Brief in English from Bechterew-Brief No. 84

In the opening article of this issue, Dr. Stephan THURAU gives an overview on iritis associated with ankylosing spondylitis, its symptoms, suspected mechanisms, possible complications, and its treatment.

Dr. Gerhild WILDNER who is also from the ophthalmologic department of the university of Munich, reports on the principle of “oral tolerance” which prevents the immune system from attacking antigens taken into the body with food. She also reports on the first successful treatment of a disease by introduction of oral tolerance: She found a peptide with the name B27PD (part of several HLA molecules) which the immune system seems to confuse with an autoantigen present in the eye. Patients with an autoimmune uveitis could essentially reduce the need for corticoids after oral treatment with this peptide. Some experts see a great future in this new type of treatment.

Dr. Uwe LANGE from Bad Nauheim gives a report on urogenital infections in patients with ankylosing spondylitis. He found urogenital infections in 28% of male AS patients and in 48% of female AS patients investigated, mainly in the form of an urethritis caused by chlamydia trachomatis. Often this infection shows no symptoms and therefore remains undetected before it causes other complications. The possibility that AS may be triggered by an urogenital infection cannot be ignored after these results.

The article by Helen C. MURRAY et al. from Newcastle upon Tyne on the frequency of poor balance in AS patients has been translated from Rheumatology. They measured (by sway magnetometry) the movement of the hips of a person standing still for 30 seconds and found an abnormally poor balance in 17% (with eyes open) and 23% (with eyes closed) of the AS patients compared to only 3% of healthy controls. The results show that it is reasonable to include balance exercises into the training program of AS patients.

A short note on the rubber ball stomach and umbilical extrusion in patients with AS by Prof. Ivo and Zrinka JAJIC from Zagreb, Croatia, has been translated from the ScandinavianJournal of Rheumatology.

Prof. Wolfgang KEITEL regards the scientific life of Adolf Strümpell (1853–1925, medical professor at the universities of Leipzig, Erlangen, Breslau, and Vienna) and how he described, in a lecture book of 1884 on pathology and therapy of internal diseases, our disease among many others, several years before Bechterew (1893) and Marie (1898) described the disease which was almost unknown before and was soon called Strümpell-Marie-Bechterew’s disease thereafter.

Dr. Uwe KAMPEN from the university in Kiel describes the conditions for an AS therapy with Radium-224 from the nuclear-medical point of view.

In October 2000, the 2nd International Con­gress on Spondyloarthropathies took place in Gent. An extended report on the results of this congress is given. Several teams reported first results of family studies in Europe and the US. Another focal point of the congress was the pathomechanism and treatment of psoriatic spondyloarthropathy and of reactive arthritis. Immune-biologic therapies by anti-TNF-alpha injections and other disease-modulating drugs were also extensively discussed. The Ankylosing Spondylitis International Federation (ASIF) and the Flemish VVB had a common stand at this congress.

In the centre of this issue, we publish the German version of the ASIF questionnaire on spinal fractures prepared in cooperation with professor Sjef VAN DER LINDEN, Maastricht. The English version was distributed to all AS societies in December 2000.

DVMB’s new lawyer, J. W. THEUNERT in Hannover, helps our members in difficulties with assurances or authorities and also contributes articles on this subject to our newsletter.

Eleven different week-end seminars organized by DVMB are announced in this issue.

E. Feldtkeller