الفهرس 
Acknowledgement
Pathogenesis of SpondyloarthritisOnly 14 pages are availabe for public view
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Abstract
Spondyloarthritis (SpA), including the prototypic and most common form ankylosing spondylitis (AS), refer to a cluster of rheumatic diseases showing common clinical, genetic, and pathophysiological characteristics. (1)
Spondyloarthritis patients are classified according to their clinical presentation as patients with predominantly axial SpA or peripheral SpA according to the latest Assessment of SpondyloArthritis international Society (ASAS) criteria. (1, 2)
Clinical examination and x-ray studies of the spine which show characteristic spinal changes and sacroiliitis are the major diagnostic tools. However, abnormalities evident by x-ray occur only several years after the onset of the disease. Only magnetic resonance imaging (MRI) allows the early detection of sacroiliitis. (5)
Immunoglobulin G (IgG) antibodies against CD74 were found to be elevated in patients with SpA compared with non-SpA patients (67–85 vs. <15%) or to healthy individuals (<1%). (6, 7)
Similarly, the detection of anti-CD74 antibodies allow the early diagnosis of SpA.(7) So, early treatment and tight disease control will be shown in the future (125)
Aim of this study:
The aim of the study is to identify autoantibodies against CD74 that could provide an important additional tool for diagnosis of spondyloarthritis
In this study we have three groups of subjects:
group I: patients with SPA were selected, (n=50), 25 females (50%) and 25 males (50%) aged from (19 – 68) years.
group II: patients with RA as control group were selected (n=15), age and sex matched.
group III: healthy subjects were taken as a control group age and sex matched . (n=15)
We measured the level of anti-CD74 IgG antibodies in the sera of the three groups and compared the results of SpA patients with those of RA and healthy control subjects
The following investigations were performed:
1- Routine investigations:
• ESR
• RF.
2- Special investigations:
• Serum level of anti-CD74 IgG antibodies.
3- Measure the Disease activity score:
• We measure the disease activity of SpA patients using ASDAS/ESR
4- Radiology:
• X-ray of sacroiliac joints
The following results were obtained:
• There isn’t correlation could be detected of anti-CD74 IgG antibodies with age and sex of patients with SpA.
• Levels of anti-CD74 IgG antibodies were significantly higher in patients with SpA than in control group (RA patients and healthy people).
• The majority of all types of SpA had positive anti-CD74 IgG antibodies; ankylosing spondylitis 88.9%, psoriatic arthritis 70%, reactive arthritis 77.8%, enteropathic arthritis 100% and undifferentiated arthritis 66.7% with no significant differences between them.
• Based on duration of SpA, enrolled patients in our study were divided into patients with early SpA (those with disease duration less than 2 years) and patients with late SpA (those with disease duration more than 2 years) and accordance to this duration, we noted that frequency of positive anti-CD74 IgG antibodies was higher in patients of early SpA as those with late SpA.
• There isn’t a correlation could be detected between anti-CD74 IgG antibodies and clinical data of patients of SpA as majority of those patients with positive articular and extra-articular manifestation had positive anti-CD74 IgG antibodies but had insignificant differences from those without.
• There is significant difference in frequency of positive anti-CD74 IgG antibodies between patient with activity (83%) and those not in activity (33.3%).
• There isn’t a correlation between level of anti-CD74 IgG antibodies and radiographic sarcoilitis on x-ray.