Ankylosing Spondylitis is NOT a Greek Tennis Player

Ankylosing Spondylitis (AS) is one of a group of auto-immune disorders (commonly referred to as Rheumatic Arthritis) called spondyloarthopathies.

AS is a kissing cousin of Crohn's Disease, Psoriatic Arthritis and Reactive Arthritis. They are linked by a common blood antigen, or marker, called HLA-B27, which is present in about 95% of patients.

What does it do?

What happens is that the immune system, through a process that researchers don't fully understand, encounters healthy cells, but thinks that they are unhealthy. The auto-immune system then sets out to destroy the "unhealthy" cells.

In all of the spondyloarthopathies, the auto-immune system does this through a process called inflammation. In the case of AS it attacks, primarily, the spine, causing all the soft mushy bits (a highly scientific term for the soft tissue that connects the vertebrae, and even the discs themselves) to turn into bone.

The inflammation process is very painful, and the end result is a loss of mobility, as the joints in the spine are fused and can no longer move.

People with Ankylosing Spondylitis often suffer from secondary inflammation, involving the bowel, shoulders and hips. They will often suffer from inflammation of the eyes (iritis or uveitis), and the disease can, in severe cases, damage the heart and lungs.

AS is a disease of flares and remissions, and patients may go through periods of feeling well, followed by periods of intense disease activity.

Ankylosing Spondylitis is a very variable disease. Many people, especially women, experience a very mild form that manifests only as low back pain. Others, such as myself, will develop a more severe form that results in a gross loss of mobility.

How is it treated?

For many years the only form of treatment was a class of drugs called NSAIDS (non-steroidal anti-inflammatory drugs) like Indocid and Naproxen. Their effectiveness was limited, and they often caused long term damage to the patient taking them.

A new class of drugs called TNF-Alpha Inhibitors (such as Enbrel, Humira and Remicade) have come on the scene in the past few years, which are much more effective. They work by shutting down a very narrow part of the auto-immune system, and reducing the inflammatory effects of the disease.