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Clinical efficacy of α4 integrin block with natalizumab in ankylosing spondylitis
  1. Francesco Ciccia1,
  2. Aroldo Rizzo2,
  3. Giuliana Guggino1,
  4. Rodolfo Bignone3,
  5. Massimo Galia3,
  6. Giovanni Triolo1
  1. 1Department of Rheumatology, University of Palermo, Palermo, Italy
  2. 2Department of Pathology, Azienda Ospedaliera Villa Sofia-Cervello, Palermo, Italy
  3. 3Department of Radiology, University of Palermo, Palermo, Italy
  1. Correspondence to Professor Giovanni Triolo, Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Piazza delle Cliniche 2, Palermo 90127, Italy; giovanni.triolo{at}unipa.it

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We describe the impact of α4-β1/7 blockade with natalizumab, a recombinant humanised immunoglobulin (Ig) G4κ monoclonal antibody (mAb) targeted to the α4 subunit of the α4β1 and α4β7 integrins, on the gut and spine inflammation in a patient with ankylosing spondylitis (AS) who developed multiple sclerosis after treatment with tumour necrosis factor (TNF)-blocking agents.

A 45-year-old man with human leucocyte antigen (HLA)-B27-positive AS was admitted in January 2007. He had been diagnosed with AS 4 years earlier based on the presence of inflammatory back pain, peripheral arthritis, radiographic bilateral grade 2 sacroiliitis, HLA-B27 positivity. At that time, he had evidence of chronic intestinal inflammation upon histological evaluation of the gut. He was treated with adalimumab for 2 years, achieving a good clinical response. In March 2009, MRI of the brain was performed for the occurrence of …

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