Spondiloartritisi u sklopu upalnih bolesti crijeva

master's thesis

• Title (english): Spondyloarthritis associated with inflammatory bowel disease
• Author: Stanko Nižić
• Mentor: Porin Perić (mentor)
• Committee member: Iva Žagar (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Porin Perić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Physical Medicine and General Rehabilitation); Zagreb
• Defense date and country: 2023-09-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Physical Medicine and Rehabilitation

Abstract

Spondiloartritisi su heterogena grupa kroničnih upalnih mišićno-koštanih bolesti koje imaju sličnosti u kliničkim, serološkim, radiološkim i imunogenetskim obilježjima. Grupa sadrži ankilozantni spondilitis, psorijatični artritis, reaktivni artritis, enteropatski artritis i nediferencirani spondiloartritis. Podjela na aksijalne i periferne spondiloartritise je također moguća. Aksijalni spondiloartritis je uglavnom karakteriziran upalnom boli u leđima i ukočenošću kralježnice, a periferni oblik ima artritis, entezitis ili daktilitis. Ekstra-artikularne manifestacije su upalna bolest crijeva, psorijaza i uveitis. HLA-B27 je važan genetski čimbenik koji je prisutan u više od 95% pacijenata s ankilozantnim spondilitisom, dok je prisutan u samo 10% opće populacije. Promjene u mikrobioti, crijevna disbioza, su mogući okidač bolest. Upalne bolesti crijeva koje pokazuju moguću povezanost s spondiloartritisima su Crohnova bolest i ulcerozni kolitis. Obje bolesti crijeva su kronične s remisijama i relapsima. Ulcerozni kolitis pogađa jedino kolon, dok Crohnova bolest može zahvatiti bilo koji dio gastrointestinalnog trakta. Krvavi proljev je glavni simptom ulceroznog kolitisa, ali je rjeđi u Crohnovoj bolesti koja je karakterizirana abdominalnom boli, proljevom i gubitkom na težini. Artritis se često pojavljuje kao ekstraintestinalna manifestacija u obje bolesti. Sakroilitis je radiološki nalaz u više od 20% pacijenata i upala perifernih zglobova u 20% slučajeva. Obrnuto, upalna bolest crijeva se pojavljuje u 6-14% slučajeva ankilozantnog spondilitisa. Veze između spondiloartritisa i upalnih bolesti crijeva bi mogle biti genetski čimbenici, crijevna disbioza i migracija stanica od crijeva prema zglobovima.

Abstract (english)

Spondyloarthritis is a heterogeneous group of chronic inflammatory musculoskeletal diseases that have similarities in clinical, serologic, radiologic and immunogenetic features. Group includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis and undifferentiated spondyloarthritis. Division into axial and peripheral spondyloarthritis is possible as well. Axial spondyloarthitis is mainly characterised by inflammatory back pain and stiffness of spine, whilst peripheral form has arthritis, enthesitis or dactylitis. Extra-articular manifestations are inflammatory bowel disease, psoriasis and uveitis. HLA-B27 is important genetic factor, which is present in more than 95% patients with ankylosing spondylitis, whereas it is only present in 10% of general population. Changes in microbiota,gut dysbiosis, are possibly disease trigger. Iflammatory bowel diseases that show possible connection to spondyoarthritis are Crohn's disease and ulcerative colitis. Both bowel diseases are chronic with remissions and relapses. Ulcerative colitis affects only colon, while Crohn's disease can affect any part of gastrointestinal tract. Bloody diarrrhea is main symptom in ulcerative colitis, but it is less common in Crohn's disease which is characterised by abdominal pain, diarrhea and weight loss. Arthritis often occurs as extraintestinal manifestation in both diseases. Sacroilitis is radiologic finding in more than 20% patients and inflammation of peripheral joints in 20% cases. Conversely, inflammatory bowel disease occurs in 6-14% ankylosing spondylitis cases. Links between spondyoarthritis and inflammatory bowel diseases could be genetic factors, gut dysbiosis and migration of cells from gut to joints.

• Keywords: spondiloartritis; HLA-B27; upalna bolest crijeva; crijevna disbioza
• Keywords (english): spondyloarthritis; HLA-B27; inflammatory bowel disease; gut dysbiosis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:895789
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-27 10:17:05