Infection and Spondyloarthropathies

Spondyloarthropathies are a group of inflammatory rheumatic diseases characterized by axial and or peripheral arthritis associated with enthesitis, dactylitis, and potential extra-articular manifestations involving the eyes, heart, lung, skin, gut, and genitourinary tract. This group of diseases includes the prototypical disease ankylosing spondylitis, reactive arthritis or spondyloarthritis, psoriatic arthritis or spondyloarthritis, spondyloarthritis associated with inflammatory bowel disease, undifferentiated spondyloarthritis and juvenile-onset spondyloarthritis. The exact etiology and pathogenesis of spondyloarthropathies remain unclear, but strong evidence indicates that genetics play a major role in an individual's susceptibility to this group of diseases, together with nongenetic environmental triggers. Studies suggest that infection can trigger spondyloarthropathies, and researchers express varying degrees of certainty about the role of infection among the subgroups of the disease. Thus, current data support the notion that infections drive the development of spondyloarthropathies, as shown in reactive arthritis. The interplay of infections, genetics, and mainly HLA-B27 contributes to the pathogenesis of this disease.