A team led by Academia Sinica researchers yesterday said that it had solved a mystery surrounding the causes of ankylosing spondylitis, a spinal disease that tends to affect men aged between 20 and 40.
The disease usually starts with inflammation of the pelvic area, extending to the vertebral column, causing severe and chronic pain, Academia Sinica doctoral student Liu Chin-hsiu (劉津秀) told a news conference in Taipei.
The team discovered that the disease is triggered by a genetic pathway linked to a specific enzyme, said the rheumatology and immunology physician at Taipei Tzu Chi Hospital, who seven years ago enrolled in the doctoral program led by Genomics Research Center professor Lin Kuo-i (林國儀) hoping to find better cures for her patients with the disease.
Photo: Chien Hui-ju, Taipei Times
Nearly 70,000 Taiwanese are affected by the disease, three times as many men as women, Liu said.
They rely on anti-inflammation drugs to alleviate the pain and some have undergone spinal surgery, but the disease’s pathogenesis had not been confirmed, except that it might be hereditary, she said.
The team found that an enzyme — tissue-nonspecific alkaline phosphatase (TNAP) — was activated when the HLA-B27 gene triggered a series of abnormal signal transductions, she said.
The gene had previously been linked to the disease, but it was not known how it was caused, Liu said.
After studying 154 serum samples provided by Taipei Tzu Chi Hospital and 184 samples provided by Raj Sengupta at the Royal National Hospital for Rheumatic Diseases in the UK, the team found that TNAP can cause bone spurs and be viewed as a disease progression biomarker, she said.
Given that existing drugs — levamisole and pamidronate — have proven effective in restricting TNAP, they could possibly be utilized to produce drugs that target the spinal disease, she added.
Chen Ing-ho (陳英和) of Hualien Tzu Chi Hospital provided the team with biopsies from his spinal surgeries, while China Medical University physician Hung Shih-chieh (洪士杰) helped to establish mesenchymal stem cells from the tissues, Lin said.
With those samples, the team conducted experiments on mice to observe the generation of pathogenic bone cells and the effect of TNAP, she said.
The team detailed its findings in a paper published in the online version of the Journal of Clinical Investigation on Nov. 4, with Liu listed as the lead author.
Nature Reviews Rheumatology published a peer review of the paper three weeks later.
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