Molecular Mechanisms of Spondyloarthropathies

1. Clinical Assessment in the Spondyloarthropathies 1
Ruth Wittoek and Herman Mielants
Abstract 1
Introduction 1
Ankylosing Spondylitis 2
Psoriatic Arthritis 9
2. Imaging in Spondyloarthritis 17
Walter P. Maksymowych
Abstract 17
Introduction 17
Plain Radiography. 18
Computed Tomography 21
Isotopic Imaging 21
Ultrasound 22
Magnetic Resonance Imaging. 22
Sacroiliac Joint 24
Spine 27
Conclusions 33
3. Spondyloarthritis, Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Chondrocalcinosis 37
Jácome Brüges Armas, Ana Rita Couto and Bruno Filipe Bettencourt
Abstract 37
Introduction 37
Spondyloarthritis 37
Diffuse Idiopathic Skeletal Hyperostosis (DISH) 40
Chondrocalcinosis/Crystal Deposition Disease (Cppd CD) 40
Molecular Genetics 42
Conclusions 47
4. The Enthesis Organ Concept and its Relevance to the Spondyloarthropathies. 57
Michael Benjamin and Dennis McGonagle
Abstract 57
Introduction 58
Enthesis Organ Structure 58
Mechanisms for Reducing Stress Concentration at the Enthesis Itself. 63
Related Concepts 66
Conclusions 67
5. Synovial and Mucosal Imunopathology in Spondyloarthritis 71
Bernard Vandooren, Paul P. Tak and Dominique Baeten
Abstract 71
Introduction 71
Axial Versus Peripheral Spondyloarthritis 73
Skeletal Remodeling in Spondyoarthritis 73
Synovial Biomarkers in Spondyoarthritis 75
Gut Inflammation in Spondyloarthritis. 76
The Pathogenesis of Spondyloarthritis: The Mucosa Hypothesis 77
Innate Immunity and Mucosal Inflammation 77
Adaptive Immunity and Mucosal Inflammation 78
The Pathogenesis of Joint Inflammation 78
Conclusions 79
6. Bone Loss in theSpondyloarthropathies: Role of Osteoclast, Rankl, Rank and Opg in the Spondyloarthropathies 85
Allen P. Anandarajah and Edward M. Schwarz
Abstract 85
Introduction 85
Pathogenesis of Bone Loss 86
Bone Loss in the Spondyloarthritis 91
Bone Loss in Ankylosing Spondylitis 91
Bone Loss in PsA 93
Bone Loss in Enteropathic Arthritis 93
Bone Loss in Reactive

CARLOS LÓPEZ-LARREA is Professor of Immunology (UC M, Madrid, Spain) and currently Head of the Histocompatiblity Unit at the "Hospital Universitario Central de Asturias" (Oviedo, Spain). He is a world expert on spondyloarthropathies (SpA), in particular genetic (MHC) and immunologic factors that influence the development of SpA. His primary research is focused on understanding the role of HLA-B27 polymorphism in the development of ankylosing spondylitis (AS), and describing relevant associations of B27 subtypes with AS in large extended worldwide populations. In the last decade, the availability of HLA-B27 subtypes differentially associated with the disease has provided a unique tool for exploring the relationship between peptide specificity and pathogenetic potential. The main research interests of his group currently include the role of innate immunity (NKs) in SpA. He is a member of several national and international scientific organizations. It is now over ten years since the first edition of HLA-B27 in the Developement of Spondyloarthropathies (SpA) was published and edited by C. López-Larrea. This current book aims to synthesize the growing knowledge in the field and present all current studies concerning basic research in SpA.

ROBERTO DÍAZ -PEÑA is a predoctoral investigator in the Histocompatibility Unit of the Department of Immunology, Hospital Universitario Central de Asturias. He graduated in biochemistry, at the University of Oviedo, Spain. His main research interests include the genetics of spondyloarthropathies, especially ankylosing spondylitis, and the role of inhibitory and activating KIR receptors in this disease.