scholarly journals Patients with Ankylosing Spondylitis and Low Disease Activity because of Anti-TNF-Alpha Therapy Have Higher TRAIL Levels Than Controls: A Potential Compensatory Effect

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fernanda Genre ◽  
Raquel López-Mejías ◽  
Javier Rueda-Gotor ◽  
José A. Miranda-Filloy ◽  
Begoña Ubilla ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Systemic Inflammation ◽  
Inverse Correlation ◽  
Chronic Inflammatory Disease ◽  
Compensatory Mechanism ◽  
Infliximab Infusion ◽  
Potential Biomarker ◽  
Marginal Association ◽  
Cv Disease

Objective. TRAIL is a potential biomarker of cardiovascular (CV) disease. Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with metabolic syndrome (MeS) and accelerated atherosclerosis. We assessed whether disease activity, systemic inflammation, and MeS features were associated with circulating TRAIL levels in AS patients undergoing TNF-αantagonist infliximab therapy and if infliximab infusion modified TRAIL levels.Methods. We measured TRAIL serum levels in 30 nondiabetic AS patients without CV disease undergoing anti-TNF-αtherapy, immediately before and after an infliximab infusion, and in 48 matched controls. Correlations of TRAIL levels with disease activity, systemic inflammation and MeS features, adipokines, and biomarkers of endothelial activation were evaluated. Changes in TRAIL levels following anti-TNF-αinfusion were analyzed.Results. TRAIL levels were higher in AS patients than controls. TRAIL levels displayed an inverse correlation with total and LDL cholesterol. We observed an inverse correlation with QUICKI and a marginal association with HOMA-IR. We also found an inverse correlation with resistin and a marginal association with apelin and OPN. Anti-TNF-αinfusion did not change TRAIL levels after 120′.Conclusion. Elevated TRAIL levels in AS patients may be the result of a compensatory mechanism to reduce CV risk in these patients.

scholarly journals IGF-1 and ADMA Levels Are Inversely Correlated in Nondiabetic Ankylosing Spondylitis Patients Undergoing Anti-TNF-Alpha Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fernanda Genre ◽  
Raquel López-Mejías ◽  
Javier Rueda-Gotor ◽  
José A. Miranda-Filloy ◽  
Begoña Ubilla ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Metabolic Syndrome ◽  
Ankylosing Spondylitis ◽  
Growth Factor ◽  
Disease Activity ◽  
Systemic Inflammation ◽  
Inverse Correlation ◽  
Insulin Like Growth Factor ◽  
Nitric Oxide Synthase Inhibitor ◽  
Igfbp 3

Like rheumatoid arthritis, ankylosing spondylitis (AS) is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS) features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1) is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-αantagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA), an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r=-0.397;P=0.04). However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-αtherapy, IGF-1 and ADMA are inversely correlated.

FRI0564 SERUM LEVELS OF IL-6 AND IL-8 IN ANKYLOSING SPONDYLITIS PATIENTS: ASSOCIATIONS WITH DISEASE ACTIVITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 884.1-885
Author(s):  
E. Aleksandrova ◽  
A. Novikov ◽  
P. Kulakova ◽  
A. Dorofeev ◽  
N. Savenkova ◽  
...  
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Heart Diseases ◽  
Elevated Serum ◽  
Serum Levels ◽  
Fecal Calprotectin ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Inflammatory Bowel

Background:Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine and sacroiliac joints characterized by new bone formation (syndesmophytes) and ankyloses. In AS cases, along with the damage to the musculoskeletal system, impairment of other organs and systems is often observed (uveitis, inflammatory bowel and heart diseases). Pro-inflammatory cytokines (TNF-α, IL-6,-17,-23,-21,-22,-31) and chemokines (IL-8) are key pathogenic markers in AS.Objectives:The aims of the study were to determine the serum levels of IL-6 and IL-8 in AS and investigate their relationship with disease activity.Methods:We studied 140 patients (pts) with AS fulfilled modified New York criteria (1984); (102M/38F); median and interquartile range (25th—75th percentile) of age 43.0; 35.0-51.0 years; disease duration 6.0; 4.0-12.0 years; BASDAI - 5.4; 4.1-6.6; ASDAS ESR - 3.6; 2.6-4.4; ASDAS CRP - 3.8; 2.7-4.5; 86% HLA-27 positive. In 50% of pts with AS, inflammatory bowel diseases (IBD) (Crohn’s disease and ulcerative colitis) were diagnosed. The control group included 17 healthy donors (HC). The serum concentrations of IL-6 and IL-8 were detected by chemiluminescence immunoassay using IMMULATE 1000 analyzer (Siemens Healthcare Diagnostics, USA).Results:AS pts had significantly higher serum level of IL-6 than HC (4.3; 0.1-8.0 pg/ml vs 2.3; 0.1-2.7 pg/ml, p <0.006). The median concentration of IL-8 didn’t differ between AS pts and HC (10.5; 8.3-18.0 pg/ml vs 11.9; 8.2-18.3 pg/ml, p>0.05). The same levels of IL-6 and IL-8 were detected in AS with IBD and AS without signs of IBD (p>0.05). In AS pts, serum IL-6 concentration was positively correlated with ASDAS ESR (r = 0.3), ASDAS CRP (r = 0.3), ESR (r = 0.3) and CRP (r = 0.5) (p <0.05); IL-8 was negatively associated with presence of fecal calprotectin (r = -0.3) (p <0.05).Conclusion:Elevated serum concentration of IL-6 in AS is associated with clinical and laboratory markers of high inflammatory activity of the disease. The levels of IL-8 in the sera of AS patients were negatively correlated with the concentration of fecal calprotectin. Data on the relationship of IL-8 with the activity of the pathological process in AS require further study.Disclosure of Interests:Elena Aleksandrova: None declared, Alexander Novikov: None declared, Polina Kulakova: None declared, Aleksey Dorofeev: None declared, Nadezhda Savenkova: None declared, Evgeniy Volnukhin: None declared, Anton Kovshik: None declared, Galina Lukina Speakers bureau: Novartis, Pfizer, UCB, Abbvie, Biocad, MSD, Roche

Evaluation of serum endothelial cell-specific molecule-1 levels and carotid intima-media thickness in patients with ankylosing spondylitis / Ankilozan spodilitli hastalarda serum endothelial cell-specific molecule-1 ve karotis intima media kalınlığının değerlendirilmesi

2016 ◽  
Vol 41 (1) ◽  
Author(s):  
Hakan Türkön ◽  
Ferhat Gökmen ◽  
Sema Uysal ◽  
Ayla Akbal ◽  
Beşir Şahin İnceer ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Media Thickness ◽  
Significant Difference

AbstractObjective: Ankylosing spondylitis (AS) is a chronic inflammatory disease and the increased mortality in these patients is largely caused by cardiovascular diseases. Endothelial cell-specific molecule-1 (ESM-1) is a novel marker to assess endothelial dysfunction and expressed by the vascular endothelium. In this study, the serum ESM-1 levels in patients with AS and the possible association between serum ESM-1 and carotid intima-media thickness (CIMT) as a marker of atherosclerosis was evaluated.Methods: A total of thirty-seven patients with AS and thirty healthy control subjects were included in this study. ESM-1, erythrocyte sedimentation rate(ESR),C-reactive protein (CRP) and CIMT were measured in all subjects. ESM-1 levels were measured by ELISA method. The disease activity of patients with AS were assessed using questionnaires Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: Serum ESM-1 levels were lower in AS patients than in healthy controls. However, there was no statistically significant difference between ESM-1 levels (304.3±185.2 vs. 373.9±206.9 ng/L, respectively; p=0.064). Patients with AS had significantly higher CIMT levels compared with controls (0.77±0.16 vs. 0.53±0.09 mm, respectively; p<0.001). While a statistically significant positive correlation was detected in all subjects between CIMT levels and ESR, CRP (r=0.378, p=0.002, r=0.547, p<0.001, respectively), no significant correlation was detected between serum ESM-1 levels and ESR, CRP, BASDAI, BASFI and CIMT.Conclusion: The results showed that CIMT values in AS patients were increased when compared to control group. There was no correlation among ESM-1 levels, disease activity and CIMT. In order to reveal the pathological role of the ESM-1 levels in patients with AS need more studies.

scholarly journals The Role of Clinical and Ultrasound Enthesitis Scores in Ankylosing Spondylitis

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 218
Author(s):  
Alesandra Florescu ◽  
Vlad Pădureanu ◽  
Dan Nicolae Florescu ◽  
Anca Bobircă ◽  
Lucian-Mihai Florescu ◽  
...  
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Clinical Score ◽  
Chronic Inflammatory Disease ◽  
Joint Involvement ◽  
History Of ◽  
Research Consortium

Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease, part of the spondyloarthritis (SpA) group, characterized by axial (spine and sacroiliac joints), entheseal, and peripheral joint involvement, which is frequently associated with extra-articular manifestations. Material and Methods: The study included a number of 30 patients diagnosed with AS according to the New York modified criteria, with history of entheseal pain, hospitalized between 2016–2018 in the Department of Rheumatology of the Emergency County Hospital of Craiova. Results: Regarding the Belgrade Ultrasound Enthesitis Score (BUSES) score and the disease activity calculated using the Ankylosing Spondylitis Disease Activity Score (ASDAS), they did not show a statistically significant association (p = 0.738). Additionally, BUSES did not have a statistically significant association with the disease activity quantified by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (p = 0.094). The Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC) clinical score was not statistically associated with ASDAS (p = 0.434) nor with BASDAI (p = 0.130). The SPARCC clinical score and the BUSES ultrasound score were statistically significantly associated, registering a value of p = 0.018. Conclusions: Our study proved a significant correlation between SPARCC and BUSES, although in literature the evidence is contrasting.

scholarly journals Long noncoding RNA intersectin 1-2 gradually declines during adalimumab treatment, and its reduction correlates with treatment efficacy in patients with ankylosing spondylitis

2021 ◽  
Author(s):  
Mingwu Li ◽  
Xianjie Zhou
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Treatment Efficacy ◽  
Long Noncoding Rna ◽  
Noncoding Rna ◽  
Disease Risk ◽  
Quantitative Polymerase Chain Reaction ◽  
Potential Biomarker ◽  
Adalimumab Treatment ◽  
Tnfα Inhibitor

AbstractPrevious studies show that long noncoding RNA intersectin 1-2 (lnc-ITSN1-2) promotes the inflammation process and serves as a potential biomarker in autoimmune diseases, except for ankylosing spondylitis (AS). Therefore, this study aimed to explore the correlation of baseline lnc-ITSN1-2 expression with disease risk and activity of AS, and to investigate its longitudinal change with treatment response to a tumour necrosis factor alpha (TNFα) inhibitor in patients with AS. In total, 63 patients with AS receiving 12-week adalimumab treatment were included and their baseline clinical features were collected. Lnc-ITSN1-2 expression in peripheral blood mononuclear cells (PBMC) of patients with AS was detected by reverse transcription quantitative polymerase chain reaction. Meanwhile, Assessment in Spondyloarthritis International Society (ASAS) 40 response was evaluated at week 2 (W2), W4, W8, and W12. According to the ASAS40 response status at W12, patients with AS were classified into responders and non-responders. PBMC lnc-ITSN1-2 expression was also determined in healthy controls (N = 60). Lnc-ITSN1-2 expression was elevated in patients with AS compared to controls (P < 0.001). Baseline lnc-ITSN1-2 expression was positively associated with C-reaction protein (CRP) (P = 0.021), interleukin (IL)-1β (P = 0.020), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (P = 0.040), and Ankylosing Spondylitis Disease Activity score with C-reactive protein (ASDASCRP) (P = 0.045) in patients with AS. Furthermore, lnc-ITSN1-2 expression declined during the treatment with adalimumab (P < 0.001). Notably, this reduction was more obvious in responders than non-responders. In conclusion, declined lnc-ITSN1-2 expression during the TNFα inhibitor treatment correlates with good treatment efficacy in patients with AS, suggesting its clinical value for AS management.

scholarly journals FRI0285 FILGOTINIB TREATMENT RESULTS IN REDUCTION OF BIOMARKERS ASSOCIATED WITH DISEASE IN PATIENTS WITH ANKYLOSING SPONDYLITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 730.2-731
Author(s):  
W. P. Maksymowych ◽  
Y. Tian ◽  
O. K. Yoon ◽  
W. Barchuk ◽  
R. Galien ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Systemic Inflammation ◽  
Clustering Analysis ◽  
Rank Correlation ◽  
Spearman Rank Correlation ◽  
Serum Samples ◽  
Spearman Rank ◽  
Time Points ◽  
Meso Scale

Background:Ankylosing spondylitis (AS) is a chronic, immune-mediated disease characterized by inflammation of the sacroiliac joints and spine, and a young age of onset of 20–40 years. In the recent TORTUGA study, filgotinib (FIL), an oral, selective Janus kinase 1 (JAK1) inhibitor, significantly reduced AS disease activity compared with placebo (PBO).1Selective JAK1 inhibition by FIL has the potential to simultaneously block multiple inflammatory pathways, thus we analyzed biomarker concentrations in serum samples from TORTUGA.Objectives:To evaluate the impact of selective JAK1 inhibition with FIL on circulating disease associated biomarkers in adult patients with active AS enrolled in the TORTUGA study.Methods:TORTUGA (Clinicaltrials.gov identifierNCT03117270) was a 12-week, randomized, double-blind, placebo-controlled, phase 2 study. Patients were randomized 1:1 to FIL 200 mg (n=58) or PBO (n=58) once-daily. Serum samples (FIL n=56, PBO n=53) were collected at baseline (BL) and weeks 1, 4 and 12, and analyzed using the Meso Scale Discovery immunoassay platform (Meso Scale Diagnostics, Rockville, MD, USA) to evaluate 135 biomarkers. Biomarker concentration changes from BL were analyzed on paired patient data and reported for weeks 1, 4 and 12, and clustering analysis was performed. Correlation between the 135 biomarkers and selected clinical scores at BL was assessed by Spearman rank correlation analysis.Results:FIL treatment produced significant reductions in serum concentrations of multiple biomarkers associated with AS disease activity. Five clusters of biomarker response were identified based on the kinetics and magnitude of percent changes from BL. These clusters also represented discrete biological functions: cluster 1 (rapid, strong >50% decrease in all three time points) included systemic inflammation biomarkers eg, CRP, SAA; cluster 2 (>20% decrease in at least one time point) included immune cell biomarkers eg, MIP3B, IL12p40; cluster 3 (<20% decrease in all three time points) included cellular adhesion biomarkers eg, ICAM-1, VCAM-1; cluster 4 (delayed decrease) included matrix remodelling biomarkers eg, MMP1, TIMP1; and cluster 5 included biomarkers that exhibited a gradual increase in serum concentration with FIL treatment.Spearman rank correlation analyses showed that at BL, the systemic inflammation biomarkers CRP and SAA, as well as a number of biomarkers including ICAM-1 and MMP3, were positively correlated with BL AS disease activity score (ASDAS); conversely, only a few biomarkers showed a negative correlation with BL ASDAS, the cytokine receptor FLT3 and the chemotactic cytokine fractalkine (FRACTAL).Conclusion:In patients with active AS, FIL treatment significantly decreased levels of circulating biomarkers associated with active AS disease, including proinflammatory cytokines and chemokines, cell adhesion molecules, and markers of matrix remodelling. Clustering analysis revealed early and late biomarker changes associated with disease. These data are consistent with reduced AS disease activity in TORTUGA and suggest that FIL treatment leads to a rapid and sustained reduction of inflammation in AS.References:[1]van der Heijde Det al. Lancet2018;392:2378–87Acknowledgments:This study was funded by Gilead Sciences, Inc. Editorial support was provided by Fishawack Communications Inc and funded by Gilead Sciences, Inc.Disclosure of Interests:Walter P. Maksymowych Grant/research support from: AbbVie, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB, Employee of: Chief Medical Officer of CARE Arthritis Limited, Speakers bureau: AbbVie, Janssen, Novartis, Pfizer, and UCB, Yuan Tian Employee of: Gilead Sciences Inc., Oh Kyu Yoon Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., William Barchuk Shareholder of: Gilead Sciences Inc and Eli Lilly, Employee of: Current employee of Gilead Sciences Inc and a former employee of AbbVie, Eli Lilly, and Johnson & Johnson, René Galien Shareholder of: Galapagos, Employee of: Galapagos, Robin Besuyen Shareholder of: Galapagos, Employee of: Galapagos, Yihua Liu Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., Amer M. Mirza Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., Vlad Malkov Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., Angie Hertz Shareholder of: Gilead Sciences Inc, Employee of: Gilead Sciences Inc

scholarly journals AB0693 TIM-3-EXPRESSING NEUTROPHILS AS A NOVEL INDICATOR TO ASSESS DISEASE ACTIVITY AND SEVERITY IN ANKYLOSING SPONDYLITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1641.1-1642
Author(s):  
X. Huang ◽  
T. Li ◽  
J. Chen ◽  
Y. Wang ◽  
S. Chen ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Immune Cells ◽  
Inflammatory Responses ◽  
Clinical Manifestations ◽  
Chronic Inflammatory Disease ◽  
Innate Immune ◽  
Innate Immune Cells ◽  
Bacterial Killing ◽  
Markers Of Inflammation

Background:Ankylosing spondylitis (AS) is a type of chronic inflammatory disease that compromises the axial skeleton and sacroiliac joints. Many studies have shown that neutrophils play an important roles in the inflammatory process of AS. However, the immunomodulatory roles and mechanisms of neutrophils in AS are poorly understood. T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) has been reported as an important regulatory molecule, expressed and regulated on different innate immune cells, plays a pivotal role in several autoimmunity diseases. Recent study indicates that Tim3 is also expressed on neutrophils. However, the frequency and roles of Tim3-expressing neutrophils in AS was not clear.Objectives:In this study, we investigated the expression of Tim3 on neutrophils in AS patients and analyzed the correlation between the level of Tim3-expressing neutrophils and the disease activity of AS.Methods:AS Patients were recruited from Guangdong Second Provincial General Hospital (n=49). Age/sex-matched volunteers as Healthy controls (HC) (n=39). The medical history, clinical manifestations, physical examination, laboratory measurements were recorded. The expression of costimulatory molecules including programmed death 1 (PD-1), Tim-3 on neutrophils were determined by flow cytometry. The frequencies of Tim3-expressing neutrophils in AS patients were further analyzed for their correlation with markers of inflammation ESR and CRP, disease activity and severity of AS.Results:The expression of Tim3 on neutrophils in patients with AS was increased compared to the HC (Figure 1A). The frequency of Tim3-expressing neutrophils in patients with AS showed an positive correlation with ESR, CRP and ASAS-endorsed disease activity score (ASDAS) (Figure 1B). Moreover, the frequency of Tim3-expressing neutrophils in active patients(ASDAS≥1.3) was increased as compare with the inactive patients (ASDAS<1.3) (Figure 1C).Conclusion:Increased Tim-3 expression on neutrophils may be a novel indicator to assess disease activity and severity in AS, which may serves as a negative feedback mechanism preventing potential tissue damage caused by excessive inflammatory responses in AS patients.References:[1]Han, G., Chen, G., Shen, B. & Li, Y., Tim-3: an activation marker and activation limiter of innate immune cells.FRONT IMMUNOL4449 (2013).[2]Vega-Carrascal, I.et al., Galectin-9 signaling through TIM-3 is involved in neutrophil-mediated Gram-negative bacterial killing: an effect abrogated within the cystic fibrosis lung.J IMMUNOL1922418 (2014).Figure 1.(A)The expression of Tim3 on neutrophils in AS and HC.(B)The correction between Tim3-expressing neutrophils and ESR,CRP,ASDAS.(C) The expression of Tim3 on neutrophils in active and inactive patients.Disclosure of Interests:None declared

scholarly journals AB0720 SOLUBLE TRANSFERRIN RECEPTOR IN DIAGNOSIS OF IRON DEFICIENCY ANEMIA IN PATIENTS WITH SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1655.1-1655
Author(s):  
K. Safarova ◽  
A. Rebrov
Keyword(s):  
Chronic Disease ◽  
Ankylosing Spondylitis ◽  
Iron Deficiency ◽  
Serum Concentration ◽  
Disease Activity ◽  
Iron Deficiency Anemia ◽  
Systemic Inflammation ◽  
Deficiency Anemia ◽  
Anemia Of Chronic Disease ◽  
Absolute Iron Deficiency

Background:Anemia is a frequent hematological disorder in patients with rheumatic diseases. The main pathogenetic variants of anemia are anemia of chronic disease (ACD), iron deficiency anemia (IDA), and anemia of chronic disease with iron deficiency (ACD/IDA). The presence of systemic inflammation hinders to diagnose absolute iron deficiency, because standard tests of iron status are affected by it. Soluble transferrin receptors (sTfR) measurement and the calculation of the sTfR/ log ferritin index (sTfR index) are recommended, but data about diagnostically significant levels of these indicators in patients with spondyloarthritis (SpA) is currently limited.Objectives:To assess the diagnostic significance of sTfR and the sTfR index for detecting absolute iron deficiency in patients with SpA and anemia.Methods:Complete blood count, standart iron metabolism parameters, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were evaluated in 68 patients with SpA. Serum concentration of sTfR was measured with enzyme-linked immunosorbent assay (ELISA) using sTfR ELISA kit («Monobind Inc.», USA). The sTfR index was calculated by the formula sTfR/log10ferritin. Anemia was defined using the World Health Organization criteria. Depending on the serum ferritin concentration, transferrin saturation, and CRP level, ACD, IDA, or combined anemia (ACD/IDA) were diagnosed. Disease activity was determined by the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score based on CRP) scales. Receiver operating characteristic (ROC) analysis was performed with MedCalc.Results:Anemia was found in 48 of 68 (70,6%) SpA patients. 16 (33,3%) patients had ACD and 32 (66,7%) had ACD/IDA. Hemoglobin level in ACD was 118 [112; 123] g/L, in ACD/IDA – 110 [106; 120] g/L, in non-anemic patients – 133 [129; 145] g/L (p<0.001 for all groups). CRP and ESR values were higher in ACD compared to ACD/IDA patients (31.5 [20.3; 46.4] mg/L and 27.0 [16.0; 35.5] mm/h versus 9.8 [5.6; 16.9] mg/L and 15.5 [12.0; 22.5] mm/h, respectively [p=0.00 and p=0.038]). No statistically significant difference was found between all groups in BASDAI and ASDAS-CRP scores.ACD/IDA patients had significant increases in serum sTfR levels (1.7 [1.4; 2.2] mg/L) compared to ACD (1.5 [1.1; 1.7] mg/L, p=0,04) and to non-anemic patients (1,3 [1,1; 1,6] mg/L, p=0,003). The sTfR index was significantly higher in ACD/IDA (0.93 [0.82; 1.24]) compared to patients with ACD (0.64 [0.48; 0.75], p<0.001) and without anemia (0.67 [0.56; 0.81], p<0.001).The areas under the curves (AUCs) for distinguishing between ACD/IDA and ACD were 0.85 for sTfR index (p<0,001), 0.72 for sTfR (p<0,001). The sTfR index (cutoff >0.83) and sTfR (cutoff >1.39 mg/L) had sensitivities of 75% and 53%, and specificities of 83% and 81%, respectively.Conclusion:According to obtained data, serum concentration of sTfR >1.39 mg/L and the sTfR index >0.83 point to the presence of iron deficiency component in the structure of anemic syndrome in patients with SpA.References:Management of patients with SpA requires constant monitoring of side effects of therapy, in particular induced by the non-steroidal anti-inflammatory drugs. Use of sTfR and the sTfR index can improve the detection of IDA. A significant advantage of these indicators is their independence from systemic inflammation.Disclosure of Interests:None declared

Investigating the Link between Psoriasis and Cardiovascular Disease: Current Evidence, Therapeutic Implications and Perspectives

2020 ◽  
Vol 18 (6) ◽  
pp. 592-609 ◽  
Author(s):  
Eirini Kapniari ◽  
Prokopios Papadimitriou ◽  
Marianna Dalamaga ◽  
George Makavos ◽  
Stefano Piaserico ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Systemic Inflammation ◽  
Chronic Inflammatory Disease ◽  
Biologic Agents ◽  
The Body ◽  
Current Evidence ◽  
Therapeutic Implications ◽  
Underlying Mechanisms ◽  
Cv Disease ◽  
The Relationship

Psoriasis; a chronic inflammatory disease is characterized by symmetric hyperkeratotic plaques affecting any part of the body. Psoriasis is nowadays considered as a systemic inflammation linked with several comorbidities as metabolic syndrome, depression, anxiety and increased prevalence of cardiovascular (CV) disease. The hypothesis that psoriasis is an independent CV risk factor leading to atherosclerosis via inflammation is now widely accepted. Deciphering the underlying mechanisms interconnecting psoriasis and CV disease may have significant implications in treatment decisions. Accumulating evidence suggests that systematic therapies and recently introduced biologic agents, that control psoriasis by suppressing the chronic and systemic inflammation, may alter the progression of CV disease. We herein attempt a review of current evidence analysing the relationship between psoriasis and CV comorbidities, comment on the mechanisms underlying this association and investigate the consequences for the management of psoriasis.

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