Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis traditional views, novel insights gained from TNF blockade, and concepts for the future 英文参考文献.docVIP

Schett et al. Arthritis Research Therapy 2011, 13(Suppl 1):S4 /content/13/S1/S4 RE VIE W Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: traditional views, novel insights gained from TNF blockade, and concepts for the future Georg Schett *, Laura C Coates , Zoe R Ash , Stefanie Finzel and Phillip G Conaghan 1 2 3 1 4 insight into the mechanism of structural changes trig- gered by chronic joint diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) is essential for developing therapies that can arrest, prevent, and even reverse bone and cartilage changes. More speci? c interventions to treat in? amma- tion in arthritis, for example monoclonal antibodies and soluble receptors, have added considerably to our know- ledge of arthritic structural damage. In particular, the blockade of TNF has shown that e? ective anti-in? am- matory therapy can preserve joint structure, which is critical to maintaining joint function. Abstract Structural changes of bone and cartilage are a hallmark of in?ammatory joint diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Despite certain similarities – in particular, in?ammation as the driving force for structural changes – the three major in?ammatory joint diseases show considerably di?erent pathologies. Whereas RA primarily results in bone and cartilage resorption, PsA combines destructive elements with anabolic bone responses, and AS is the prototype of a hyper-responsive joint disease associated with substantial bone and cartilage apposition. In the present review we summarize the clinical picture and pathophysiologic processes of bone and cartilag