Ankylosing spondylitis and bowel disease

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Ankylosing spondylitis and bowel disease

Dominique Baeten, Filip De Keyser, Herman Mielants, M. Veys

p 537-549, Volume 16, Number 4, September 2002

Abstract

Clinical studies indicate an important role for bowel inflammation in

ankylosing spondylitis and other spondyloarthropathies whereby two different

aspects have to be considered. First, the gut inflammation is clinically and

histologically closely related to Crohn's disease. Recent data on

subclinical immune alterations confirm this relationship and suggest that

spondyloarthropathy is a unique human model for studying early Crohn's

disease. Second, bowel and peripheral joint inflammation are clinically,

histologically and pathogenetically linked. The most important clinical

implication of these observations is that targeted therapies for Crohn's

disease could also be effective for intestinal as well as extra-intestinal

disease manifestations in spondyloarthropathy, as evidenced by the recent

studies on TNF-[alpha] blockade. Unravelling the gut-synovium axis in

spondyloarthopathy could also contribute to the identification of new

therapeutic targets. Finally, assessment of subclinical gut inflammation by

histology, serology and genetics could contribute to the stratification of

individual patients in subgroups with an optimal response to specific

therapeutic interventions. Copyright 2002 Elsevier Science Ltd