A 22-year-old woman comes to the office because of a 6-month history of increasing neck and low back pain that is most severe in the morning. Her pain improves as the day passes. The patient has no history of trauma, rashes, or urinary symptoms. Vital signs are within normal limits. Examination shows tenderness over the lumbosacral area and at the insertion site of the Achilles tendon. Forward flexion is reduced. This patient's symptoms are most likely attributable to upregulation of which of the following cytokines?

Question

A 22-year-old woman comes to the office because of a 6-month history of increasing neck and low back pain that is most severe in the morning.  Her pain improves as the day passes.  The patient has no history of trauma, rashes, or urinary symptoms.  Vital signs are within normal limits.  Examination shows tenderness over the lumbosacral area and at the insertion site of the Achilles tendon.  Forward flexion is reduced.  This patient's symptoms are most likely attributable to upregulation of which of the following cytokines?

Quizplus · Accepted Answer

Eductional Objective: The pathogenesis of ankylosing spondylitis likely originates with defects in the intestinal mucosal barrier and exposure to the gut microbiome that lead to an enhanced IL-17-mediated inflammatory response.  IL-17 stimulates production of additional inflammatory factors, primarily tumor necrosis factor-alpha and prostaglandins, which have synergistic proinflammatory effects and induce bony erosions and abnormal bone regrowth in the skeleton.

A 22-Year-Old Woman Comes to the Office Because of a 6-Month