Seronegative spondyloarthropathies (SpA) represent a group of chronic articular inflammatory diseases which differ from rheumatoid arthritis for the typical absence of rheumatoid factor in serum, and have in common several epidemiological, pathological, clinical, and radiological features. SpA include ankylosing spondylitis (AS), reactive arthritis (ReA), enteropathic (IBD) associated arthritis, psoriatic arthritis (PsA), as well as undifferentiated, and juvenile SpA. The main clinical manifestations include inflammatory back pain, peripheral arthritis, enthesitis, and extra-skeletal manifestations, such as uveitis. Although the cause of SpA is unknown, it is generally accepted that SpA is a multifactorial disease. Genetics (such as HLA-B27), inflammatory cytokines (such as TNF), and more recently the IL-23/IL-17 cytokine pathway have links to pathogenesis. Biologic agents, particularly TNF blockers, are primary treatment options and have been shown to reduce symptomatic inflammation.
Paparo F, Revelli M, Semprini A, Camellino D, Garlaschi A, Cimmino MA, Rollandi GA, Leone A