Espondilitis anquilosante: una mirada inmunológica

Autores

Mauricio Vargas-Valverde

RESUMEN

La espondilitis anquilosante (EA) es la enfermedad modelo de las espondiloartropatías. Los pacientes que la padecen, por lo general, expresan el HLA-B27 en las células nucleadas. No se comprende con exactitud los mecanismos mediante los cuales el HLA-B27 participa en la patogénesis de la EA. Para explicar dicha asociación, se han postulado hipótesis como la del péptido artritogénico, el plegamiento inadecuado del HLA, las cadenas pesadas libres de HLA y la vía IL-23/IL-17. Además, se ha asociado la EA a infecciones por microorganismos como Klebsiella pneumoniae. En los últimos años, se ha considerado que la EA es una enfermedad autoinflamatoria poligénica en la que el sistema inmune innato ejerce un rol trascendental.

Palabras clave

Espondilitis anquilosante, HLA-B27, retículo endoplasmático, IL-23, microbiota intestinal.

ABSTRACT

Ankylosing spondylitis (AS) is the model disease of spondyloarthropathies. Patients who suffer from it usually express HLA-B27 in nucleated cells. The mechanisms by which HLA-B27 participates in the pathogenesis of AS are not fully understood. To explain this association, hypotheses such as the arthritogenic peptide, the inadequate folding of the HLA, the HLA free heavy chains and the IL-23/IL-17 pathway have been postulated. In addition, AS has been associated with infections by microorganisms such as Klebsiella pneumoniae. In recent years it has been considered that AS is a polygenic autoinflammatory disease in which the innate immune system exerts a transcendental role.

Keywords

Ankylosing spondylitis, HLA-B27, endoplasmic reticulum, IL-23, intestinal microbiota.
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