Spondyloarthritis: May the force be with you?

摘要

In this issue Jacques et al provide proof of concept that experimental spondyloarthritis (SpA) may be a biomechanically triggered process. The implication is that an aberrant mesenchymal tissue response to physiological mechanical forces that occur during joint movement may trigger inflammation associated with SpA. Given the long-known genetic association of human SpA with human leukocyte antigen (HLA)-B27, which governs initiation of adaptive immune responses, the concept that SpA resembles a biomechanically driven rather than autoimmune disease may come as a great surprise. The en face argument that mechanically driven animal models bear no resemblance to human SpA, however, has to be taken with caution, given that the role of mechanics in human SpA has several supporting strands of evidence that date back over 50 years.