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Spondyloarthritis: From Pathophysiology to Treatment
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Spondyloarthritis: From Pathophysiology to Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (20 December 2021) | Viewed by 18790

Special Issue Editors

Prof. Dr. Francesco Ciccia

E-Mail Website
Guest Editor
Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Caserta, Italy
Interests: ankylosing spondylitis; psoriatic arthritis; gut inflammation; immunopathogenesis; typ
Dr. Daniele Mauro

E-Mail Website
Guest Editor
Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy

Special Issue Information

Dear Colleagues,

Recent acquisitions on the pathophysiology, diagnosis, and treatment of spondyloarthritis (SpA) have profoundly changed our cognitive approach to SpA.

Numerous studies have elucidated the immune mechanisms underlying specific clinical manifestations of the disease, opening the way to the possibility of new and more personalized therapeutic approaches. In particular, the presence of new and more specific treatments promises to make the concepts of treat-to-target and the achievement of a drug-free remission in the SpA no longer objectives that are impossible to achieve. Although the diagnostic delay in SpA is still considerable, the increased awareness and insights into diagnosis at the early stage of the disease are contributing to soon making the change in the natural history of the disease possible.

The present Special Issue aims to deepen the aspects from bench to bedside of SpA, providing a broad updated spectrum of knowledge on pathophysiological, diagnostic, and therapeutic aspects of the disease.

Prof. Francesco Ciccia
Dr. Daniele Mauro
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Genetic of SpA
  • Pathophysiology of SpA
  • Diagnosis of SpA
  • Established therapeutic approaches in SpA
  • New therapeutic approaches in SpA

Published Papers (6 papers)

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Research

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9 pages, 401 KiB  
Article
Epidemiology and Characteristics of Spondyloarthritis in the Predominantly Afro-Descendant Population of Martinique, a French Caribbean Island
by Fabienne Louis-Sidney, Valentine Kahn, Benoit Suzon, Michel De Bandt, Christophe Deligny, Serge Arfi and Georges Jean-Baptiste
J. Clin. Med. 2022, 11(5), 1299; https://doi.org/10.3390/jcm11051299 - 27 Feb 2022
Viewed by 1508
Abstract
(1) Background: The prevalence of Spondyloarthritis (SpA) varies significantly in different regions and ethnic groups due several factors such as heterogeneity in study populations, the diversity of classification criteria used in epidemiological studies, the prevalence variability of HLA-B27 or disparity in healthcare access. [...] Read more.
(1) Background: The prevalence of Spondyloarthritis (SpA) varies significantly in different regions and ethnic groups due several factors such as heterogeneity in study populations, the diversity of classification criteria used in epidemiological studies, the prevalence variability of HLA-B27 or disparity in healthcare access. To our knowledge, there is no data on SpA in Martinique, a French region in the Caribbean with a predominantly Afro-descendant population and a high level of healthcare. (2) Methods: This was a retrospective study of all SpA patients treated at the Fort de France University Hospital between 1 January 1997 and 1 January 2008. (3) Results: In our cohort of 86 SpA patients, age at diagnosis was late (41 years old), ankylosing spondylitis (AS) was the most frequent sub-type (60.5%), inflammatory bowel disease was the most frequent extra articular feature (23.3%) and no one had personal familial history of the disease. Inflammatory syndrome concerned 55.6% of patients, no one was positive for HIV and HLA-B27 positivity was low (42.2%). However, HLA-B27 was statistically associated with AS. Out of 64 patients, 41 had sacroiliitis. (4) Conclusion: To our knowledge, this is the first comprehensive descriptive study of SpA subtypes in Martinique, a French region in the Caribbean. We report clinical and biological similarities in our SpA cohort with those of sub-Saharan Africa and with SpA subtypes reported in Afro-descendant populations. Full article
(This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment)
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13 pages, 1996 KiB  
Article
Effectiveness of Global Postural Reeducation in Ankylosing Spondylitis: A Systematic Review and Meta-Analysis
by Gloria Gonzalez-Medina, Veronica Perez-Cabezas, Antonio-Jesus Marin-Paz, Alejandro Galán-Mercant, Carmen Ruiz-Molinero and Jose Jesus Jimenez-Rejano
J. Clin. Med. 2020, 9(9), 2696; https://doi.org/10.3390/jcm9092696 - 20 Aug 2020
Cited by 4 | Viewed by 3579
Abstract
The aim of this study was to determine the role of global postural reeducation for people with ankylosing spondylitis. We compared the effects of treatments on pain, dysfunction (using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index), range [...] Read more.
The aim of this study was to determine the role of global postural reeducation for people with ankylosing spondylitis. We compared the effects of treatments on pain, dysfunction (using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index), range of motion, and chest expansion in a specific population aged over 18 years old with ankylosing spondylitis. We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. The search was conducted using the PubMed, Physiotherapy Database (PEDro), Scientific Electronic Library Online (SciELO), and Web of Science (WoS) databases. Clinical trials and systematic reviews/meta-analysis were reviewed. Results: 154 studies were found. Finally, four were included. Conclusions: global postural reeducation is beneficial for ankylosing spondylitis, but no more so than other conventional treatments, except for spinal mobility, where Global Postural Reeducation demonstrated an advantage. Full article
(This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment)
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11 pages, 1620 KiB  
Article
Patients with Axial Spondyloarthritis Are at Risk of Developing Adhesive Capsulitis: Real-World Evidence Database Study in Taiwan
by Shih-Wei Huang, Jr-Yi Wang, Che-Li Lin, Chi-Chang Huang, Tsan-Hon Liou and Hui-Wen Lin
J. Clin. Med. 2020, 9(3), 787; https://doi.org/10.3390/jcm9030787 - 13 Mar 2020
Cited by 4 | Viewed by 2765
Abstract
Patients with axial spondyloarthritis (ax-SpA) present with inflammation invading the axial skeleton. Symptoms of ax-SpA interfere with patients’ quality of life, and peripheral symptoms are also noted. Human leukocyte antigen B27 was associated with adhesive capsulitis. However, epidemiological studies investigating the associated incidence [...] Read more.
Patients with axial spondyloarthritis (ax-SpA) present with inflammation invading the axial skeleton. Symptoms of ax-SpA interfere with patients’ quality of life, and peripheral symptoms are also noted. Human leukocyte antigen B27 was associated with adhesive capsulitis. However, epidemiological studies investigating the associated incidence and risk factors for patients with ax-SpA with adhesive capsulitis are limited. The data of patients with ax-SpA were recorded during the 2004–2008 period and followed to the end of 2010. The control cohort comprised age- and sex-matched non-ax-SpA subjects. A Cox multivariate proportional hazards model was applied to analyze the risk factors for adhesive capsulitis. The hazard ratio (HR) and adjusted hazard ratio (aHR) were estimated between the study and control cohorts after confounders were adjusted for. Effects of sulfasalazine (SSZ), methotrexate (MTX), and hydroxychloroquine (HCQ) use on adhesive capsulitis risk were also analyzed. We enrolled 2859 patients with ax-SpA in the study cohort and 11,436 control subjects. A higher incidence of adhesive capsulitis was revealed in the ax-SpA cohort: The crude HR was 1.63 (95% CI, 1.24–2.13; p < 0.001), and the aHR was 1.54 (95% CI, 1.16–2.05; p = 0.002). For patients with ax-SpA using SSZ or HCQ, no difference in aHR was noted compared with control participants, but patients with ax-SpA treated with MTX had higher HR and aHR than controls. Patients with ax-SpA are at risk for adhesive capsulitis. When these patients receive SSZ or HCQ, the risk of adhesive capsulitis can be lowered compared with that of the control cohort. Full article
(This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment)
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Review

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20 pages, 4645 KiB  
Review
Intestinal Microbial Metabolites in Ankylosing Spondylitis
by Giuseppe Scalise, Antonio Ciancio, Daniele Mauro and Francesco Ciccia
J. Clin. Med. 2021, 10(15), 3354; https://doi.org/10.3390/jcm10153354 - 29 Jul 2021
Cited by 8 | Viewed by 3534
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation of axial joints and the pelvis. It is known that intestinal dysbiosis may exert direct pathogenic effects on gut homeostasis and may act as a triggering factor for the host innate immune [...] Read more.
Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation of axial joints and the pelvis. It is known that intestinal dysbiosis may exert direct pathogenic effects on gut homeostasis and may act as a triggering factor for the host innate immune system to activate and cause inflammation in extraintestinal sites in the so-called “gut-joint axis”, contributing to AS pathogenesis. However, although the intestinal microbiota’s influence on the clinical manifestation of AS is widely accepted, the mechanisms mediating the cross-talk between the intestinal lumen and the immune system are still not completely defined. Recent evidence suggests that the metabolism of microbial species may be a source of metabolites and small molecules participating in the complex network existing between bacteria and host cells. These findings may give inputs for further research of novel pharmacological targets and pave the way to applying dietary interventions to prevent the onset and ameliorate the clinical presentation of the disease. In this review, we discuss the role of some of the biological mediators of microbial origin, with a particular focus on short-chain fatty acids, tryptophan and vitamin B derivatives, and their role in barrier integrity and type 3 immunity in the context of AS. Full article
(This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment)
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10 pages, 929 KiB  
Review
Haptoglobin and Its Related Protein, Zonulin—What Is Their Role in Spondyloarthropathy?
by Magdalena Chmielińska, Marzena Olesińska, Katarzyna Romanowska-Próchnicka and Dariusz Szukiewicz
J. Clin. Med. 2021, 10(5), 1131; https://doi.org/10.3390/jcm10051131 - 08 Mar 2021
Cited by 4 | Viewed by 2849
Abstract
Haptoglobin (Hp) is an acute phase protein which supports the immune response and protects tissues from free radicals. Its concentration correlates with disease activity in spondyloarthropathies (SpAs). The Hp polymorphism determines the functional differences between Hp1 and Hp2 protein products. The role of [...] Read more.
Haptoglobin (Hp) is an acute phase protein which supports the immune response and protects tissues from free radicals. Its concentration correlates with disease activity in spondyloarthropathies (SpAs). The Hp polymorphism determines the functional differences between Hp1 and Hp2 protein products. The role of the Hp polymorphism has been demonstrated in many diseases. In particular, the Hp 2-2 phenotype has been associated with the unfavorable course of some inflammatory and autoimmune disorders. Its potential role in modulating the immune system in SpA is still unknown. This article contains pathophysiological considerations on the potential relationship between Hp, its polymorphism and SpA. Full article
(This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment)
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15 pages, 888 KiB  
Review
Patient-Centered Care in Psoriatic Arthritis—A Perspective on Inflammation, Disease Activity, and Psychosocial Factors
by Bogdan Batko
J. Clin. Med. 2020, 9(10), 3103; https://doi.org/10.3390/jcm9103103 - 25 Sep 2020
Cited by 14 | Viewed by 3200
Abstract
Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy characterized by skin lesions, dactylitis, and enthesitis. Patients with PsA suffer from a variety of psychosocial difficulties and nonspecific symptoms early on in the disease course and continue to experience progressive disease due to delays in [...] Read more.
Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy characterized by skin lesions, dactylitis, and enthesitis. Patients with PsA suffer from a variety of psychosocial difficulties and nonspecific symptoms early on in the disease course and continue to experience progressive disease due to delays in diagnosis and treatment. Symptoms initially viewed as somatization could lead to undertreatment and promote psychological distress, poor coping, and negative patient–provider relationships. Pain and fatigue are important complaints that affect the patient’s perception and may need to be addressed with a multidisciplinary approach. Maladaptive cognitive responses can lead to a negative illness perception and impact patient beliefs and concerns over treatment, as well as nonadherence. An underlying inflammatory component in affective disorders has been examined, though whether and how it may interact mechanistically in PsA warrants interest. Cognitive behavioral therapy represents a nonpharmacological treatment modality that can be combined with cytokine-targeted therapy to address both somatic and psychological complaints. Future directions for research include: (1) Elucidating nonspecific manifestations (e.g., subclinical stage, differential with functional syndromes) of PsA and how they impact diagnosis and management; (2) characterizing immune-mediated components of mood disorders in PsA; and (3) whether a bidirectional approach with abrogating inflammation and psychotherapeutic support leads to improved outcomes. Full article
(This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment)
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