Authors: Laura-Ioana Crînguș1, Alina Elena Ciobanu2, Daniela Ciobanu3, Andrei Adrian Tica1
1 Department of Pharmacology, University of Medicine and Pharmacy of Craiova, Romania
2 University of Medicine and Pharmacy of Craiova, Romania
3 Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Romania
Background. The identification of serum biomarkers associated with the degree of ankylosing spondylitis (AS) can give us a more accurate picture of the evolution, prognosis and future quality of life of these patients.
Aims. The aim of the study was to compare, evaluate and correlate changes in the serum titer of the most important cytokines, interleukin‐17 (IL-17), IL-23, tumor necrosis factor (TNF-α) and IL-6 with a role in the pathogenesis of AS, with the disease activity score and inflammation markers.
Methods. We included in the study 21 patients diagnosed with AS, hospitalized consecutively, according to the Assessment of SpondyloArthritis international Society (ASAS) criteria, who were evaluated in the Rheumatology Clinic, Emergency County Clinical Hospital of Craiova. For the comparative analysis, we included a control group (group C) consisting of 20 subjects with no history of spondylarthritis or autoimmune inflammatory diseases.
Results. For both studied interleukins, IL-17 and IL-23, we obtained significantly higher concentrations in the serum of patients with AS compared to group C. We found that the serum levels of IL-17, IL-23 and IL-6 increased directly proportional to the severity of AS activity, with the highest concentrations in patients with High activity, unlike TNF-α whose serum levels have increased inversely proportional to SA activity, with the highest concentrations in patients with Moderate disease activity. We identified the presence of correlations between AS activity and serum concentrations of the studied interleukins, IL-17 and IL-23 andwe observed that serum levels of IL-17 correlated much better with disease indices used to assess this entity, ASDAS and BASFI, respectively.
Conclusions. Due to the almost 100% specificities obtained for IL-17 and IL-23, we can consider that they can be a diagnostic alternative to the already known cytokines, TNF-α and IL-6 and other scores such as ASDAS, BASDAI and BASFI, which evaluate AS activity. We can also use these cytokines with determined threshold values to differentiate patients with High activity from those with Moderate activity.
Key words: ankylosing spondylitis, Interleukin‐17, Interleukin‐23, disease activity.