The objective of this study was to investigate the patient-reported outcomes (PROs) and matrix metalloproteinase (MMP) derived extracellular matrix (ECM) biomarkers in non-radiographic (nr)-axial spondyloarthritis (axSpA) and radiographic (r)-axSpA after exercise intervention. Forty-six axSpA patients with stable disease and treatment underwent 24 weeks long exercise intervention. The clinical and laboratory assessments were performed at baseline and at follow-up. The PROs included evaluation of patient's global disease activity (PGDA), disease activity (DA7), pain (PAIN7) and fatigue during last week and quality of life questionnaires. ELISAs for MMP-degraded collagen type II, C-reactive protein (CRPM) and citrullinated vimentin were used. The data of 23 r-axSpA and 19 nr-axSpA were analysed. The PDGA was similar for nr-axSpA (35.2 ± 18.9) and r-axSpA (33.4 ± 22.3) at baseline, improved significantly after intervention (p < 0.01) and the change of PDGA was almost identical for nr-axSpA (- 10.0 ± 15.4) and r-axSpA (- 9.8 ± 11.9). Evaluations of DA7 and PAIN7 were significantly improved only in nr-axSpA (3.5 ± 2.3 and 34.7 ± 25.6 at baseline vs. 2.1 ± 1.9 and 21.0 ± 20.5, respectively, p < 0.01). The decline of DA7 and PAIN7 was more profound, but not significantly in nr-axSpA than in r-axSpA (- 1.4 ± 1.6 and - 13.7 ± 17.4 vs. - 0.5 ± 3.1 and - 3.7 ± 3.3, respectively). The quality of life was not changed. At baseline, increased levels of CRPM were found in r-axSpA (14.85 ± 4.10) compared to nr-axSpA (11.83 ± 3.20), p < 0.05, but all three biomarkers were not influenced by exercise therapy. We found that exercise therapy mainly in the nr-axSpA improves PROs, but not ECM turnover biomarkers. This indicates that exercise therapy is important for patients' health but does not affect ECM turnover.
- MeSH
- biologické markery analýza MeSH
- C-reaktivní protein analýza MeSH
- dospělí MeSH
- hodnocení výsledků péče pacientem * MeSH
- kvalita života MeSH
- lidé MeSH
- matrixové metaloproteinasy analýza MeSH
- peptidové mapování MeSH
- spondylartritida rehabilitace MeSH
- terapie cvičením * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Non-radiographic (nr-axSpA) and radiographic (AS) forms of axial spondyloarthritis (axSpA) share clinical features, but have different radiographic patterns. Radiographic progression is not associated with the current disease activity biomarkers. We investigated a matrix metalloproteinase mediated metabolite of C-reactive protein (CRPM) and two biomarkers of citrullinated vimentin (VICM and anti-MCV) as novel biomarkers of disease activity. METHODS: AxSpA patients (n=121 nr-axSpA and n=72 AS) were characterised by activity (AS disease activity score with CRP [ASDAS-CRP], Bath AS disease activity index [BASDAI] and functional index [BASFI]), radiographic scores and quality of life questionnaires. CRPM, VICM and anti-MCV levels were analysed by ELISA in serum. Asymptomatic controls (n=100) were used as reference. Multiple regression investigated association with disease activity and diagnostic potential. RESULTS: CRPM and VICM levels were increased in AS compared to nr-axSpA (11.9nM vs. 10.2nM, p<0.001 and 4.92nM vs. 3.77nM, p=0.0025). Anti-MCV was similar in both axSpA subgroups, but lowered in controls. In nr-axSpA, CRPM correlated with CRP (ρ=0.33, p<0.001) and VICM (ρ=0.29, p=0.001); in AS, VICM correlated with CRP (ρ=0.34, p=0.0032) and ESR (ρ=0.38, p<0.001). ASDAS-CRP correlated with CRPM and anti-MCV, but when adjusting for CRP the correlation only remained with CRPM. CRPM and VICM separated the subgroups with odds ratios of 1.19 and 1.10 adjusted for age, gender, BMI, and disease duration. VICM lost significance when adjusting for CRP. CONCLUSIONS: CRPM was associated with disease activity in axSpA, and CRPM and VICM separated the axSpA groups. This study indicates that serological biomarkers may be novel biomarkers in axSpA.
