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不同药物的作用机制 总结 AS是一种慢性炎性疾病,炎症与病情及预后相关。 在SpA ,骨修复过程主要由Wnt介导。前列腺素E2通过下调Wnt的负性调节因子DKK-1及sclerostin,进而增强Wnt通路的活性,促进新骨形成。 NSAIDs抑制前列腺素生成,具有减轻炎症和阻止新骨形成的作用。 RA以关节软骨丢失、局部骨侵蚀和系统性骨丢失为主要特征,即使临床成功控制炎症,也不会发生明显的骨修复过程。 DMARDs和生物制剂可阻止结构破坏,NSAIDs可有效控制炎症。 AS的结构破坏与大量的新骨形成相关,导致骶髂关节和脊柱融合。NSAIDs不但可控制炎症,还可阻止结构破坏,而DMARDs对中轴关节无效,TNF抑制剂虽可有效控制炎症,但不能 阻止影像学进展 谢 谢 xuhuji@smmu.edu.cn huji.xu@uq.edu.au * The two major divisions of the immune system are the Cellular Components and the Effector Molecules, which are discussed in more detail on the next few slides. * Ankylosing spondylitis: thoracic and lumbar vertebrae squaring, osteopenia, and ossification (radiographs) Left, A lateral view of the lower thoracic spine shows osteopenia; the intervertebral spaces are preserved. There are also loss of the anterior concavity of the vertebral bodies and straightening of the anterior margins. This squaring of the vertebral bodies is caused by anterior spondylitis with resorption at the enthesis (ligamentous attachment). Squaring is significant when seen in the lumbar vertebrae, but it may be normal in the thoracic spine. Right, A lateral projection of the lumbar spine shows moderate osteopenia and ossification of the anterior longitudinal ligaments. The intervertebral spaces are well preserved, and the configuration of the vertebral bodies is relatively normal. In this instance, the lumbar lordosis is maintained, although often it is lost. #9507050 * Ankylosing spondylitis: thoracic and lumbar vertebrae squaring, osteopenia, and ossification (radiographs) Left, A lateral view of the lower thoracic spine shows osteopenia; the intervertebral spaces are preserved. There are also loss of the anterior concavity of the vertebral bodies and straightening of the anterior margins. This squaring of the vertebral bodies is caused by anterior spondylitis with resorption at the enthesis (ligamentous attachment). Squaring is significant when seen in the lumbar vertebrae, but it may be normal in the thoracic
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