The rheumatologist of the Alcorcón Foundation University Hospital in Madrid Raquel Almodóvar He has assured that, despite the importance of genetics, it has been shown that “Microbiotic infections or alterations can contribute to the development of spondylartritis“
In depth
This has been assured in the framework of the III National Conference of Researchers of the Spondylartritis group of the Spanish Rheumatology Society (Gresser), which has taken place in Madrid.
It is estimated that half a million people in Spain, which is equivalent to 1.2 percent of the population, could suffer from spondyloarthritis, a set of rheumatic diseases that include pathologies such as Axial, peripheral spondylartritis, psoriatic arthritis, spondyl artis associated with intestinal inflammatory disease or reactive arthritis.
“Axial spondyl artis has been related clearly With genetic markers, classically with HLA-B27. However, it has been observed that this gene can occur and never develop the disease, thus demonstrating that there are more genes related to these pathologies, “said the doctor Mireia Morenoof the Rheumatology Service of the University Hospital Parc Taulí of Barcelona.
In addition, Taulí has mentioned the progress of research centered on all “omics”, including Genomic (genome study), transcriptomic (study of a cell RNA molecules), metabolomic (study of chemical processes that involve metabolites), proteomic (protein study) and without forgetting the microbiome.
For experts, even though it has “Humanly advanced“In this area,” there are still various challenges such as early detection and precise diagnosis, since variable symptomatology and lack of awareness about these diseases can cause delays in adequate diagnosis and treatment“
More details
In this sense, Almodóvar has specified that “In the case of radiographic axial spondyl arthritis there may be a delay between 7 and 10 years since the beginning of the symptomsbeing this delay mostly in the female sex. “
“Inflammatory lumbar pain is confuses with mechanical low back pain or muscle problems; In addition, in early radiographs there are not always alterations (such as sacroilitis), delaying diagnosis until structural signs appear, since some doctors, who are not specialists in rheumatology, They do not recognize the early signs“He said.
In his opinion, “it would be essential to improve the diagnosis by strengthening the formation of primary care doctors in the identification of alert signs, such as chronic inflammatory lowering pain and family history, which can favor rapid derivation to rheumatology before any clinical suspicion. It would also be key Uveitis, psoriasis and intestinal inflammatory disease. “
The objective is to reduce diagnostic time to less than 2-3 years, “allowing starting early treatment and avoiding structural damage“Almodóvar points out.
To take into account
In addition to the delay in the most marked diagnosis in women, Moreno has explained that other differences related to gender appear in the case of radiographic axial spondyl arthritis, such as a worse quality of life or worse response to treatment in the case of women. However, “It is the male sex that has the greatest structural damage“, he indicates.
In this sense, he has recognized that differences have been evidenced in axial spondilatritis, but also in psoria arthritis. “Therefore,” added, “it would be important to take into account These differences to make a more faithful approach to reality and be able to individualize the assessment of affected people“
Finally, both specialists have stressed the importance of transmitting patients the importance of “leading a healthy life, integrating physical exercise regularly, always appropriate to the capacities of each one, as collected by the project ‘Reumafit‘of the Spanish Society of Rheumatology. Following a Mediterranean diet, avoiding toxic substances such as tobacco or excess alcohol, managing stress and, above all, fulfilling clinical controls and complementary tests that are required is fundamental“
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