By Stefan Siebert, Raj Sengupta, Alexander Tsoukas
Axial spondyloarthritis is the most typical inflammatory arthritis affecting the backbone. mostly first proposing to a number of basic and secondary care pros, the excessive worldwide illness burden of this situation has created a necessity for elevated expertise of this throughout various rheumatology specialties.
A pocketbook aimed toward the non-specialist reader Axial Spondyloarthritis is the basic advisor to this universal . targeting the sensible implications of advancements in category, prognosis and therapy, this simply available textual content absolutely covers the wider spectrum of the disease.
Concise and completely illustrated, this addition to the Oxford Rheumatology Library covers the background and pathophysiology of axial spondylitis, along particular sections on remedies, problems and manifestations of the . With every one part supported by means of a convenient key issues part, Axial Spondyloarthritis is an invaluable and positive source for any practitioner or trainee encountering this condition.
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Extra info for Axial spondyloarthritis
However, symptoms suggestive of IBP, particularly in combination with other clinical, imaging, and genetic factors, should raise the possibility of a diagnosis of axSpA and trigger appropriate referral or investigation, based on the likelihood of axSpA. Key References and further reading Braun A, Saracbasi E, Grifka J, et al. Identifying patients with axial spondyloarthritis in primary care: how useful are items indicative of inflammatory back pain? Ann Rheum Dis. 2011;70(10):1782–7. 151167 Calin A, Porta J, Fries JF, et al.
However, to date, no arthritogenic peptides have been identified, while disease in HLA-B27 animal models of SpA has been shown to be mediated by CD4+ (helper) and not CD8+ (cytotoxic) T cells. 2. Endoplasmic reticulum stress and unfolded protein response theory This theory proposes that HLA-B27 chains fold more slowly, thereby misfolding and remaining in the endoplasmic reticulum for longer. This, in turn, is proposed to result in endoplasmic reticulum stress and precipitate the pro-inflammatory unfolded protein response in an attempt at homeostasis.
These and other observations have raised questions about the performance of the ASAS classification criteria in clinical practice, so steps are underway to improve their validity (see Chapter 12 for more details about the differences between classification and diagnostic criteria). Ultimately it is hoped that clinical, imaging, and/or molecular biomarkers will in future allow better and earlier identification of patients who are at particularly high or low risk of radiographic progression, in order to maximize resource utilization.