Spondyloarthropathy as an old world phenomenon

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Abstract

The presence of spine and sacroiliac involvement and the nature and distribution of erosive lesions allowed definitive diagnosis of spondyloarthropathy in the great apes (Gorilla and Pan [chimpanzee]), the lesser ape (Hylobates), and Old World monkeys (Theropithecus, Papio, Cercopithecus, Macaca, Colobus, Presbytis, and Erythrocebus). Analysis of lesional character, distribution, radiological appearance, and sex ratios showed a picture indistinguishable from human spondyloarthropathy. This contrasts with orangutans (Pongo), who lack reactive bone or sacroiliac involvement. A different pathophysiology, as yet undefined, is implied for their erosive arthritis. Limited individual susceptibility to spondyloarthropathy in humans (1% to 4%), Old World monkeys (2.4%), and lesser apes (2.4%) contrasts with the high frequency of disease in the great apes (20% to 28%). The wide geographic distribution of this phenomenon suggests an African and perhaps Asian “panendemic.” This natural disease state provides a unique model for in-depth analysis of the contribution of genetic and environmental factors to disease pathophysiology.

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    Supported in part by NIH Division of Diagnostic Resources grant no. RR00919 and National Institute of Arthritis and Musculoskeletal and Skin Disease grant no. AR35736-03.

    1

    From the Arthritis Center of Northeast Ohio, Youngstown, OH; Northeast Ohio Universities College of Medicine, Rootstown, OH; University of Akron, Akron, OH; Carnegie Institute, Pittsburgh, PA; and Ohio State University, Columbus, OH.

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