Document Detail

Immunohistologic analysis of zygapophyseal joints in patients with ankylosing spondylitis.
MedLine Citation:
PMID:  16947385     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Zygapophyseal joints of the spine are often affected in ankylosing spondylitis (AS). In this study, we undertook a systematic immunohistologic evaluation of the immunopathology of the zygapophyseal joints in patients with advanced AS. METHODS: We obtained zygapophyseal joints from 16 AS patients undergoing polysegmental correction of kyphosis and from 10 non-AS controls (at autopsy). Immunohistologic analysis of the bone marrow was performed by analyzing the number of infiltrating T cells (CD3, CD4, CD8), B cells (CD20), osteoclasts (CD68), bone marrow macrophages (CD68), and microvessel density (CD34) per high-power field. RESULTS: Zygapophyseal joints from 6 of 16 AS patients, but from none of the controls, exhibited 2 or more CD3+ T cell aggregates, signifying persistent inflammation. Interstitial CD4+ and CD8+ T cells were significantly more frequent in AS patients compared with non-AS controls (P = 0.002 and P = 0.049, respectively). While there was no clear difference between the number of CD20+ B cells in AS patients overall compared with controls, there was a significant difference when persistently inflamed joints from patients with AS were compared with joints without active inflammation from patients with AS or joints from controls (both P = 0.03). Microvessel density in bone marrow from AS patients with active inflammation was significantly higher than that in bone marrow from controls. CONCLUSION: This immunohistologic study of bone marrow from zygapophyseal joints demonstrates persistent inflammation in the spine of patients with AS, including those with longstanding disease. The findings of increased numbers of T cells and B cells and neoangiogenesis suggest that these features play a role in the pathogenesis of AS.
Heiner Appel; Maren Kuhne; Simone Spiekermann; Harald Ebhardt; Zarko Grozdanovic; Dorothee Köhler; Marc Dreimann; Axel Hempfing; Martin Rudwaleit; Harald Stein; Peter Metz-Stavenhagen; Joachim Sieper; Christoph Loddenkemper
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  54     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-10-02     Completed Date:  2006-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2845-51     Citation Subset:  AIM; IM    
Charité Berlin, Campus Benjamin Franklin, Berlin, Germany.
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MeSH Terms
Antigens, CD / analysis*
Antigens, CD3 / analysis
CD4-Positive T-Lymphocytes / immunology
CD8-Positive T-Lymphocytes / immunology
Immunohistochemistry / methods
Reference Values
Spondylitis, Ankylosing / immunology*,  pathology*,  radiography,  surgery
T-Lymphocytes / immunology*
Zygapophyseal Joint / immunology*,  pathology*
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, CD3

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