L’enthèse : la piste pour la pathogénie des spondyloarthrites ?

Abstract

The spondyloarthritis are a group of chronic inflammatory conditions whose common characteristic is the development of inflammation in the bone interface with tendons/ligaments or joint capsule. This interface, called “enthesitis”, may be the seat of ossification in spondyloarthritis. The development of fine imaging techniques such as MRI have attracted new interest in this structure by better defining the sequences leading to the ossification and showing in particular the importance of initial inflammation and fatty metaplasia before the appearance of this ossification. The physiopathological phenomena leading to the early onset of inflammation appears to be of various origins, related to mechanical stress, for example, or the presence of resident cells that are responsive to interleukin 23 and produce pro-inflammatory cytokines. Understanding of the pathogenic mechanisms underlying inflammation and ossification of enthesis could well be the clue to SpA pathogenesis.