HLA-B27阳性脊柱关节炎相关眼部疾病

HLA-B27 positive spinal arthritis-related eye disease

脊柱关节炎(SpA)是与人类白细胞抗原B27(HLA-B27)关系密切的一种炎症性风湿性疾病,可累及骶髂关节、脊柱、外周关节、关节周围附着点,往往还伴有关节外的多系统受累。眼部疾病是HLAB27阳性SpA常见的关节外表现,其中较为常见的为急性前葡萄膜炎,还包括表层巩膜炎、巩膜炎、结膜炎、角膜炎等。HLA-B27阳性SpA并发眼部疾病的病因及发病机制尚不完全清楚,目前的研究发现与遗传易感性、肠道菌群改变、细胞因子失衡有关。本文就HLA-B27阳性SpA相关眼部疾病的发病机制、流行病学、临床特点以及治疗予以综述。

Spondyloarthritis(SpA),an inflammatory rheumatic disease,is closely associated with human leukocyte antigen B27(HLA-B27),which can affect the sacroiliac joints,spine,peripheral joints,and periarticular entheses,and is often accompanied by multisystem involvement beyond the joints.Ocular manifestations are common extraarticular features in HLA-B27 positive SpA,with prevalent acute anterior uveitis,and other ocular diseases such as episcleritis,scleritis,conjunctivitis,keratitis and so on.The etiology and pathogenesis of ocular complications in HLAB27 positive SpA are not fully understood.Current research suggests that genetic susceptibility,alterations in gut microbiota,and cytokine imbalances might play significant roles.This review summarizes the pathogenesis,epidemiology,clinical characteristics,and treatment of ocular diseases associated with HLA-B27 positive SpA.