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Molecular Mechanisms
of Spondylorthropathies


Edited By:

Carlos López-Larrea
Hospital Central de Asturias
Oveido, Spain

ISBN: TBA
Published: 2008-09-01




Chapters available from this book


Biochemical Features of Hla‑B27 and Antigen Processing

Simon J. Powis, Susana G. Santos and Antony N. Antoniou

The strong association of the human MHC class I allele HLA‑B27 with the development of the chronic inflammatory disease ankylosing spondylitis (AS) is clear and has been known for over three decades. Despite this, it is far from clear how HLA‑B27 is directly involved in AS. In recent yea...

Synovial and Mucosal Immunopathology in Spondyloarthritis

Bernard Vandooren, Paul P. Tak and Dominique Baeten

Chronic inflammation of musculoskeletal structures is the most prominent disease manifestation of SpA. More specifically, the axial disease affects the spine, the sacroiliac joints and the hips. Peripheral disease includes peripheral arthritis, with a preference for asymmetrical inflammation of join...

Dendritic Cell: T-Cell Interactions in Spondyloarthritis

J.S. Hill Gaston, Lorna B. Jarvis, Libin Zhang and Jane C. Goodall

The discovery of the association between spondyloarthritis (SpA) and HLA‑B27 inevitably turned the spotlight on T‑lymphocytes as the cells which recognize peptide antigens within the binding groove of the HLA‑B27 molecule and then carry out effector functions. These include cytolys...

Animal Models of Spondyloarthritis

Joel D. Taurog

Animal models are available for the study of several different aspects of spondyloarthritis. The models include naturally occurring spontaneous disorders in primates and rodents, spontaneous disorders in transgenic or gene‑deleted rodents and induced disorders in rodents. Areas of investigatio...

Spondyloarthritis, Diffuse Idiopathic Skeletal Hyperostosis and Chondrocalcinosis (DISH)

Jácome Bruges Armas, Ana Rita Couto and Bruno Filipe Bettencourt

The authors describe the main clinical and radiological findings of common enthesopathic disorders—Spondylarthritis (SpA), Chondrocalcinosis/calcium pyrophosphate dehydrate crystal deposition disease (CPPD CDD) and Diffuse Idiopathic Skeletal Hyperostosis (DISH), stressing similarities and differenc...

HLA‑B27‑Bound Peptide Repertoires: Their Nature, Origin and Pathogenetic Relevance

Jose A. López de Castro

Peptide binding is a central biological property of HLA‑B27. The availability of HLA‑B27 subtypes differentially associated to ankylosing spondylitis provides a unique tool to explore the relationship between peptide specificity and pathogenetic potential. Many studies have focused on de...

Genomewide Screens in Ankylosing Spondylitis

Matthew A. Brown

Efforts to identify genes other than HLA‑B27 in AS have been driven by the strength of the evidence from genetic epidemiology studies indicating that HLA‑B27, although a major gene in AS, is clearly not the only significant gene operating. This is the case for both genetic determinants o...

Bone Formation Versus Bone Resorption in Ankylosing Spondylitis

Georg Schett

Ankylosing spondylitis (AS) and other forms of seronegative spondylarthritis (SpA) are characterized by two major processes in joints‑ the first is chronic inflammation and the second is progressive ankylosis. Both features go hand‑in‑hand and determine the clinical picture of dise...

HLA‑B27 and Host‑Pathogen Interaction

Anna S. Sahlberg, Kaisa Granfors and Markus A. Penttinen

HLA‑B27 is a risk factor closely associated to spondyloarthropathies (SpA). One form of SpA is reactive arthritis (ReA), which develops as a complication after certain bacterial infections (e.g., Salmonellae, Yersiniae, Shigellae, Campylobacteriae and Chlamydiae). The development of infection&...

Innate Immunity of Spondyloarthritis: The Role of Toll‑Like Receptors

Robert D. Inman

Amongst the spondyloarthropathies (SpA), the relationship of host susceptibility and environmental triggers is best seen in reactive arthritis (ReA). There are several points from the clinical studies of ReA which highlight important unresolved issues in the pathogenesis. Innate and adaptive immune ...

The Enthesis Organ Concept and its Relevance to the Spondyloarthropathies

Michael Benjamin and Dennis McGonagle

A characteristic feature of the spondyloarthropathies is inflammation at tendon or ligament attachment sites. This has traditionally been viewed as a focal abnormality, even though the inflammatory reaction intrinsic to enthesitis may be quite extensive. We argue that the diffuse nature of the patho...

RankL/Rank as Key Factors for Osteoclast Development and Bone Loss in Arthropathies

Andreas Leibbrandt and Josef M. Penninger

Osteoporosis or rheumatoid arthritis are bone diseases affecting hundreds of millions of people worldwide and thus pose a tremendous burden to health care. Ground‑breaking discoveries made in basic science over the last decade shed light on the molecular mechanisms of bone metabolism and bone ...

Biomarkers in Spondyloarthropathies

Chun-Hsiung Chen, David Tak Yan Yu and Chung-Tei Chou

The study of biomarkers in spondyloarthropathy (SpA) has emerged to be a very important field of research. This is particularly because the two commonly used biomarkers, erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP), are of very low sensitivity and specificity. The second r...

HLA‑B27 Misfolding and Spondyloarthropathies

Robert A. Colbert, Monica L. DeLay, Gerlinde Layh-Schmitt and Dawn P. Sowders

HLA‑B27 plays a central role in the pathogenesis of many spondyloarthropathies and in particular ankylosing spondylitis. The observation that the HLA‑B27 heavy chain has a tendency to misfold has raised the possibility that associated diseases may belong in a rapidly expanding category o...

The Role of B27 Heavy Chain Dimer Immune Receptor Interactions in Spondyloarthritis

Simon Kollnberger and Paul Bowness

HLA‑B27 (B27) is strongly associated with spondyloarthopathy. The classical role of B27 is to present peptides from intracellular pathogens as a heterotrimeric complex with β2 microglobulin for recognition by the T‑cell receptor (TCR) of CD8 T‑cells. In addition to heterotrime...

Clinical Assessment in the Spondyloarthropathies

Ruth Wittoek and Herman Mielants

In order to measure disease activity, progression and response to therapy, it is important to use accurate, reliable and feasible outcome measures that can ideally be used in longitudinal cohorts, clinical trials and clinical practice.rnWith emerging therapies, the focus on the methodology of outcom...

Implications of Structural and Thermodynamic Studies of Hla-B27 Subtypes Exhibiting Differential Association with Ankylosing Spondylitis

Andreas Ziegler, Bernhard Loll, Rolf Misselwitz and Barbara Uchanska-Ziegler

Structural and thermodynamic properties of HLA‑B27 molecules provide the basis for their function within the immune system and are probably also central for the understanding of the pathology of HLA‑B27‑associated diseases such as ankolysing spondylitis (AS). Several HLA‑B27 ...

Imaging in Spondyloarthritis

Walter P. Maksymowych

The role of imaging in the evaluation and management of SpA has experienced a resurgence of interest with the introduction of MRI and more sophisticated sonographic technologies. Several approaches have been developed to score plain radiographic abnormalities in the spine and sacroiliac joints of pa...

T-Cell Responses Against Viral and Self‑Epitopes and Hla‑B27 Subtypes Differentially Associated with Ankylosing Spondylitis

Rosa Sorrentino and Maria T. Fiorillo

HLA‑B27 family comprehends some alleles strongly associated with Ankylosing Spondylitis (AS) and some others that are not. A comparative analysis at genetic and functional level is likely to give a clue to the understanding of disease pathogenesis. Here, we summarize our recent studies on the ...

Bone Loss in the Spondyloarthropathies: Role of Osteoclast, Rankl, Rank and Opg in the Spondyloarthropathies

Allen P. Anandarajah and Edward M. Schwarz

Bone loss is a common finding in the spondyloarthropathies. It may be localized and present as erosions or be generalized and cause osteoporosis. The pathogenesis of bone loss in the spondyloarthropathies is yet to be fully understood. There is however increasing evidence to support a role for the o...

KIR Genes and Their Role in Spondyloarthropathies

Roberto Díaz-Peña, Miguel Angel Blanco-Gelaz and Carlos López-Larrea

Cellular activity of Natural killer cells (NK cells) is defined by the balance between activating and inhibitory signals coming from their receptors. With respect to this response, Killer immunoglobulin‑like receptors (KIR) are unique because of their diversity and capacity to recognize specif...


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