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CD74 Antibodies: A biomarker for the diagnosis of spondylitis

Spondyloarthritis (SPA) is a more general term for rheumatic inflammatory disorders, which includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis after a previous infection, arthritis associated with a chronic inflammatory bowel disease and a form of juvenile idiopathic arthritis. The various clinical manifestations include inflammation of the axial skeleton (axial spondylitis) with the main symptoms being back pain and hieroglyphitis and also others such as peripheral arthritis, enthesopathies, uveitis, psoriatic arthritis and inflammatory bowel disease.

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Spondyloarthritis occurs in the population with a prevalence of 0.5% to 2%.

Most patients develop the disease in the age group of 20-45 years, they are mainly men in a ratio of 3: 1 compared to women and they usually have the most serious development.

For the treatment of the disease, non-steroidal anti-inflammatory drugs (NSAIDs) are administered in parallel with physiotherapy, to improve the long-term prognosis of patients.

In more severe cases, treatment with biological agents (anti-TNFα) can contribute positively to the course of the disease by slowing down the inflammatory processes and its progression.

The pathogenesis of axial vertebral arthritis remains largely unexplained, but there is a strong genetic association, as 95% of patients carry the HLA-B27 histocompatibility antigen.

The presence of HLA-B27 is directly related to an increased risk of developing the disease and therefore, its detection has been included in the ASAS (Assessment of SpondyloArthritis International Society) criteria for its diagnosis.

The proven presence of hieroglyphitis, using plain radiography or MRI is an additional important criterion for its detection.

The symptoms of axial spondylitis may be non-specific at the onset of the disease and plain X-rays do not usually reveal the presence of inflammation in the hieroglyphic joints and spine. For this reason, her diagnosis, until recently, was often delayed by several years, with all that entails.

Recently, the literature has shown that antibodies against the CD74 antigen, show a high correlation with the presence of vertebral arthritis and especially axial, already in its early stage and before its development into Ankylosing Spondylitis. Detection of these antibodies, anti-CD74, in patients, regardless of the presence of the HLA-B27 histocompatibility antigen, becomes a very important biomarker for the early diagnosis of the disease.