Inflammation, new bone formation and aorta

Abstract

The formation of osteophytes in general is attributed to aging, mechanical stress and local inflammation; however, the precise pathophysiology remains to be clarified. [1][2][3] In ankylosing spondylitis (AS), osteophytes develop in the enthesis at the annulus bone junction of the vertebral body and eventually bridge the adjacent vertebrae, namely syndesmophytes, which are the hallmarks of the disease. 1,[3][4][5] A well-conceived intriguing observation is that osteophytes or syndesmophytes tend to spare the aorta side, as characterized in a non-inflammatory disease, diffuse idiopathic skeletal hyperostosis (DISH), with prominent continuous right-sided syndesmophytes away from aorta (left-sided). 6 In a recent report using a semiautomated method based on computed tomography (CT) scans, Tan et al illustrated that in AS, syndesmophytes are also less frequent and smaller in the area of the vertebral rim adjacent to the aorta than in neighboring regions in the lower thoracic and upper lumbar

Aortic‐vertebral interaction in inflammation

“…We read with great interest the article by Chen et al, in which the aortic‐vertebral interaction was proposed in the context of inflammation 1 . The study suggested that inflammation may promote ossification and was linked to a large aorta ipsilateral ratio of the osteophytes.…”

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Aortic-vertebral interaction in inflammationDear editor, We read with great interest the article by Chen et al, in which the aortic-vertebral interaction was proposed in the context of inflammation. 1 The study suggested that inflammation may promote ossification and was linked to a large aorta ipsilateral ratio of the osteophytes. This topic has significant clinical relevance, and future cohort studies covering various aspects are needed to further validate the findings in this study.First, it is important to note that baseline demographics and comorbidities may have influenced the study observations.

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“…These medications include nonsteroidal anti‐inflammatory drugs (NSAIDs), which are commonly used to manage AS and recommended as a prophylactic regimen for postoperative heterotopic ossification 31,32 . Similarly, the use of tumor necrosis factor (TNF) alpha inhibitors and interleukin‐17 inhibitors may inhibit tenascin‐C from affecting aorta‐vertebrae remodeling 1 . Additionally, low doses of corticosteroids have been found to significantly reduce CRP levels, 33 which can also affect the aorta ipsilateral ratio or observed radiographic progression.…”