Inflammation chronique de l’intestin et rhumatismes inflammatoires : physiopathologie

Abstract

There is a close connection between intestinal inflammation and chronic inflammation of the joints. Indeed since the 1980s, intestinal inflammation, with macroscopic and histological characteristics indistinguishable from Crohn's disease, was detected in 60% of patients with spondyloarthritis (SpA). Although joint damage in patients with IBD, and conversely intestinal inflammation in patients with SpA, have been widely observed in many prospective studies, interactions between arthropathy and chronic intestinal inflammation are not fully understood. Two major hypotheses have been advanced to explain the possible relationship between inflammation of the mucosal immune system and peripheral arthritis. The first refers to the potential involvement of gut bacteria in the development of joint inflammation, while the second suggests the recruitment of lymphocytes from the gut or activated macrophages to the joints. Of different pathophysiological studies emerges a central pathogenic factor that is the molecule of the major histocompatibility complex HLA-B27. This monograph provides an update on the knowledge on the pathophysiology of the relationship between chronic intestinal inflammation and inflammatory rheumatism.