SAPHO syndrome Is a range of pathogen-associated rheumatic diseases extended 英文参考文献.docVIP

Available online /content/11/6/131 Editorial SAPHO syndrome: Is a range of pathogen-associated rheumatic diseases extended? Alexander P Rozin B. Shine Department of Rheumatology, Rambam Health Care Campus and Rappaport Faculty of Medicine, Technion, P.O. Box 9602, Haifa, Bat-Galim, 31096, Israel Corresponding author: Alexander P Rozin, a_rozin@.il Published: 5 November 2009 Arthritis Research Therapy 2009, 11:131 (doi:10.1186/ar2837) This article is online at /content/11/6/131 ? 2009 BioMed Central Ltd See related research by Assmann et al., /content/11/5/R140 Abstract arthritogenic stimulants leading to various rheumatic conditions. Infectious agents may be the initial trigger of the production of cross-reacting antibodies (molecular mimicry) and may also induce the inflammatory ‘second hit’ mediated by Toll-like receptors (TLRs) [2]. Molecular similarity of microbial and host antigens (molecular mimicry) has recently been proposed as a promoting factor for pathogen expansion when microbial agents are not recognized as alien and not completely eliminated [3]. SAPHO syndrome, representing a constellation of synovitis, acne, palmo-plantar pustulosis, hyperostosis, and osteitis, is now recog- nized as a distinct medical entity: a reactive infectious osteitis. Genetic, immunological, and bacterial mechanisms are implicated in the development of the disease. Diagnostic problems may arise due to non-complete manifestations of SAPHO: either acne and arthritis or acne and anterior wall osteitis with an unclear pustulosis history. The interventional study of Assmann et al. is a significant addition to a long range of publications showing an association of SAPHO with Propionibacterium acnes. Randomized control studies are needed to confirm the effects of antibiotic therapy. Infectious agents isolated from SAPHO patients have merited special attention for many years. Their possible etio