Ankylosing Spondylitis: Diagnosis and Management by Barend J. van Royen, Ben A. C. Dijkmans

By Barend J. van Royen, Ben A. C. Dijkmans

The 1st and in basic terms interdisciplinary consultant devoted to the topic, this reference leads readers during the pathogenic, genetic, medical, and biomechanical facets of ankylosing spondylitis (AS) and addresses matters relating to results overview, scientific therapy, surgical issues, illness administration, and genetics.

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These data suggest that in some populations it is not just the presence of B27 which is crucial in susceptibility to AS, but also the B27 subtype. However, this is not true in western Europeans, where the B27 subtype does not play a role in determining which B27-positive individuals develop AS (88). The Role of B27 in the Causation of AS Despite extensive research since the association with AS of B27 was first described in 1973, the role of B27 in disease pathology is still unknown. Numerous theories have been proposed, and are reviewed in the following sections.

Nonetheless, the development of spondyloarthritis in the absence of B27 has led to the hypothesis that B27 may not be causing spondyloarthritis by a mechanism involving traditional peptide presentation to cytotoxic T-lymphocytes. B27 has been demonstrated to have many unusual properties in comparison with other class I antigens which may explain these findings. An unusual structural feature of B27 is the presence of an unpaired cysteine residue at position 67 (Cys67) in the B pocket of the peptide-binding groove.

Character of pre-Columbian North American spondyloarthropathy. J Rheumatol 1992; 19:1229–1235. 4. Sokoloff L, Snell KC, Steward H. Spinal ankylosis in old Rhesus Monkeys. Clin Orthop 1968; 61:285–293. 5. Bjorkengren AG, Sartoris D, Shermis S, Resnick D. Patterns of paravertebral ossification in the prehistoric Saber-Toothed Cat. Am J Roentgenol 1987; 148:779–782. 6. Spencer DG, Sturrock RD, Watson Buchanan W. Ankylosing spondylitis: yesterday and today. Med Hist 1980; 24:60–64. 7. Ruffer MA. In: Moodie RL, ed.

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