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PRACA PRZEGLĄDOWA
Nowe aspekty patogenezy spondyloartropatii zapalnych. Część III – zapalenie stawów, patologiczna przebudowa kości
 
 
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Data nadesłania: 30-04-2014
 
 
Data ostatniej rewizji: 27-06-2014
 
 
Data akceptacji: 25-07-2014
 
 
Data publikacji online: 12-09-2014
 
 
Data publikacji: 31-08-2014
 
 
Reumatologia 2014;52(4):247-254
 
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Spondyloartropatie (SpA) są formą przetrwałego zapalenia stawów obwodowych i kręgosłupa, które może być zapoczątkowane przez zapalenie podchrzęstnego szpiku kostnego w stawach albo zapalenie przyczepów ścięgnistych. Inwazyjna tkanka włóknista zastępująca szpik kostny, rezydujące w przyczepach ścięgnistych limfocyty T o cechach komórek odporności wrodzonej oraz cytokiny: czynnik martwicy nowotworów (tumor necrosis factor – TNF), interleukiny 23, 17 i 22, biorą udział w tych lokalnych procesach patologicznych. Mechanizmy molekularne, które biorą udział w zapaleniu stawów, destrukcji chrząstki i kości stawowej, są podobne do tych w reumatoidalnym zapaleniu stawów i są zatrzymywane przez skuteczną terapię przeciwzapalną, w tym leki biologiczne neutralizujące TNF. Terapie anty-TNF jednak nie hamują patologicznego tworzenia kości, a to zjawisko jest cechą charakterystyczną SpA. Powoduje ono m.in. powstawanie syndesmofitów i ankylozę kręgosłupa. Mechanizmy molekularne leżące u podłoża patologicznej przebudowy kości w SpA, jak również ich interakcje ze szlakami zapalnymi nie są w pełni poznane. Trzy główne omówione w artykule hipotezy są próbą wyjaśnienia tego problemu.
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