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Axial spondyloarthritis by Stefan Siebert, Raj Sengupta, Alexander Tsoukas

By Stefan Siebert, Raj Sengupta, Alexander Tsoukas

Axial spondyloarthritis is the most typical inflammatory arthritis affecting the backbone. as a rule first offering to a number of basic and secondary care execs, the excessive international disorder burden of this situation has created a necessity for elevated expertise of this situation throughout a variety of rheumatology specialties.

A pocketbook aimed toward the non-specialist reader Axial Spondyloarthritis is the fundamental advisor to this universal . concentrating on the sensible implications of advancements in category, prognosis and remedy, this simply obtainable textual content totally covers the wider spectrum of the disease.

Concise and entirely illustrated, this addition to the Oxford Rheumatology Library covers the heritage and pathophysiology of axial spondylitis, along unique sections on remedies, issues and manifestations of the . With each one part supported via a convenient key issues part, Axial Spondyloarthritis is an invaluable and optimistic source for any practitioner or trainee encountering this condition.

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1), with the most notable pathways including: 1. g. interleukin (IL)-​1, IL-​1 receptor 2. g. HLA-​B27, ERAP1 and 2 3. g. g. ANTXR2). 1 Potential pathways or roles of susceptibility genes identified in ankylosing spondylitis Antigen presentation or processing HLA-​B27, ERAP1, ERAP2, LNPEP, NPEPPS Th17 and IL-​23/​IL-​17 pathway IL-​23R, IL12B, TYK2, IL6, (TNFRSF1A) Innate immunity IL1R1-​IL1R2 locus, (CARD9, TBkBP1) Ubiquitination UBE2E3, UBE2L3 Lymphocyte development RUNX3, IL7R G-​protein coupled receptors GPR35, GPR65, (PTGER4) Intergenic regions with no translated gene product (gene and role unknown) 2p15, 21q22 Interestingly, the implicated pathways, and several of the implicated genes, have also been reported to be associated with the clinically related conditions psoriasis, psoriatic arthritis, and Crohn’s disease (see Chapter 8 on extra-​articular manifestations of axSpA).

Since then, a number of different IBP criteria sets have been developed in an attempt to operationalize the identification and measurement of IBP, mainly for epidemiological and clinical research. While the specific features vary across criteria, there are several common features such as relatively young age of onset, duration for at least 3 months, morning stiffness, and improvement with activity. Other suggestive features include insidious onset, pain at night, worsening with rest, and alternating buttock pain.

The ASAS axSpA criteria (see Chapter 12) were developed in part in response to the recognition that the radiographic changes required to make a diagnosis of definite AS take many years to develop from symptom onset and that there are a significant number of patients with similar symptoms and disease burden who never achieve a formal diagnosis of AS. The underlying assumption and hope was that earlier diagnosis would facilitate earlier treatment, which in turn would lead to better outcomes and prevent or slow progression.

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