Exploration of Multidimensional Treatment for Ankylosing Spondylitis: From Traditional Medications to Emerging Immune-Targeted Perspectives.

Ankylosing spondylitis (AS) is a chronic immune-mediated disease involving persistent inflammation of the axial skeleton and peripheral joints, often progressing to spinal deformity and irreversible ankylosis. Current therapeutic strategies, primarily non-steroidal anti-inflammatory drugs and biologic agents, focus on symptomatic relief and inflammation suppression. However, these treatments fail to halt long-term structural progression or prevent bone fusion. Recently, advanced immunotherapies, including mesenchymal stem cell (MSC) transplantation and chimeric antigen receptor (CAR)-based therapies, have been proposed as emerging exploratory strategies. While these modalities offer the theoretical potential for deep immune remodeling and might influence pathological ossification, their application in AS remains largely extrapolated from other autoimmune diseases. It is crucial to note that while traditional therapies are supported by robust clinical evidence, advanced targeted cellular immunotherapies in AS are currently in preclinical or early exploratory stages with limited direct clinical data. Globally, AS exerts a substantial socioeconomic burden, affecting young adults and requiring more effective disease-modifying interventions. Unlike existing reviews focused primarily on standard pharmaceutical updates, this article provides a novel synthesis by connecting AS immunopathogenesis with the translational potential of precision cellular engineering, offering a roadmap for future clinical research.