Osteoclast-development patterns and their alterations across Ankylosing Spondylitis(AS)conditions are mysterious,making AS treatment difficult.Our study aims to clarify osteoclast-precursor(OCP)development patterns fr...Osteoclast-development patterns and their alterations across Ankylosing Spondylitis(AS)conditions are mysterious,making AS treatment difficult.Our study aims to clarify osteoclast-precursor(OCP)development patterns from monocytes and their variations under AS conditions.We performed single-cell transcriptomics in peripheral blood mononuclear cells(PBMCs)from healthy donors and AS patients in the early,aggravated and remission stages.After monocytic reclustering,OCP-development patterns and the alterations upon AS onset and different outcomes were revealed based on single-cell trajectory.The trajectories revealed two monocyte states with strong OCP features,and AS pathogenesis was characterized by their reduction.Ribosome synthesis was considered the essential function for the development towards OCP-featured states,and this function and its representative molecule,RPS17,showed a decreasing trend with AS onset and outcomes.Histology assessment showed that RPS17underexpression participated in AS inflammatory osteogenesis and ankylosing destruction.Conditional knockout of RPS17ameliorated ovariectomy-induced bone loss and enhanced osteoclastogenesis,and RPS17 overexpression improved the phenotype of AS-like mice.Importantly,local injection of RPS17-overexpressed monocytic OCPs markedly ameliorated the joint alterations of AS-like mice without promoting bone loss;this was associated with enhanced osteoclastogenesis adjacent to the articular surface and T-cell-suppressive property in monocytic OCPs.Overall,the evolution of monocytes towards OCP-lineage fate mainly depends on ribosome synthesis,and OCP-development disorder participates in AS lesions due to a reduction in RPS17-dependent ribosome synthesis.Notably,RPS17-overexpressed monocytic OCPs have translational potential in preventing and treating AS peripheral lesions.展开更多
BACKGROUND Ankylosing spondylitis(AS)is recognized as a long-term inflammatory disorder that leads to inflammation in the spine and joints,alongside abnormal bone growth.In previous studies,we reported that mesenchyma...BACKGROUND Ankylosing spondylitis(AS)is recognized as a long-term inflammatory disorder that leads to inflammation in the spine and joints,alongside abnormal bone growth.In previous studies,we reported that mesenchymal stem cells(MSCs)derived from individuals with AS demonstrated a remarkable inhibition in the formation of osteoclasts compared to those obtained from healthy donors.The mechanism through which MSCs from AS patients achieve this inhibition remains unclear.AIM To investigate the potential underlying mechanism by which MSCs from individuals with ankylosing spondylitis(AS-MSCs)inhibit osteoclastogenesis.METHODS We analysed fat mass and obesity-associated(FTO)protein levels in AS-MSCs and MSCs from healthy donors and investigated the effects and mechanism by which FTO in MSCs inhibits osteoclastogenesis by coculturing and measuring the levels of tartrate-resistant acid phosphatase,nuclear factor of activated T cells 1 and cathepsin K.RESULTS We found that FTO,an enzyme responsible for removing methyl groups from RNA,was more abundantly expressed in MSCs from AS patients than in those from healthy donors.Reducing FTO levels was shown to diminish the capacity of MSCs to inhibit osteoclast development.Further experimental results revealed that FTO affects the stability of the long non-coding RNA activated by DNA damage(NORAD)by altering its N6-methyladenosine methylation status.Deactivating NORAD in MSCs significantly increased osteoclast formation by affecting miR-4284,which could regulate the MSC-mediated inhibition of osteoclastogenesis reported in our previous research.CONCLUSION This study revealed elevated FTO levels in AS-MSCs and found that FTO regulated the ability of AS-MSCs to inhibit osteoclast formation through the long noncoding RNA NORAD/miR-4284 axis.展开更多
Ankylosing spondylitis(AS)is a chronic,progressive,systemic autoimmune disease characterised by spinal stiffness and ocular,cardiac,intestinal,and peripheral joint involvements.Genetics,infectious agents,and immune-me...Ankylosing spondylitis(AS)is a chronic,progressive,systemic autoimmune disease characterised by spinal stiffness and ocular,cardiac,intestinal,and peripheral joint involvements.Genetics,infectious agents,and immune-mediated inflammatory processes have all been hypothesized to contribute to AS pathogenesis,but the precise aetiology remains elusive.Recent studies have identified biological and cellular factors that correlate with the onset and progression of AS.This has provided avenues of research that may help elucidate disease mechanisms and lead to advances in therapeutic interventions.This study aimed to examine some of the findings from recent molecular studies,focusing on the molecular mechanism and associated factors such as interleukin-17,tumor necrosis factor-alpha,receptor activator of nuclear factor-kappa B/receptor activator of nuclear factor-kappa B ligand/osteoprotegerin pathway,and related micro-RNAs to gain insight into aberrant bone formation in AS and potential approaches to its prevention.This editorial also addresses the contribution of osteoclasts to bone pathology in AS.The author examined the molecular pathways governing osteoclast differentiation and activity,with particular emphasis on relevant cytokines and immune cell interactions.A comprehensive understanding of these mechanisms is essential for the development of targeted therapies to mitigate excessive bone resorption and pathological skeletal remodeling in AS.展开更多
Background:Multiple meta-analyses have found that acupuncture combined with drug treatment can effectively improve the efficacy of clinical treatment for ankylosing spondylitis.The efficacy of acupuncture is based on ...Background:Multiple meta-analyses have found that acupuncture combined with drug treatment can effectively improve the efficacy of clinical treatment for ankylosing spondylitis.The efficacy of acupuncture is based on nearby action and/or remote action,and there have been very few studies comparing the efficacy of these two actions in the treatment of active ankylosing spondylitis.Therefore,we designed this study to observe the clinical efficacy of different acupuncture methods combined with drug treatment for ankylosing spondylitis.Methods:Sixty patients with active ankylosing spondylitis were randomized into a test group and a control group.In addition to basic treatment with nonsteroidal anti-inflammatory drugs and empirical formula of Chinese medicine named heat-clearing,Yin-nourishing,and dehumidifying pills,the test group mainly adopted distal point acupuncture with needles manipulated once every 10 minutes and retained for 30 minutes at each of the nine acupoints,including Houxi(SI3),Shugu(BL65),Siguan(LI4),Quchi(LI11),Yanglingquan(GB34),Shenmai(BL62),Sanyinjiao(SP6),Taixi(KI3),and Zusanli(ST36),for five consecutive days per week(two days of rest per week)for two consecutive weeks.The control group mainly adopted proximal and local point acupuncture with needles manipulated once every 10 minutes and retained for 30 minutes at each of the six acupoints,including Jiaji(EX-B2),Dazhui(DU14),Tianzhu(BL10),Dachangshu(BL25),Shenshu(BL23),and Yaoyangguan(DU3),for five consecutive days per week(two days of rest per week)for two consecutive weeks.Changes between pretreatment and posttreatment ankylosing spondylitis disease activity score,McGill score,and Bath score were evaluated.Results:Ankylosing spondylitis,McGill,and Bath score were lower in both groups with a more significant drop in the test group.After the treatments were discontinued,ankylosing spondylitis,McGill,and Bath scores were lower for the test group compared to those immediately after the two-week treatment.For the control group,ankylosing spondylitis and McGill scores were higher compared to those immediately after the two-week treatment but lower than the pretreatment scores;the Bath score was lower compared to that immediately after the two-week treatment.The differences between the two groups were statistically significant(P<0.05).Conclusion:Though both distal point and proximal point acupuncture combined with drug treatment can improve disease symptoms in patients with ankylosing spondylitis,the distal acupoint group had higher and longer-lasting clinical efficacy.展开更多
OBJECTIVE: To study changes in the nuclear factor-κB p65(NF-κB p65)-inducible nitric oxide synthase(i NOS)-nitric oxide(NO) signaling pathway and the effects of Xinfeng capsules(XFC) in patients with ankylosing spon...OBJECTIVE: To study changes in the nuclear factor-κB p65(NF-κB p65)-inducible nitric oxide synthase(i NOS)-nitric oxide(NO) signaling pathway and the effects of Xinfeng capsules(XFC) in patients with ankylosing spondylitis(AS)METHODS: One hundred twenty patients with AS were randomly divided into an XFC group and a Salazopyrin group. Sixty health subjects were included as a normal control group. In the two treatment groups, pulmonary functional parameters,forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), maximal voluntary ventilation(MVV), peak expiratory flow(PEF), forced expiratory flow at 25% of forced vital capacity(FEF25),forced expiratory flow at 50% of forced vital capacity(FEF50), and forced expiratory flow at 75% of forced vital capacity(FEF75) were determined. Enzyme linked immunosorbent assays were used for detection of the serum oxidative stress indexes,NF-κB p65, i NOS, NO, reactive oxygen species(ROS), reactive nitrogen species(RNS), malondialdehyde(MDA), superoxide dismutase(SOD), catalase(CAT), total antioxidative capacity(TAOC) and interleukin-4(IL-4), IL-10, IL-1β, and tumor necrosis factor-α(TNF-α) contents. Westergren's method was used for determination of erythrocyte sedimentation rate(ESR). High-sensitivity C-reactive protein(Hs-CRP) was detected with a 7060 full-automatic biochemical analyzer(Hitachi, Japan).RESULTS: The clinical therapeutic effect in the XFC group was significantly superior to that in the Salazopyrin group(P<0.01). Compared with the normal control group, FEV1, MVV, PEF, FEF50, FEF75, SOD, CAT,TAOC, IL-4, IL-10 were significantly lower, and NF-κB p65, i NOS, NO, ROS, RNS, MDA, IL-1β, TNF-α, ESR,and Hs-CRP significantly higher in patients with AS(P<0.01 or P<0.05). Compared with before treatment, FEV1, MVV, PEF, FEF50, FEF75, SOD, CAT, TAOC,IL-4, and IL-10 were significantly increased, and NF-κB p65, i NOS, NO, ROS, RNS, MDA, IL-1β, TNF-α,ESR, CRP, visual analog scales(VAS), Bath ankylosing spondylitis disease active index, Bath ankylosing spondylitis functional index, and Bath ankylosing spondylitis global index significantly decreased in the two treatment groups after treatment(P<0.01 or P<0.05), with significant differences between the XFC and Salazopyrin groups(P<0.01 or P<0.05). Spearman correlation analysis indicated that FEV1, MVV, PEF, FEF50, and FEF75 were positively correlated with SOD, CAT, TAOC, IL-4, and IL-10, and were negatively correlated with NF-κB p65, i NOS,NO, ROS, RNS, MDA, IL-1β, TNF-α, ESR, and CRP.CONCLUSION: Patients with AS have local pathologic changes in the spinal cord and other joints.They also have decreased pulmonary function,which is negatively correlated with the NF-κB-i NOS-NO signaling pathway, oxidative indexes, and inflammatory factors. XFC improves rigidity and pain in spinal joints and other symptoms, laboratory indexes, and pulmonary function. The mechanism is possibly related to inhibition of the NF-κB-i NOS-NO signaling pathway.展开更多
Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, ca...Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS.展开更多
There is no radical cure for ankylosing spondylitis,a chronic inflammation in joint,till now.Tumor necrosis factor-alpha（TNF-α） inhibitors can block the cascade in inflammatory chain and improve clinical symptom.Am...There is no radical cure for ankylosing spondylitis,a chronic inflammation in joint,till now.Tumor necrosis factor-alpha（TNF-α） inhibitors can block the cascade in inflammatory chain and improve clinical symptom.Among these biological agents,three of them are marketed in China：etanercept,infliximab and adalimumab.Some of the research progresses between 2014 and 2016 are summarized including treatment application,side effects of drugs,and comprehensive research of TNF-α inhibitors.展开更多
The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS p...The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS patients initiating etanerceptunderwent clinical and PDUS examinations of six bilateral entheseal sites at baseline and after 1, 2 and 3 months of treatment. Clinical and PDUS examinations identified at least one entheseal lesion in nine （45%） and 19 （95%） patients, respectively. Furthermore, of 240 entheseal sites examined in these 20 patients, PDUS detected 123 entheseal lesions （51.3% of sites）, compared with only 47 entheseal lesions （19.6%） detected by clinical examination （P〈0.05）. The entheseal lesions found on PDUS were most commonly identified by calcification （33.3%）, tendon edema （29.2%）, abnormal blood flow （25.8%）, a thickened tendon （22.1%）, cortical irregularity （12.9%）, bony erosions （9.6%） and bursitis at the tendon insertion to the bone cortex （7.1%）. Improvements in clinical symptoms and laboratory parameters, and significant decreases in PDUS scores were observed following treatment with etanereept. Improvements in PDUS scores continued during follow-up in patients who entered remission following treatment. In conclusion, PDUS improves detection of structural and inflammatory abnormalities of the enthesis in AS compared to physical examination. In addition, PDUS may be useful inascertaining medications.展开更多
AIM: To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. METHODS: Two hundred and three patients with uveitis associate...AIM: To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. METHODS: Two hundred and three patients with uveitis associated with AS followed-up in the Third Military Medical University Daping Hospital between 2005 and 2010 were retrospectively evaluated in this study. Complete ophthalmological examinations were evaluated at baseline and during the follow-up period. The gender, age, follow-up time, mean frequency of uveitis onset, and accompanying eye examination findings, history, demographical parameters were reviewed. All the patients presented complete clinical and radiologic (sacroiliac, lumbar, dorsal and cervical spine, knee, ankle, shoulder, hip, elbow) evaluation. HLA-B27 typing was also searched. RESULTS: There were 203 patients diagnosed with AS associated welt's. All showed sacroiliac X-ray changes indicative of AS. There were 184 male and 19 female patients. The average age of patients was 35 +/- 12 (range 18-50). Mean follow-up period was 2.4 years (1-5 years). Acute anterior wets was the most common type of uveitis in both genders. 121 eyes presented unilateral involvement (55.2%), and 92 eyes presented bilateral involvement (45.3%) with onset alternately. 22 eyes occurred hypopyon, 16 eyes were found anterior vitreous cells, 7 eyes were noted reactive macular edema or exudation, 29 eyes presented posterior synechiae of iris, and 14 eyes presented cataract, 9 eyes presented secondary glaucoma, 2 eyes presented bend corneal degeneration and 1 eyes presented atrophy of eyeball. At the final visit, uveitis was well controlled in most patients. CONCLUSION: AS associated with uveitis in Chinese patients mainly manifests as acute anterior uveitis. A combination of corticosteroids with other mydriasis agents is effective for most AS associated with uveitis patients. In general, the prognosis is good in these cases.展开更多
Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incid...Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among an- kylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treat- ments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the 〈 6 months medication and 〉 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclu- sion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.展开更多
AIM: To assess lung parenchymal changes in ankylosing spondylitis (AS) using high resolution computed tomography (HRCT). METHODS: We included 78 AS patients whose average age was 33.87 (18-56) years with a ratio of 53...AIM: To assess lung parenchymal changes in ankylosing spondylitis (AS) using high resolution computed tomography (HRCT). METHODS: We included 78 AS patients whose average age was 33.87 (18-56) years with a ratio of 53 males to 25 females who were followed up for 3.88 (1-22) years on average. neumonia and tuberculosis were excluded. In a detailed examination of lung HRCT findings, we investigated the presence of parenchymal micronodules,parenchymal bands, subpleural bands, interlobular and intralobular septal thickening, irregularity of interfaces,ground glass opacity, consolidation, mosaic pattern,bronchial wall thickening, bronchial dilatation, tracheal dilatation, pleural thickening, emphysema, thoracic cage asymmetry, honeycomb appearance, structural distortion, apical fibrosis and other additional findings.RESULTS: In detailed HRCT evaluations, lung parenchymal changes were found in 46 (59%) of all patients. We found parenchymal bands in 21 (27%) cases, interlobular septal thickening in 9 (12%), emphysema in 9 (12%), apical fibrosis in 8 (10%), ground-glass opacities in 7 (9%), parenchymal micronodules in 5 (6%), irregularity in interfaces in 3 (4%), bronchial dilatation in 3 (4%), mosaic pattern in 2 (3%), pleural thickening in 2 (3%), consolidation in 1 (1%), bronchial wall thick ening in 1 (1%) and a subpleural band in 1 (1%) case. Furthermore, we detected subsegmental atelectasis in 2 patients and a cavitary lesion in 1 patient. CONCLUSION: Our study had the highest number of AS cases of all previous studies in evaluating lung paren chymal changes. The rate of lung parenchymal changes was slightly lower than that reported in recent literature.展开更多
BACKGROUND Ankylosing spondylitis(AS)frequently occurs in people aged 30-45 years,and its prevalence is generally believed to be between 0.1%and 1.4%globally.At present,the“gold standard”for diagnosis of AS requires...BACKGROUND Ankylosing spondylitis(AS)frequently occurs in people aged 30-45 years,and its prevalence is generally believed to be between 0.1%and 1.4%globally.At present,the“gold standard”for diagnosis of AS requires the provision of pelvic X-rays,which makes it more difficult to perform in population-based epidemiological studies.Therefore,the identification of serological indicators related to the diagnosis,treatment,and prognosis of AS patients is of great significance.AIM To analyze the therapeutic,diagnostic significance and prognostic value of dickkopf-related protein-1(DKK-1)and tumor necrosis factor-α(TNF-α)in AS.METHODS A total of 113 patients with active AS were selected as the research group,and 100 healthy subjects who underwent physical examination were selected as the control group.The levels of DKK-1 and TNF-α in peripheral blood in the two groups were compared.The diagnostic and predictive values of DKK-1 and TNF-α for AS were analyzed with ROC curves,and the factors influencing AS recurrence were analyzed with COX regression.RESULTS Before treatment,the research group showed lower DKK-1 levels but higher TNF-αlevels than the control group(both aP<0.05).In the research group,DKK-1 was up-regulated and TNF-αwas down-regulated after 12 wk of treatment(aP<0.05).The area under the curve,sensitivity and specificity of DKK-1 combined with TNF-αfor diagnosing AS were 0.934,82.30%and 97.00%,respectively.Before treatment,the area under the curve,cutoff value,sensitivity and specificity of DKK-1 for predicting the curative effect were 0.825,68.42 pg/mL,73.68%and 80.00%,respectively,and those of TNF-αwere 0.863,32.79 ng/L,92.11%and 77.33%,respectively.DKK-1 and TNF-αlevels after treatment were closely related to the curative effect(aP<0.05).C-reactive protein,the Bath Ankylosing Spondylitis Disease Activity Index,DKK-1,and TNF-αwere risk factors for AS recurrence(aP<0.05).CONCLUSION DKK-1 and TNF-αare effective in the diagnosis and treatment of AS and are risk factors for its recurrence.In addition,DKK-1 may be a potential target for the diagnosis of AS.展开更多
Objective The current study was designed to find out the effect of Glucosidorum Tripterygii Totorum (GTT) on the serum level of soluble interleukin-2 receptor (sIL-2R) in patient with ankylosing spondylitis (AS). Meth...Objective The current study was designed to find out the effect of Glucosidorum Tripterygii Totorum (GTT) on the serum level of soluble interleukin-2 receptor (sIL-2R) in patient with ankylosing spondylitis (AS). Method 29 patients with active AS were selected to take GTT (1mg per kg) three times a day for one year. After that, its curative effect was evaluated. The serum level of sIL-2R of these patients was measured by sandwich ELISA method and was compared with that of normal subjects. Result The serum level of sIL-2R in active AS patients was obviously higher than that of the non-active AS patients. (P<0.01). The total effective rate of GTT on AS was 89.6%, while clinical relief rate 27.6%, obvious effective rate 44.8%, effective rate 17.2% and non-effective rate 10.4%. The patients’ serum level of sIL-2R after therapy was significantly lower than that before therapy except patients with no effect. (P<0.05). Conclusion GTT has positive curative effect on active AS patients and could cause obvious decrease of the serum level of sIL-2R. The serum level of sIL-2R can be used as an important index of activity of AS and as a guide of therapy.展开更多
BACKGROUND Andersson lesion(AL)is an uncommon complication in ankylosing spondylitis(AS),which is characterized by nonneoplastic bone destruction and often appears as bone destruction and sclerosis in the vertebral bo...BACKGROUND Andersson lesion(AL)is an uncommon complication in ankylosing spondylitis(AS),which is characterized by nonneoplastic bone destruction and often appears as bone destruction and sclerosis in the vertebral body and/or the area involving the intervertebral disc.According to the literature,Andersson lesion commonly occur in the thoracic and lumbar spine and rarely in the cervical spine.CASE SUMMARY This case involved a 78-year-old man with a long history of AS who developed AL in the cervical spine(C5/6 and C6/7).One-stage anterior-posterior approach surgery was successfully performed.At the 6-month follow-up,the pain was significantly reduced,and the limb function was gradually improved.CONCLUSION AL uncharacteristically appears in the cervical spine and tends to be misdiagnosed as vertebral metastases or spinal tuberculosis.Posterior combined with anterior surgery achieves solid biological stabilization in the treatment of AL bone destruction.展开更多
OBJECTIVE:To investigate the effects of icariin on apoptosis and the expression of Fas, Fas ligand(Fas L), B cell lymphoma(Bcl-2), and Bcl-2-associated X protein(Bax) in CD4+ T lymphocytes from patients with ankylosin...OBJECTIVE:To investigate the effects of icariin on apoptosis and the expression of Fas, Fas ligand(Fas L), B cell lymphoma(Bcl-2), and Bcl-2-associated X protein(Bax) in CD4+ T lymphocytes from patients with ankylosing spondylitis.METHODS:Primary cultures of peripheral blood CD4+ T lymphocytes were established and treated with icariin at high, medium, and low doses(0.5,0.25, and 0.125 mg/mL).Sulfasalazine treated and helthy cells were used as controls.Apoptosis of treated cells was determined by flow cytometry.Reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assays were used to determine the effects of icariin on the expression of Fas, Fas L, Bcl-2, and Bax.The activity of caspase 8 and caspase 3 was determined by a colorimetric assay.RESULTS:The m RNA and protein expression of Fas,and activity of caspase 8 and caspase 3 in CD4+ T lymphocytes were increased by icariin(P < 0.05).Conversely, the m RNA and protein expression of Bcl-2 was decreased(P < 0.05).The expression of Fas L and Bax were not significantly different between groups.The proapoptotic effects of icariin were dose-dependent.CONCLUSION:Icariin induces the apoptosis of CD4 + T cells from patients with AS comparing to normal control.Therefore, the induction of apoptosis may be the likely mechanism of action of icariin's antirheumatics activities.展开更多
Ankylosing spondylitis(AS)is characterized by involvement of the spine and hip joints with progressive stiffness and loss of function.Functional impairment is significant,with spine and hip involvement,and is predomin...Ankylosing spondylitis(AS)is characterized by involvement of the spine and hip joints with progressive stiffness and loss of function.Functional impairment is significant,with spine and hip involvement,and is predominantly seen in the younger age group.Total hip arthroplasty(THA)for fused hips with stiff spines in AS results in considerable improvement of mobility and function.Spine stiffness associated with AS needs evaluation before THA.Preoperative assessment with lateral spine radiographs shows loss of lumbar lordosis.Spinopelvic mobility is reduced with change in sacral slope from sitting to standing less than 10 degrees conforming to the stiff pattern.Care should be taken to reduce acetabular component anteversion at THA in these fused hips,as the posterior pelvic tilt would increase the risk of posterior impingement and anterior dislocation.Fused hips require femoral neck osteotomy,true acetabular floor identification and restoration of the hip center with horizontal and vertical offset to achieve a good functional outcome.Cementless and cemented fixation have shown comparable long-term results with the choice dependent on bone stock at THA.Risks at THA in AS include intraoperative fractures,dislocation,heterotopic ossification,among others.There is significant improvement of functional scores and quality of life following THA in these deserving young individuals with fused hips and spine stiffness.展开更多
Objective:To explore the expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis(AS).Methods:A total of 48 active AS patients in our hospital and 40 normal control subjects were selec...Objective:To explore the expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis(AS).Methods:A total of 48 active AS patients in our hospital and 40 normal control subjects were selected in our study.Bath ankylosing spondylitis disease activity index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),Bath ankylosing spondylitis metrology index(BASMI),ESR and CRP expression levels were compared before treatment,12 h after treatment and 24 h after treatment.IL-2 and IL-11 expression were also compared between these two groups.Results:The BASDAI score,BASH score and BASMI score of the AS patients before treatment significantly decreased compared with those 12 weeks and 24 weeks after treatment(P【0.05).ESB and CRP levels of the AS patients 12 weeks and 24 weeks after treatment significantly decreased compared with those before treatment(P【0.05).Difference was significant in serum IL-2 and IL-11 levels between 12 weeks and 24 weeks after treatment and before treatment(P【0.05).And no statistically significance was observed for serum IL-2 and IL-11 levels between normal control group and those of patients in AS group 24 weeks after treatment(P】0.05). Pearson’s linear-correlation analysis showed that serum IL-2 level had a positive correlation with BASDAI,BASFI,BASMI,ESR and CRP(r=0.661.0.547,0.474,0.362,0.416,P【0.05) and serum IL-11 level had a negative correlation with BASDAI,BASFI,BASMI,ESR and CRP(r=-0.629, -0.412,-0.422,-0.387,-0.408,-0.315,P【0.05).Conclusions:Serum levels of IL-2 in active AS patients significantly increase and will decrease after treatment.However,serum levels of IL- 11 significantly decrease and will increase after treatment,which indicates that serum IL-2 has a positive correlation with the degree of AS and serum IL-11 has a negative correlation with the degree of AS,both of which are correlated closely with the onset of AS.展开更多
Chemokine-like factor 1（CKLF1） is a newly cloned chemotactic cytokine with CCR4 being its functional receptor. Recent evidence demonstrates a role of CKLF1 in arthritis. The aim of this study was to quantify the exp...Chemokine-like factor 1（CKLF1） is a newly cloned chemotactic cytokine with CCR4 being its functional receptor. Recent evidence demonstrates a role of CKLF1 in arthritis. The aim of this study was to quantify the expression of CKLF1 as well as assess the correlation between CKLF1 and plasma acute-phase markers. Synovium was obtained from 16 osteoarthritis（OA）, 15 rheumatoid arthritis（RA） and 10 ankylosing spondylitis（AS） patients undergoing total joint arthroplasty, with other 11 patients treated for meniscal tears during sport accidents serving as normal controls. Levels of CKLF1 and CCR4 m RNA were detected by q RT-PCR, and the expression of CKLF1 was investigated by immunohistochemistry staining, subsequently analyzed with semiquantitative scores. Plasma acute-phase markers of inflammation were determined by ELISA. CKLF1 was found with a particularly up-regulated expression in synovim from AS and RA patients, and CCR4 m RNA levels increased in RA patients, not in OA or AS patients. Elevated levels of plasma markers of inflammation including CRP, ESR and Ddimer were observed in RA. Further, significantly positive correlations between relative expression levels of CKLF1 and CRP/ESR in RA patients and a positive correlation between CKLF1 and ESR in AS patients were found. There was no detectable correlation between CKLF1 and plasma D-dimer. This study confirms an increased but different level of CKLF1 in RA, OA and AS patients, all significantly higher than that in controls. Additionally, the significant positive correlations between CKLF1 levels and CRP/ESR in RA and between CKLF1 and ESR suggest that CKLF1 might contribute to the inflammation state and clinical symptoms in these rheumatic diseases. Further studies are required to investigate the utility of targeting specific CKLF1 for symptom control or disease modification in RA and AS.展开更多
BACKGROUND Patients with ankylosing spondylitis(AS)combined with severe cervical fusion deformity have difficult airways.Awake fiberoptic intubation is the standard treatment for such patients.Alleviating anxiety and ...BACKGROUND Patients with ankylosing spondylitis(AS)combined with severe cervical fusion deformity have difficult airways.Awake fiberoptic intubation is the standard treatment for such patients.Alleviating anxiety and discomfort during intubation while maintaining airway patency and adequate ventilation is a major challenge for anesthesiologists.Bronchial blockers(BBs)have significant advantages over double-lumen tubes in these patients requiring one-lung ventilation.AIM To evaluate effective drugs and their optimal dosage for awake fiberoptic nasotracheal intubation in patients with AS and to assess the pulmonary isolation effect of one-lung ventilation with a BB.METHODS We studied 12 AS patients(11 men and one woman)with lung or esophageal cancer who underwent thoracotomy with a BB.Preoperative airway evaluation found that all patients had a difficult airway.All patients received an intramuscular injection of penehyclidine hydrochloride(0.01 mg/kg)before anesthesia.In the operating room,dexmedetomidine(0.5μg/kg)was infused intravenously for 10 min,with 2%lidocaine for airway surface anesthesia,and a 3%ephedrine cotton swab was used to contract the nasal mucosa vessels.Before tracheal intubation,fentanyl(1μg/kg)and midazolam(0.02 mg/kg)were administered intravenously.Awake fiberoptic nasotracheal intubation was performed in the semi-reclining position.Intravenous anesthesia was administered immediately after successful intubation,and a BB was inserted laterally.The pre-intubation preparation time,intubation time,facial grimace score,airway responsiveness score during the fiberoptic introduction,time of end tracheal catheter entry into the nostril,and lung collapse and surgical field score were measured.Systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)were recorded while entering the operation room(T1),before intubation(T2),immediately after intubation(T3),2 min after intubation(T4),and 10 min after intubation(T5).After surgery,all patients were followed for adverse reactions such as epistaxis,sore throat,hoarseness,and dysphagia.RESULTS All patients had a history of AS(20.4±9.6 years).They had a Willson's score of 5 or above,grade III or IV Mallampati tests,an inter-incisor distance of 2.9±0.3 cm,and a thyromental(T-M)distance of 4.8±0.7 cm.The average pre-intubation preparation time was 20.4±3.4 min,intubation time was 2.6±0.4 min,facial grimace score was 1.7±0.7,airway responsiveness score was 1.1±0.7,and pulmonary collapse and surgical exposure score was 1.2±0.4.The SBP,DBP,and HR at T5 were significantly lower than those at T1-T4(P<0.05).While the values at T1 were not significantly different from those at T2-T4(P>0.05),they were significantly different from those at T5(P<0.05).Seven patients had minor epistaxis during endotracheal intubation,two were followed 24 h after surgery with a mild sore throat,and two had hoarseness without dysphagia.CONCLUSION Patients with AS combined with severe cervical and thoracic kyphosis should be intubated using fiberoptic bronchoscopy under conscious sedation and topical anesthesia.Proper doses of penehyclidine hydrochloride,dexmedetomidine,fentanyl,and midazolam,combined with 2%lidocaine,administered prior to intubation,can provide satisfactory conditions for tracheal intubation while maintaining the comfort and safety of patients.BBs are safe and effective for onelung ventilation in such patients during thoracotomy.展开更多
BACKGROUND Ankylosing spondylitis(AS)is an autoimmune disease characterized by sacroiliitis and spondylitis,with a few hematological abnormalities.Myelodysplastic syndromes(MDS)are a heterogeneous group of hematopoiet...BACKGROUND Ankylosing spondylitis(AS)is an autoimmune disease characterized by sacroiliitis and spondylitis,with a few hematological abnormalities.Myelodysplastic syndromes(MDS)are a heterogeneous group of hematopoietic stem cell disorders with frequent autoimmune phenomena.The relationship between AS and MDS remains unknown.CASE SUMMARY We describe a rare case of concurrent AS and MDS.An 18-year-old man with low back pain and anemia was diagnosed with AS;however,the cause of anemia could not be determined by the first bone marrow examination.He recovered from anemia and the symptoms of AS resolved after treatment with etanercept,glucocorticoid,and blood transfusion,but he developed pancytopenia with an increased myeloblast count(from 2.5%to 9%).Chromosome analysis revealed del(7q)and trisomy 8.Refractory anemia with excess of blasts-1(RAEB-1)/MDS was confirmed by repeating the bone marrow examination.He became blood transfusion-dependent and received decitabine-based chemotherapy but eventually died.CONCLUSION We suspect that AS may be an early autoimmune phenomenon related to MDS.However,a condition of coexistence cannot be excluded.展开更多
基金supported by National Natural Science Foundation of China(82472473,81991510,81991511 and 81820108020)Major Scientific Research Project of Health in Fujian Province(20212D01003)+3 种基金Fujian Province Joint Fund Project for Science and Technology Innovation(2021Y9023,2023Y9601)China Postdoctoral Science Foundation(2022M710702)Fujian Provincial Natural Science Foundation Projects(2023J01177,2023J011209,2023J01172)Fujian Provincial Health Technology Project(2023GGA004)。
文摘Osteoclast-development patterns and their alterations across Ankylosing Spondylitis(AS)conditions are mysterious,making AS treatment difficult.Our study aims to clarify osteoclast-precursor(OCP)development patterns from monocytes and their variations under AS conditions.We performed single-cell transcriptomics in peripheral blood mononuclear cells(PBMCs)from healthy donors and AS patients in the early,aggravated and remission stages.After monocytic reclustering,OCP-development patterns and the alterations upon AS onset and different outcomes were revealed based on single-cell trajectory.The trajectories revealed two monocyte states with strong OCP features,and AS pathogenesis was characterized by their reduction.Ribosome synthesis was considered the essential function for the development towards OCP-featured states,and this function and its representative molecule,RPS17,showed a decreasing trend with AS onset and outcomes.Histology assessment showed that RPS17underexpression participated in AS inflammatory osteogenesis and ankylosing destruction.Conditional knockout of RPS17ameliorated ovariectomy-induced bone loss and enhanced osteoclastogenesis,and RPS17 overexpression improved the phenotype of AS-like mice.Importantly,local injection of RPS17-overexpressed monocytic OCPs markedly ameliorated the joint alterations of AS-like mice without promoting bone loss;this was associated with enhanced osteoclastogenesis adjacent to the articular surface and T-cell-suppressive property in monocytic OCPs.Overall,the evolution of monocytes towards OCP-lineage fate mainly depends on ribosome synthesis,and OCP-development disorder participates in AS lesions due to a reduction in RPS17-dependent ribosome synthesis.Notably,RPS17-overexpressed monocytic OCPs have translational potential in preventing and treating AS peripheral lesions.
基金Supported by Guangdong Provincial Clinical Research Center for Orthopedic Diseases,No.2023B110001the Excellent Medical Innovation Talent Program of the Eighth Affiliated Hospital of Sun Yat-sen University,No.YXYXCXRC202101+3 种基金the National Natural Science Foundation of China,No.82172349,No.82372372,No.22105229,No.32170708,No.82102530,No.82102541,No.82103098,No.82103909,No.82104182,No.82104350,No.82170427,No.82171291,No.82172215,No.82172385,and No.82302661Guangdong Natural Science Foundation,No.2023A1515010568 and No.2021A1515111057Shenzhen Science and Technology Program,No.JCYJ20220530144201004 and No.RCBS20210609104445097Futian Healthcare Research Project,No.FTWS2022022,No.FTWS2021013,No.FTWS2023072,and No.FTWS2022047.
文摘BACKGROUND Ankylosing spondylitis(AS)is recognized as a long-term inflammatory disorder that leads to inflammation in the spine and joints,alongside abnormal bone growth.In previous studies,we reported that mesenchymal stem cells(MSCs)derived from individuals with AS demonstrated a remarkable inhibition in the formation of osteoclasts compared to those obtained from healthy donors.The mechanism through which MSCs from AS patients achieve this inhibition remains unclear.AIM To investigate the potential underlying mechanism by which MSCs from individuals with ankylosing spondylitis(AS-MSCs)inhibit osteoclastogenesis.METHODS We analysed fat mass and obesity-associated(FTO)protein levels in AS-MSCs and MSCs from healthy donors and investigated the effects and mechanism by which FTO in MSCs inhibits osteoclastogenesis by coculturing and measuring the levels of tartrate-resistant acid phosphatase,nuclear factor of activated T cells 1 and cathepsin K.RESULTS We found that FTO,an enzyme responsible for removing methyl groups from RNA,was more abundantly expressed in MSCs from AS patients than in those from healthy donors.Reducing FTO levels was shown to diminish the capacity of MSCs to inhibit osteoclast development.Further experimental results revealed that FTO affects the stability of the long non-coding RNA activated by DNA damage(NORAD)by altering its N6-methyladenosine methylation status.Deactivating NORAD in MSCs significantly increased osteoclast formation by affecting miR-4284,which could regulate the MSC-mediated inhibition of osteoclastogenesis reported in our previous research.CONCLUSION This study revealed elevated FTO levels in AS-MSCs and found that FTO regulated the ability of AS-MSCs to inhibit osteoclast formation through the long noncoding RNA NORAD/miR-4284 axis.
基金Supported by 2024 Yeungnam University Research Grant.
文摘Ankylosing spondylitis(AS)is a chronic,progressive,systemic autoimmune disease characterised by spinal stiffness and ocular,cardiac,intestinal,and peripheral joint involvements.Genetics,infectious agents,and immune-mediated inflammatory processes have all been hypothesized to contribute to AS pathogenesis,but the precise aetiology remains elusive.Recent studies have identified biological and cellular factors that correlate with the onset and progression of AS.This has provided avenues of research that may help elucidate disease mechanisms and lead to advances in therapeutic interventions.This study aimed to examine some of the findings from recent molecular studies,focusing on the molecular mechanism and associated factors such as interleukin-17,tumor necrosis factor-alpha,receptor activator of nuclear factor-kappa B/receptor activator of nuclear factor-kappa B ligand/osteoprotegerin pathway,and related micro-RNAs to gain insight into aberrant bone formation in AS and potential approaches to its prevention.This editorial also addresses the contribution of osteoclasts to bone pathology in AS.The author examined the molecular pathways governing osteoclast differentiation and activity,with particular emphasis on relevant cytokines and immune cell interactions.A comprehensive understanding of these mechanisms is essential for the development of targeted therapies to mitigate excessive bone resorption and pathological skeletal remodeling in AS.
基金Scientific Research and Cultivation Plan project of Beijing Municipal Hospital(No.PZ2019018).
文摘Background:Multiple meta-analyses have found that acupuncture combined with drug treatment can effectively improve the efficacy of clinical treatment for ankylosing spondylitis.The efficacy of acupuncture is based on nearby action and/or remote action,and there have been very few studies comparing the efficacy of these two actions in the treatment of active ankylosing spondylitis.Therefore,we designed this study to observe the clinical efficacy of different acupuncture methods combined with drug treatment for ankylosing spondylitis.Methods:Sixty patients with active ankylosing spondylitis were randomized into a test group and a control group.In addition to basic treatment with nonsteroidal anti-inflammatory drugs and empirical formula of Chinese medicine named heat-clearing,Yin-nourishing,and dehumidifying pills,the test group mainly adopted distal point acupuncture with needles manipulated once every 10 minutes and retained for 30 minutes at each of the nine acupoints,including Houxi(SI3),Shugu(BL65),Siguan(LI4),Quchi(LI11),Yanglingquan(GB34),Shenmai(BL62),Sanyinjiao(SP6),Taixi(KI3),and Zusanli(ST36),for five consecutive days per week(two days of rest per week)for two consecutive weeks.The control group mainly adopted proximal and local point acupuncture with needles manipulated once every 10 minutes and retained for 30 minutes at each of the six acupoints,including Jiaji(EX-B2),Dazhui(DU14),Tianzhu(BL10),Dachangshu(BL25),Shenshu(BL23),and Yaoyangguan(DU3),for five consecutive days per week(two days of rest per week)for two consecutive weeks.Changes between pretreatment and posttreatment ankylosing spondylitis disease activity score,McGill score,and Bath score were evaluated.Results:Ankylosing spondylitis,McGill,and Bath score were lower in both groups with a more significant drop in the test group.After the treatments were discontinued,ankylosing spondylitis,McGill,and Bath scores were lower for the test group compared to those immediately after the two-week treatment.For the control group,ankylosing spondylitis and McGill scores were higher compared to those immediately after the two-week treatment but lower than the pretreatment scores;the Bath score was lower compared to that immediately after the two-week treatment.The differences between the two groups were statistically significant(P<0.05).Conclusion:Though both distal point and proximal point acupuncture combined with drug treatment can improve disease symptoms in patients with ankylosing spondylitis,the distal acupoint group had higher and longer-lasting clinical efficacy.
基金the Twelfth Five-Year Support Project of the Ministry of Science and Technology for Clinical Studies Investigating Xin'an Medicine in the Treatment of Complicated Ascites Diseases(No.2012BAI26B02)Technology Planning Project of Anhui Science and Technology Department(No.11010402170)State Key Discipline Construction Project of TCM:Chinese Medical Arthralgia Syndrome Subject [No.(2009)30]
文摘OBJECTIVE: To study changes in the nuclear factor-κB p65(NF-κB p65)-inducible nitric oxide synthase(i NOS)-nitric oxide(NO) signaling pathway and the effects of Xinfeng capsules(XFC) in patients with ankylosing spondylitis(AS)METHODS: One hundred twenty patients with AS were randomly divided into an XFC group and a Salazopyrin group. Sixty health subjects were included as a normal control group. In the two treatment groups, pulmonary functional parameters,forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), maximal voluntary ventilation(MVV), peak expiratory flow(PEF), forced expiratory flow at 25% of forced vital capacity(FEF25),forced expiratory flow at 50% of forced vital capacity(FEF50), and forced expiratory flow at 75% of forced vital capacity(FEF75) were determined. Enzyme linked immunosorbent assays were used for detection of the serum oxidative stress indexes,NF-κB p65, i NOS, NO, reactive oxygen species(ROS), reactive nitrogen species(RNS), malondialdehyde(MDA), superoxide dismutase(SOD), catalase(CAT), total antioxidative capacity(TAOC) and interleukin-4(IL-4), IL-10, IL-1β, and tumor necrosis factor-α(TNF-α) contents. Westergren's method was used for determination of erythrocyte sedimentation rate(ESR). High-sensitivity C-reactive protein(Hs-CRP) was detected with a 7060 full-automatic biochemical analyzer(Hitachi, Japan).RESULTS: The clinical therapeutic effect in the XFC group was significantly superior to that in the Salazopyrin group(P<0.01). Compared with the normal control group, FEV1, MVV, PEF, FEF50, FEF75, SOD, CAT,TAOC, IL-4, IL-10 were significantly lower, and NF-κB p65, i NOS, NO, ROS, RNS, MDA, IL-1β, TNF-α, ESR,and Hs-CRP significantly higher in patients with AS(P<0.01 or P<0.05). Compared with before treatment, FEV1, MVV, PEF, FEF50, FEF75, SOD, CAT, TAOC,IL-4, and IL-10 were significantly increased, and NF-κB p65, i NOS, NO, ROS, RNS, MDA, IL-1β, TNF-α,ESR, CRP, visual analog scales(VAS), Bath ankylosing spondylitis disease active index, Bath ankylosing spondylitis functional index, and Bath ankylosing spondylitis global index significantly decreased in the two treatment groups after treatment(P<0.01 or P<0.05), with significant differences between the XFC and Salazopyrin groups(P<0.01 or P<0.05). Spearman correlation analysis indicated that FEV1, MVV, PEF, FEF50, and FEF75 were positively correlated with SOD, CAT, TAOC, IL-4, and IL-10, and were negatively correlated with NF-κB p65, i NOS,NO, ROS, RNS, MDA, IL-1β, TNF-α, ESR, and CRP.CONCLUSION: Patients with AS have local pathologic changes in the spinal cord and other joints.They also have decreased pulmonary function,which is negatively correlated with the NF-κB-i NOS-NO signaling pathway, oxidative indexes, and inflammatory factors. XFC improves rigidity and pain in spinal joints and other symptoms, laboratory indexes, and pulmonary function. The mechanism is possibly related to inhibition of the NF-κB-i NOS-NO signaling pathway.
文摘Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS.
文摘There is no radical cure for ankylosing spondylitis,a chronic inflammation in joint,till now.Tumor necrosis factor-alpha（TNF-α） inhibitors can block the cascade in inflammatory chain and improve clinical symptom.Among these biological agents,three of them are marketed in China：etanercept,infliximab and adalimumab.Some of the research progresses between 2014 and 2016 are summarized including treatment application,side effects of drugs,and comprehensive research of TNF-α inhibitors.
基金supported by the National Natural Science Foundation of China(No.81671608,81202350,81571586 and 81302559)Pfizer Competitive Grant(WS1620920)+5 种基金Jiangsu Six Talent Peaks Project(2015-WSN-074)Jiangsu 333 High Level Talents ProjectJiangsu Government Scholarship for Overseas StudiesJiangsu Health International Exchange Program sponsorshipNanjing Young Medical Talents ProjectNanjing Health Bureau Key Project(ZKX15018)
文摘The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS patients initiating etanerceptunderwent clinical and PDUS examinations of six bilateral entheseal sites at baseline and after 1, 2 and 3 months of treatment. Clinical and PDUS examinations identified at least one entheseal lesion in nine （45%） and 19 （95%） patients, respectively. Furthermore, of 240 entheseal sites examined in these 20 patients, PDUS detected 123 entheseal lesions （51.3% of sites）, compared with only 47 entheseal lesions （19.6%） detected by clinical examination （P〈0.05）. The entheseal lesions found on PDUS were most commonly identified by calcification （33.3%）, tendon edema （29.2%）, abnormal blood flow （25.8%）, a thickened tendon （22.1%）, cortical irregularity （12.9%）, bony erosions （9.6%） and bursitis at the tendon insertion to the bone cortex （7.1%）. Improvements in clinical symptoms and laboratory parameters, and significant decreases in PDUS scores were observed following treatment with etanereept. Improvements in PDUS scores continued during follow-up in patients who entered remission following treatment. In conclusion, PDUS improves detection of structural and inflammatory abnormalities of the enthesis in AS compared to physical examination. In addition, PDUS may be useful inascertaining medications.
基金Supported by National Natural Science Foundation of China (No. 30400487)International Cooperation Project of Guangdong Province, China (No. 2004B50301002)"1135" Talent Doctor Foundation of Daping Hospital, China(2008-2012)
文摘AIM: To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. METHODS: Two hundred and three patients with uveitis associated with AS followed-up in the Third Military Medical University Daping Hospital between 2005 and 2010 were retrospectively evaluated in this study. Complete ophthalmological examinations were evaluated at baseline and during the follow-up period. The gender, age, follow-up time, mean frequency of uveitis onset, and accompanying eye examination findings, history, demographical parameters were reviewed. All the patients presented complete clinical and radiologic (sacroiliac, lumbar, dorsal and cervical spine, knee, ankle, shoulder, hip, elbow) evaluation. HLA-B27 typing was also searched. RESULTS: There were 203 patients diagnosed with AS associated welt's. All showed sacroiliac X-ray changes indicative of AS. There were 184 male and 19 female patients. The average age of patients was 35 +/- 12 (range 18-50). Mean follow-up period was 2.4 years (1-5 years). Acute anterior wets was the most common type of uveitis in both genders. 121 eyes presented unilateral involvement (55.2%), and 92 eyes presented bilateral involvement (45.3%) with onset alternately. 22 eyes occurred hypopyon, 16 eyes were found anterior vitreous cells, 7 eyes were noted reactive macular edema or exudation, 29 eyes presented posterior synechiae of iris, and 14 eyes presented cataract, 9 eyes presented secondary glaucoma, 2 eyes presented bend corneal degeneration and 1 eyes presented atrophy of eyeball. At the final visit, uveitis was well controlled in most patients. CONCLUSION: AS associated with uveitis in Chinese patients mainly manifests as acute anterior uveitis. A combination of corticosteroids with other mydriasis agents is effective for most AS associated with uveitis patients. In general, the prognosis is good in these cases.
基金financially supported by the Natural Science Foundation of Liaoning Province of China,No.2014021081
文摘Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among an- kylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treat- ments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the 〈 6 months medication and 〉 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclu- sion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.
文摘AIM: To assess lung parenchymal changes in ankylosing spondylitis (AS) using high resolution computed tomography (HRCT). METHODS: We included 78 AS patients whose average age was 33.87 (18-56) years with a ratio of 53 males to 25 females who were followed up for 3.88 (1-22) years on average. neumonia and tuberculosis were excluded. In a detailed examination of lung HRCT findings, we investigated the presence of parenchymal micronodules,parenchymal bands, subpleural bands, interlobular and intralobular septal thickening, irregularity of interfaces,ground glass opacity, consolidation, mosaic pattern,bronchial wall thickening, bronchial dilatation, tracheal dilatation, pleural thickening, emphysema, thoracic cage asymmetry, honeycomb appearance, structural distortion, apical fibrosis and other additional findings.RESULTS: In detailed HRCT evaluations, lung parenchymal changes were found in 46 (59%) of all patients. We found parenchymal bands in 21 (27%) cases, interlobular septal thickening in 9 (12%), emphysema in 9 (12%), apical fibrosis in 8 (10%), ground-glass opacities in 7 (9%), parenchymal micronodules in 5 (6%), irregularity in interfaces in 3 (4%), bronchial dilatation in 3 (4%), mosaic pattern in 2 (3%), pleural thickening in 2 (3%), consolidation in 1 (1%), bronchial wall thick ening in 1 (1%) and a subpleural band in 1 (1%) case. Furthermore, we detected subsegmental atelectasis in 2 patients and a cavitary lesion in 1 patient. CONCLUSION: Our study had the highest number of AS cases of all previous studies in evaluating lung paren chymal changes. The rate of lung parenchymal changes was slightly lower than that reported in recent literature.
文摘BACKGROUND Ankylosing spondylitis(AS)frequently occurs in people aged 30-45 years,and its prevalence is generally believed to be between 0.1%and 1.4%globally.At present,the“gold standard”for diagnosis of AS requires the provision of pelvic X-rays,which makes it more difficult to perform in population-based epidemiological studies.Therefore,the identification of serological indicators related to the diagnosis,treatment,and prognosis of AS patients is of great significance.AIM To analyze the therapeutic,diagnostic significance and prognostic value of dickkopf-related protein-1(DKK-1)and tumor necrosis factor-α(TNF-α)in AS.METHODS A total of 113 patients with active AS were selected as the research group,and 100 healthy subjects who underwent physical examination were selected as the control group.The levels of DKK-1 and TNF-α in peripheral blood in the two groups were compared.The diagnostic and predictive values of DKK-1 and TNF-α for AS were analyzed with ROC curves,and the factors influencing AS recurrence were analyzed with COX regression.RESULTS Before treatment,the research group showed lower DKK-1 levels but higher TNF-αlevels than the control group(both aP<0.05).In the research group,DKK-1 was up-regulated and TNF-αwas down-regulated after 12 wk of treatment(aP<0.05).The area under the curve,sensitivity and specificity of DKK-1 combined with TNF-αfor diagnosing AS were 0.934,82.30%and 97.00%,respectively.Before treatment,the area under the curve,cutoff value,sensitivity and specificity of DKK-1 for predicting the curative effect were 0.825,68.42 pg/mL,73.68%and 80.00%,respectively,and those of TNF-αwere 0.863,32.79 ng/L,92.11%and 77.33%,respectively.DKK-1 and TNF-αlevels after treatment were closely related to the curative effect(aP<0.05).C-reactive protein,the Bath Ankylosing Spondylitis Disease Activity Index,DKK-1,and TNF-αwere risk factors for AS recurrence(aP<0.05).CONCLUSION DKK-1 and TNF-αare effective in the diagnosis and treatment of AS and are risk factors for its recurrence.In addition,DKK-1 may be a potential target for the diagnosis of AS.
文摘Objective The current study was designed to find out the effect of Glucosidorum Tripterygii Totorum (GTT) on the serum level of soluble interleukin-2 receptor (sIL-2R) in patient with ankylosing spondylitis (AS). Method 29 patients with active AS were selected to take GTT (1mg per kg) three times a day for one year. After that, its curative effect was evaluated. The serum level of sIL-2R of these patients was measured by sandwich ELISA method and was compared with that of normal subjects. Result The serum level of sIL-2R in active AS patients was obviously higher than that of the non-active AS patients. (P<0.01). The total effective rate of GTT on AS was 89.6%, while clinical relief rate 27.6%, obvious effective rate 44.8%, effective rate 17.2% and non-effective rate 10.4%. The patients’ serum level of sIL-2R after therapy was significantly lower than that before therapy except patients with no effect. (P<0.05). Conclusion GTT has positive curative effect on active AS patients and could cause obvious decrease of the serum level of sIL-2R. The serum level of sIL-2R can be used as an important index of activity of AS and as a guide of therapy.
基金Supported by the National Natural Science Foundation of China,No. 81902239the Natural Science Foundation of Jiangsu Province,No. BK20191169
文摘BACKGROUND Andersson lesion(AL)is an uncommon complication in ankylosing spondylitis(AS),which is characterized by nonneoplastic bone destruction and often appears as bone destruction and sclerosis in the vertebral body and/or the area involving the intervertebral disc.According to the literature,Andersson lesion commonly occur in the thoracic and lumbar spine and rarely in the cervical spine.CASE SUMMARY This case involved a 78-year-old man with a long history of AS who developed AL in the cervical spine(C5/6 and C6/7).One-stage anterior-posterior approach surgery was successfully performed.At the 6-month follow-up,the pain was significantly reduced,and the limb function was gradually improved.CONCLUSION AL uncharacteristically appears in the cervical spine and tends to be misdiagnosed as vertebral metastases or spinal tuberculosis.Posterior combined with anterior surgery achieves solid biological stabilization in the treatment of AL bone destruction.
基金Supported by the Fundamental Research Funds for the Central Public Welfare Research Institutes:Pharmacogenomics of Tripterygium wilfordii Hook F response and liver toxic reaction in Rheumatoid Arthritis(No.ZZ0708079)the Fundamental Research Funds for the Central Public Welfare Research Institutes Pharmacogenomics of Tripterygium wilfordii Hook F response reaction in Rheumatoid Arthritis(No.31470962)
文摘OBJECTIVE:To investigate the effects of icariin on apoptosis and the expression of Fas, Fas ligand(Fas L), B cell lymphoma(Bcl-2), and Bcl-2-associated X protein(Bax) in CD4+ T lymphocytes from patients with ankylosing spondylitis.METHODS:Primary cultures of peripheral blood CD4+ T lymphocytes were established and treated with icariin at high, medium, and low doses(0.5,0.25, and 0.125 mg/mL).Sulfasalazine treated and helthy cells were used as controls.Apoptosis of treated cells was determined by flow cytometry.Reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assays were used to determine the effects of icariin on the expression of Fas, Fas L, Bcl-2, and Bax.The activity of caspase 8 and caspase 3 was determined by a colorimetric assay.RESULTS:The m RNA and protein expression of Fas,and activity of caspase 8 and caspase 3 in CD4+ T lymphocytes were increased by icariin(P < 0.05).Conversely, the m RNA and protein expression of Bcl-2 was decreased(P < 0.05).The expression of Fas L and Bax were not significantly different between groups.The proapoptotic effects of icariin were dose-dependent.CONCLUSION:Icariin induces the apoptosis of CD4 + T cells from patients with AS comparing to normal control.Therefore, the induction of apoptosis may be the likely mechanism of action of icariin's antirheumatics activities.
文摘Ankylosing spondylitis(AS)is characterized by involvement of the spine and hip joints with progressive stiffness and loss of function.Functional impairment is significant,with spine and hip involvement,and is predominantly seen in the younger age group.Total hip arthroplasty(THA)for fused hips with stiff spines in AS results in considerable improvement of mobility and function.Spine stiffness associated with AS needs evaluation before THA.Preoperative assessment with lateral spine radiographs shows loss of lumbar lordosis.Spinopelvic mobility is reduced with change in sacral slope from sitting to standing less than 10 degrees conforming to the stiff pattern.Care should be taken to reduce acetabular component anteversion at THA in these fused hips,as the posterior pelvic tilt would increase the risk of posterior impingement and anterior dislocation.Fused hips require femoral neck osteotomy,true acetabular floor identification and restoration of the hip center with horizontal and vertical offset to achieve a good functional outcome.Cementless and cemented fixation have shown comparable long-term results with the choice dependent on bone stock at THA.Risks at THA in AS include intraoperative fractures,dislocation,heterotopic ossification,among others.There is significant improvement of functional scores and quality of life following THA in these deserving young individuals with fused hips and spine stiffness.
文摘Objective:To explore the expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis(AS).Methods:A total of 48 active AS patients in our hospital and 40 normal control subjects were selected in our study.Bath ankylosing spondylitis disease activity index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),Bath ankylosing spondylitis metrology index(BASMI),ESR and CRP expression levels were compared before treatment,12 h after treatment and 24 h after treatment.IL-2 and IL-11 expression were also compared between these two groups.Results:The BASDAI score,BASH score and BASMI score of the AS patients before treatment significantly decreased compared with those 12 weeks and 24 weeks after treatment(P【0.05).ESB and CRP levels of the AS patients 12 weeks and 24 weeks after treatment significantly decreased compared with those before treatment(P【0.05).Difference was significant in serum IL-2 and IL-11 levels between 12 weeks and 24 weeks after treatment and before treatment(P【0.05).And no statistically significance was observed for serum IL-2 and IL-11 levels between normal control group and those of patients in AS group 24 weeks after treatment(P】0.05). Pearson’s linear-correlation analysis showed that serum IL-2 level had a positive correlation with BASDAI,BASFI,BASMI,ESR and CRP(r=0.661.0.547,0.474,0.362,0.416,P【0.05) and serum IL-11 level had a negative correlation with BASDAI,BASFI,BASMI,ESR and CRP(r=-0.629, -0.412,-0.422,-0.387,-0.408,-0.315,P【0.05).Conclusions:Serum levels of IL-2 in active AS patients significantly increase and will decrease after treatment.However,serum levels of IL- 11 significantly decrease and will increase after treatment,which indicates that serum IL-2 has a positive correlation with the degree of AS and serum IL-11 has a negative correlation with the degree of AS,both of which are correlated closely with the onset of AS.
基金supported by National Natural Science Foundation of China(No.81441056 and 81541134)
文摘Chemokine-like factor 1（CKLF1） is a newly cloned chemotactic cytokine with CCR4 being its functional receptor. Recent evidence demonstrates a role of CKLF1 in arthritis. The aim of this study was to quantify the expression of CKLF1 as well as assess the correlation between CKLF1 and plasma acute-phase markers. Synovium was obtained from 16 osteoarthritis（OA）, 15 rheumatoid arthritis（RA） and 10 ankylosing spondylitis（AS） patients undergoing total joint arthroplasty, with other 11 patients treated for meniscal tears during sport accidents serving as normal controls. Levels of CKLF1 and CCR4 m RNA were detected by q RT-PCR, and the expression of CKLF1 was investigated by immunohistochemistry staining, subsequently analyzed with semiquantitative scores. Plasma acute-phase markers of inflammation were determined by ELISA. CKLF1 was found with a particularly up-regulated expression in synovim from AS and RA patients, and CCR4 m RNA levels increased in RA patients, not in OA or AS patients. Elevated levels of plasma markers of inflammation including CRP, ESR and Ddimer were observed in RA. Further, significantly positive correlations between relative expression levels of CKLF1 and CRP/ESR in RA patients and a positive correlation between CKLF1 and ESR in AS patients were found. There was no detectable correlation between CKLF1 and plasma D-dimer. This study confirms an increased but different level of CKLF1 in RA, OA and AS patients, all significantly higher than that in controls. Additionally, the significant positive correlations between CKLF1 levels and CRP/ESR in RA and between CKLF1 and ESR suggest that CKLF1 might contribute to the inflammation state and clinical symptoms in these rheumatic diseases. Further studies are required to investigate the utility of targeting specific CKLF1 for symptom control or disease modification in RA and AS.
基金Supported by National Natural Science Foundation of China,No.81672250Special Fund for Resident Training in Qilu Hospital of Shandong University,No.ZPZX2019A08.
文摘BACKGROUND Patients with ankylosing spondylitis(AS)combined with severe cervical fusion deformity have difficult airways.Awake fiberoptic intubation is the standard treatment for such patients.Alleviating anxiety and discomfort during intubation while maintaining airway patency and adequate ventilation is a major challenge for anesthesiologists.Bronchial blockers(BBs)have significant advantages over double-lumen tubes in these patients requiring one-lung ventilation.AIM To evaluate effective drugs and their optimal dosage for awake fiberoptic nasotracheal intubation in patients with AS and to assess the pulmonary isolation effect of one-lung ventilation with a BB.METHODS We studied 12 AS patients(11 men and one woman)with lung or esophageal cancer who underwent thoracotomy with a BB.Preoperative airway evaluation found that all patients had a difficult airway.All patients received an intramuscular injection of penehyclidine hydrochloride(0.01 mg/kg)before anesthesia.In the operating room,dexmedetomidine(0.5μg/kg)was infused intravenously for 10 min,with 2%lidocaine for airway surface anesthesia,and a 3%ephedrine cotton swab was used to contract the nasal mucosa vessels.Before tracheal intubation,fentanyl(1μg/kg)and midazolam(0.02 mg/kg)were administered intravenously.Awake fiberoptic nasotracheal intubation was performed in the semi-reclining position.Intravenous anesthesia was administered immediately after successful intubation,and a BB was inserted laterally.The pre-intubation preparation time,intubation time,facial grimace score,airway responsiveness score during the fiberoptic introduction,time of end tracheal catheter entry into the nostril,and lung collapse and surgical field score were measured.Systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)were recorded while entering the operation room(T1),before intubation(T2),immediately after intubation(T3),2 min after intubation(T4),and 10 min after intubation(T5).After surgery,all patients were followed for adverse reactions such as epistaxis,sore throat,hoarseness,and dysphagia.RESULTS All patients had a history of AS(20.4±9.6 years).They had a Willson's score of 5 or above,grade III or IV Mallampati tests,an inter-incisor distance of 2.9±0.3 cm,and a thyromental(T-M)distance of 4.8±0.7 cm.The average pre-intubation preparation time was 20.4±3.4 min,intubation time was 2.6±0.4 min,facial grimace score was 1.7±0.7,airway responsiveness score was 1.1±0.7,and pulmonary collapse and surgical exposure score was 1.2±0.4.The SBP,DBP,and HR at T5 were significantly lower than those at T1-T4(P<0.05).While the values at T1 were not significantly different from those at T2-T4(P>0.05),they were significantly different from those at T5(P<0.05).Seven patients had minor epistaxis during endotracheal intubation,two were followed 24 h after surgery with a mild sore throat,and two had hoarseness without dysphagia.CONCLUSION Patients with AS combined with severe cervical and thoracic kyphosis should be intubated using fiberoptic bronchoscopy under conscious sedation and topical anesthesia.Proper doses of penehyclidine hydrochloride,dexmedetomidine,fentanyl,and midazolam,combined with 2%lidocaine,administered prior to intubation,can provide satisfactory conditions for tracheal intubation while maintaining the comfort and safety of patients.BBs are safe and effective for onelung ventilation in such patients during thoracotomy.
基金Supported by National Natural Science Foundation of China,No.81701600.
文摘BACKGROUND Ankylosing spondylitis(AS)is an autoimmune disease characterized by sacroiliitis and spondylitis,with a few hematological abnormalities.Myelodysplastic syndromes(MDS)are a heterogeneous group of hematopoietic stem cell disorders with frequent autoimmune phenomena.The relationship between AS and MDS remains unknown.CASE SUMMARY We describe a rare case of concurrent AS and MDS.An 18-year-old man with low back pain and anemia was diagnosed with AS;however,the cause of anemia could not be determined by the first bone marrow examination.He recovered from anemia and the symptoms of AS resolved after treatment with etanercept,glucocorticoid,and blood transfusion,but he developed pancytopenia with an increased myeloblast count(from 2.5%to 9%).Chromosome analysis revealed del(7q)and trisomy 8.Refractory anemia with excess of blasts-1(RAEB-1)/MDS was confirmed by repeating the bone marrow examination.He became blood transfusion-dependent and received decitabine-based chemotherapy but eventually died.CONCLUSION We suspect that AS may be an early autoimmune phenomenon related to MDS.However,a condition of coexistence cannot be excluded.
