Progress in spondylarthritis. Mechanisms of new bone formation in spondyloarthritis 英文参考文献.docVIP

Available online /content/11/2/221 Review Progress in spondylarthritis Mechanisms of new bone formation in spondyloarthritis Rik JU Lories, Frank P Luyten and Kurt de Vlam Laboratory for Skeletal Development and Joint Disorders, Division of Rheumatology, Department of Musculoskeletal Sciences, Katholieke Universiteit Leuven, Belgium Corresponding author: Rik Lories, Rik.Lories@uz.kuleuven.be Published: 27 April 2009 Arthritis Research Therapy 2009, 11:221 (doi:10.1186/ar2642) This article is online at /content/11/2/221 ? 2009 BioMed Central Ltd Abstract into the bone through a fibrocartilaginous connection, is hypothesized to be the primary disease localization in SpA [4]. Entheses are found as a part of the joint organ or at extra- articular sites [5,6]. The synovium and the underlying bone marrow are in close contact and communication with the entheses [5-7]. Although compelling evidence is lacking, synovitis and osteitis in SpA can be understood by this close anatomical relationship. Chemotaxis and accumulation of Targeted therapies that neutralize tumour necrosis factor are often able to control the signs and symptoms of spondyloarthritis. How- ever, recent animal model data and clinical observations indicate that control of inflammation may not be sufficient to impede disease progression toward ankylosis in these patients. Bone morphogenetic proteins and WNTs (wingless-type like) are likely to play an important role in ankylosis and could be therapeutic targets. The relationship between inflammation and new bone formation is still unclear. This review summarizes progress made in our understanding of ankylosis and offers an alternative view of the relationship between inflammation and ankylosis. inflammatory cells in combination with increased angiogenesis are more likely to occur in the easily accessible synovium and bone marrow than in the enth