ankylosing spondylitis

Ankylosing spondylitis

Ankylosing spondylitis (AS) is a type of arthritis from the disease spectrum of axial spondyloarthritis. The term comes from the Greek ankylos meaning crooked, curved or rounded, spondylos meaning vertebra, and -itis meaning inflammation. It is characterized by long-term inflammation of the joints of the spine, typically where the spine joins the pelvis. Lower back pain is a hallmark, but eye and gastrointestinal problems and arthritis of other joints may also occur. Joint mobility in the affected areas often worsens over time, though the progression of symptoms varies significantly. Ankylosing spondylitis is believed to involve a combination of genetic and environmental factors. More than 90% of people affected in the UK have a specific human leukocyte antigen known as the HLA-B27 antigen, though the genetic correlation varies across populations (e.g., only 70% of AS patients in Turkey are HLA-B27 positive). The underlying mechanism is believed to be autoimmune or autoinflammatory. Diagnosis is based on symptoms with support from medical imaging and blood tests. AS is a type of seronegative spondyloarthropathy, meaning that tests show no presence of rheumatoid factor (RF) antibodies. As of 2019, there is no cure for AS. Treatments may include medication, physical therapy, and surgery. Medication therapy focuses on relieving the pain and other symptoms of AS, as well as stopping the disease progression by counteracting long-term inflammatory processes. Commonly used medications include NSAIDs, TNF inhibitors, IL-17 antagonists, and DMARDs. Glucocorticoid injections are o...