臨床整形外科45巻12号

2010年12月発行

整形外科／知ってるつもり

強直性脊椎炎（AS）の新知見

著者： 森幹士¹

所属機関： ¹滋賀医科大学整形外科

ページ範囲：P.1124 - P.1127

　はじめに

　強直性脊椎炎（ankylosing spondylitis，以下AS）は血清反応陰性脊椎関節症の代表的疾患である．脊椎や仙腸関節などの付着部を中心とした慢性炎症を起こし，さらにはsyndesmophyteと呼ばれる骨新生を伴う病変を来す．進行すると，その病名が示すように脊柱の靱帯骨化・強直による“bamboo spine”と呼ばれる特徴的な状態へと至る．同じ慢性炎症性疾患の代表である関節リウマチ（rheumatoid arthritis，以下RA）が，骨・関節破壊の一途をたどるのとは大きく異なる．

　Tumor necrosis factor-α（TNF-α）やinterleukin 6（IL6）などを標的とした生物学的製剤の登場で，RAの治療は大きな転換期を迎え，炎症だけではなく骨・関節破壊までもが治療ターゲットとなった．

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