic axial spondyloarthritis is a chronic immune-mediated rheumatic disorder characterized by the inflammation in the axial skeleton, peripheral joints, and soft tissues (enthesis, fascia, and ligament). In addition, the extra-skeletal complications including anterior uveitis, interstitial lung diseases and aortitis are found. The pathogenesis of AS implicates an intricate interaction among HLA (HLA-B27) and non-HLA loci [endoplasmic reticulum aminopeptidase 1 (ERAP1), and interleukin-23 receptor (IL23R), gut dysbiosis, immune plasticity, and numerous environmental factors (infections, heavy metals, stress, cigarette smoking, etc.) The latter multiple non-genetic factors may exert a powerful stress on epigenetic regulations. These epigenetic regulations of gene expression contain DNA methylation/demethylation, histone modifications and aberrant non-coding RNAs (ncRNAs) expression, leading to inflammation and immune dysfunctions. In the present review, we shall discuss these contributory factors that are involved in AS pathogenesis, especially the aberrant ncRNA expression and its effects on the proinflammatory cytokine productions (TNF-α, IL-17 and IL-23), T cell skewing to Th1/Th17, and osteoclastogenic/osteogenic differentiation. Finally, some potential investigatory approaches are raised for solving the puzzles in AS pathogenesis.

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Ankylosing spondylitis risk factors: a systematic literature review

Cited by 70 publications

References 122 publications

Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study

Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study

Distribution of Acute and Chronic Lesions in the Sacroiliac Joints of Patients with Axial Spondyloarthritis

The Potential Role of Genetics, Environmental Factors, and Gut Dysbiosis in the Aberrant Non-Coding RNA Expression to Mediate Inflammation and Osteoclastogenic/Osteogenic Differentiation in Ankylosing Spondylitis

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