Recent therapeutic advances, in particular the use of anti-tumour necrosis factor (anti-TNF) agents, have revived interest in the seronegative spondyloarthropathies (SpA), a group of arthritides characterised by axial skeletal involvement and the absence of rheumatoid factor. The purpose of this article is to review the studies that have been done in the Asia Pacific region, as a broad understanding of the scope and severity of this group of diseases would enable rheumatologists and physicians in this part of the world to better manage their patients. The majority of genetic studies have focused on the associations of HLA-B27 with ankylosing spondylitis (AS) and SpA, while a few studies examined the associations of the CARD, IL-1, LMP2, TAP and TGF with AS. There are a handful of studies on the immunological responses to bacteria and cytokine levels in AS. The onset and clinical features of SpA have been reported from most countries in the region, but no data on patient outcomes, using current measurement tools such as the Bath Ankylosing Spondylitis Disease Activity index (BASDAI), is available. Validation of these instruments of measurement as well as classification criteria in different ethnic populations is necessary where no prior data exist. Future studies will likely be focused on better clinical characterisation of patient cohorts, particularly with regard to the use of currently used measurement tools for disease activity and spinal function and mobility, and the identification of the need for biologic therapy in each country.

译文

最近的治疗进展,特别是抗肿瘤坏死因子 (anti-TNF) 药物的使用,重新引起了对血清阴性脊柱关节病 (SpA) 的兴趣,该病是一组以轴向骨骼受累和类风湿因子缺乏为特征的关节炎。本文的目的是回顾在亚太地区所做的研究,因为对这组疾病的范围和严重程度的广泛了解将使世界这一地区的风湿病学家和医生能够更好地管理他们的患者。大多数遗传学研究都集中在HLA-B27与强直性脊柱炎 (AS) 和SpA的关联上,而一些研究则检查了CARD,IL-1,LMP2,TAP和TGF与AS的关联。关于AS中对细菌和细胞因子水平的免疫反应的研究很少。该地区大多数国家都报道了SpA的发作和临床特征,但没有使用当前测量工具 (例如Bath强直性脊柱炎疾病活动指数 (BASDAI)) 的患者预后数据。在没有先前数据的情况下,必须对这些测量工具以及不同种族人群的分类标准进行验证。未来的研究可能会集中在更好的患者队列临床特征上,特别是在使用当前使用的疾病活动,脊柱功能和活动度测量工具以及确定每个国家/地区对生物疗法的需求方面。

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