Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that affects the spine and sacroiliac joints. Early detection of axSpA is crucial to slow disease progression and maintain remission or low disease activity. However, current biomarkers are insufficient for diagnosing axSpA or distinguishing between its radiographic (r-axSpA) and non-radiographic (nr-axSpA) subsets. To address this, we conducted a study using miRNA profiling with massive parallel sequencing (MPS) and SmartChip qRT-PCR validation. The goal was to identify differentially expressed miRNAs in axSpA patients, specifically those subdiagnosed with nr-axSpA or r-axSpA. Disease activity was measured using C-reactive protein (CRP) and the Ankylosing Spondylitis Disease Activity Score (ASDAS). Radiographic assessments of the cervical and lumbar spine were performed at baseline and after two years. Out of the initial 432 miRNAs, 90 met the selection criteria, and 45 were validated out of which miR-1-3p was upregulated, whereas miR-1248 and miR-1246 were downregulated in axSpA patients. The expression of miR-1-3p correlated with interleukin (IL)-17 and tumour necrosis factor (TNF) levels, indicating its significant role in axSpA pathogenesis. Although specific miRNAs distinguishing disease subtypes or correlating with disease activity or spinal changes were not found, the study identified three dysregulated miRNAs in axSpA patients, with miR-1-3p linked to IL-17 and TNF, underscoring its pathogenetic significance. These findings could help improve the early detection and treatment of axSpA.
- Publikační typ
- časopisecké články MeSH
Pojem spondyloartritidy (SpA) zahrnují zánětlivá revmatická onemocnění postihující převážně axiální skelet. Na základě predominantního postižení osového či periferního skeletu rozlišujeme spondyloartritidy periferní a axiální. Axiální forma se vyznačuje zánětlivou bolestí zad vzniklou do 45. roku věku. Dále rozlišujeme u axiálních spondyloartritid formu radiografickou, kdy je přítomna sakroiliitida na RTG snímku, a formu neradiografickou, kdy sakroiliitida je zachycena pouze na MR sakroiliakálního skloubení.Mezi extraspinální manifestace spondyloartritid řadíme periferní artikulární projevy, entezitidy, dále postižení kůže, oka a střev (psoriáza, uveitida, nespecifický střevní zánět). Kromě těchto projevů přímo spjatých se SpA vídáme některá další onemocnění častěji než v běžné populaci (tzv. komorbidity). Mezi nejdůležitější komorbidity u spondyloartritid řadíme osteoporózu, kardiovaskulární onemocnění, onemocnění plic, infekce, malignity, peptické vředy a deprese. Z rizikových faktorů kardiovaskulárních onemocnění hraje důležitou roli arteriální hypertenze, kouření, dyslipidemie a diabetes. Výskyt komorbidit je úzce spjat s aktivitou a délkou trvání základního onemocnění, funkčním postižením a mortalitou. Screening a péče o komorbidity u pacientů se SpA by měly být v rámci optimalizace péče o pacienta stejně důležité, jako terapie základního onemocnění.
The term spondyloarthritis (SpA) includes inflammatory rheumatic diseases affecting mainly the axial skeleton. Based on the predominant involvement of the axial or peripheral skeleton, we distinguish between peripheral and axial spondyloarthritis. The axial form is characterized by inflammatory back pain developing before the age of 45. In axial spondyloarthritis, we further distinguish between the radiographic form, when sacroiliitis is present on the X-ray image, and the non-radiographic form, when sacroiliitis is captured only on MRI of the sacroiliac joint. Extraspinal manifestations of spondyloarthritis include peripheral articular manifestations, enthesitis, as well as skin, eye, and intestinal involvement (psoriasis, uveitis, inflammatory bowel disease). In addition to these manifestations directly related to SpA, we see some other diseases more often than in the general population (so-called comorbidities). The most important comorbidities in spondyloarthritis include osteoporosis, cardiovascular disease, lung involvement, infections, malignancies, peptic ulcers, and depression. Among the risk factors for cardiovascular diseases, arterial hypertension, smoking, dyslipidemia, and diabetes play an important role. The occurrence of comorbidities is closely Komorbidity u spondyloartritid Adresa pro korespondenci: MUDr. Kateřina Mintálová Revmatologický ústav Na Slupi 4 128 50 Praha 2 e-mail: mintalova@revma.cz Autorka prohlašuje, že není v konfliktu zájmů. Do redakce doručeno: 31. 7. 2022 Čes. Revmatol. 2022; 30(3): 106–113 Mintálová K. Revmatologický ústav Praha 107 related to the activity and duration of the underlying disease, functional disability, and mortality. Screening and care for comorbidities in patients with SpA should be as important as therapy for the underlying disease in optimizing patient care.
- MeSH
- ankylózující spondylitida * MeSH
- komorbidita * MeSH
- lidé MeSH
- spondylartritida * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: Acute anterior uveitis (AAU) is a relatively common extra-musculoskeletal manifestation of axial spondyloarthritis (axSpA); however, data on the prevalence of active sacroiliitis in patients with AAU are limited. METHODS: 102 patients with AAU and 39 healthy subjects (HS) underwent clinical assessment and sacroiliac joint MRI. Patients with absence of active sacroiliitis were reassessed after two years. International Spondyloarthritis Society (ASAS) classification criteria for axSpA (regardless of patient's age) and expert opinion for definitive diagnosis of axSpA were applied. RESULTS: Although chronic back pain was equally present in both groups, bone marrow edema (BME) in SIJ and BME highly suggestive of axSpA was found in 52 (51%) and in 33 (32%) patients with AAU compared with 11 (28%) and none in HS, respectively. Out of all AAU patients, 41 (40%) patients fulfilled the ASAS classification criteria for axSpA, and 29 (28%) patients were considered highly suggestive of axSpA based on clinical features. Two out of the 55 sacroiliitis-negative patients developed active sacroiliitis at the two-year follow-up. CONCLUSIONS: One-third of patients with AAU had active inflammation on SIJ MRI and clinical diagnosis of axSpA. Therefore, patients with AAU, especially those with chronic back pain, should be referred to a rheumatologist, and the examination should be repeated if a new feature of SpA appears.
- Publikační typ
- časopisecké články MeSH
Aim: Heat shock protein 90 (Hsp90) is a molecular chaperone regulating immune response. We aimed to assess systemic Hsp90 as a biomarker for spondyloarthritis (SpA). Materials & methods: Total of 80 axial SpA (axSpA) and 22 psoriatic arthritis patients and a corresponding number of age- and sex-matched healthy controls (HC) were included. Plasma Hsp90 levels were measured by ELISA. Results: Hsp90 was significantly increased in axSpA patients compared with HC (median interquartile range: 15.7 [10.5-19.8] vs 8.3 [6.6-11.8] ng/ml, p < 0.001). Moreover, Hsp90 was superior to C-reactive protein in differentiating axSpA (and both radiographic axSpA [r-axSpA] and nonradiographic-axSpA) from HC. Hsp90 levels correlated with bone marrow edema of sacroiliac joints in r-axSpA patients (r = 0.594, p = 0.019). Conclusion: Hsp90 could become a biomarker for active inflammation in r-axSpA, and can better distinguish axSpA patients from healthy subjects than C-reactive protein.
- MeSH
- C-reaktivní protein MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- proteiny tepelného šoku MeSH
- průřezové studie MeSH
- spondylartritida * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
- Publikační typ
- tisková chyba MeSH
This study aimed to examine serum tenascin C (TNC) in different subsets of axial spondyloarthritis (axSpA) patients. Sixty-one patients fulfilling the Assessment of SpondyloArthritis international Society classification criteria for axSpA and 20 healthy subjects (HS) were included in study. Based on imaging, patients were classified as non-radiographic (n=16) and radiographic (n=45) axSpA. TNC serum levels were determined by ELISA. Disease-related factors including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C-reactive protein (CRP) levels, were determined. TNC levels were elevated in axSpA patients [535.3 (457.7-677.2) ng/ml] compared to HS [432.1 (329.1-565.9) ng/ml, p=0.007]. Dividing axSpA into radiographic and non-radiographic subsets, the difference in TNC was observed between the radiographic subset and HS [535.3 (434.5-677.2) vs. 432.1 (329.1-565.9) ng/ml, p=0.022]. TNC levels did not correlate with disease activity measures (serum CRP or BASDAI). Nevertheless, the weak correlation of TNC levels with different disease stages (r=0.25, p=0.025) was found, with the highest levels in patients with syndesmophytes. TNC levels are elevated across various subsets of axSpA, and although not related to systemic disease activity, TNC levels might reflect chronic structural spinal changes in axSpA patients. However, its specific role in bone metabolism should be elucidated in further studies.
Local inflammation in axial spondyloarthritis (axSpA) leads to the release of collagen metabolites from the disease-affected tissue. We investigated whether collagen metabolites were associated with disease activity and could distinguish non-radiographic(nr)-axSpA from ankylosing spondylitis (AS). A total of 193 axSpA patients (nr-axSpA, n = 121 and AS, n = 72) and asymptomatic controls (n = 100) were included. Serum levels of metalloproteinase (MMP)-degraded collagen type I (C1M), type II (C2M), type III (C3M) and type IV (C4M2) were quantified by enzyme-linked immunosorbent assay (ELISA). All metabolites were higher in axSpA than in controls (all p < 0.001). Serum levels of C1M, C3M, and C4M2 were increased in AS compared to nr-axSpA (43.4 ng/mL vs. 34.6; p < 0.001, 15.4 vs. 12.8; p = 0.001, and 27.8 vs. 22.4; p < 0.001). The best metabolite to differentiate between axSpA and controls was C3M (AUC 0.95; specificity 92.0, sensitivity 83.4). C1M correlated with ASDAS-CRP in nr-axSpA (ρ = 0.37; p < 0.001) and AS (ρ = 0.57; p < 0.001). C1M, C3M, and C4M2 were associated with ASDAS-CRP in AS and nr-axSpA after adjustment for age, gender, and disease duration. Serum levels of collagen metabolites were significantly higher in AS and nr-axSpA than in controls. Moreover, the present study indicates that collagen metabolites reflect disease activity and are useful biomarkers of axSpA.
- MeSH
- ankylózující spondylitida krev diagnóza MeSH
- biologické markery krev MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- fibrilární kolageny metabolismus MeSH
- kolagen typ II metabolismus MeSH
- kolagen typ III metabolismus MeSH
- kolagen typu I metabolismus MeSH
- kolagen typu IV metabolismus MeSH
- lidé MeSH
- spondylartritida krev diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- B-lymfocyty účinky léků MeSH
- humanizované monoklonální protilátky aplikace a dávkování farmakologie MeSH
- injekce intravenózní MeSH
- injekce subkutánní MeSH
- intravenózní podání MeSH
- lidé MeSH
- nežádoucí účinky léčiv MeSH
- systémový lupus erythematodes * farmakoterapie imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinické zkoušky kontrolované MeSH
- pozorovací studie MeSH
OBJECTIVE: This study compared demographic, clinical and laboratory characteristics between patients with radiographic and non-radiographic axial spondyloarthritis (axSpA). METHODS: In this single-centre cross-sectional study, a total of 246 patients with axSpA fulfilling the imaging arm of Assessment of SpondyloArthritis International Society classification criteria were recruited. A total of 140 patients were diagnosed as non-radiographic axial spondyloarthritis (nr-axSpA), and 106 patients had ankylosing spondylitis (AS). Sociodemographic characteristics, disease manifestations, clinical and laboratory disease activity and their differences between subsets were analysed. P values below 0.05 with CI 95% were considered statistically significant. RESULTS: More nr-axSpA patients were women (61.4%) compared with 24.7% of AS patients. First symptoms developed earlier in AS patients compared with nr-axSpA (23.0 (IQR 17.5-30.0) vs 27.8 (IQR 21.0-33.7) years, p=0.001). Disease manifestations did not differ, but patients with nr-axSpA experienced peripheral arthritis more frequently (35.7% vs 17.0%, p=0.001) with less hip involvement (8.6% vs 18.9%, p=0.022) compared with patients with AS. Patients with AS exhibited worse spinal mobility and physical function compared with nr-axSpA. AS Disease Activity Scores and CRP levels were significantly higher in patients with AS compared with nr-axSpA (2.4 (IQR 1.7-2.8) vs 2.0 (IQR 1.1-2.3), p=0.022 and 7.1 (IQR 2.6-14.9) vs 2.5 (IQR 0.8-8.2) mg/L, p<0.001, respectively). CONCLUSIONS: Our data demonstrated some known and also novel differences between the two imaging arm fulfilling axSpA subgroups. Non-radiographic patients were mostly women who had experienced shorter disease duration, milder disease activity and better functional status with less hip involvement but more peripheral arthritis compared with patients with AS.
- MeSH
- ankylózující spondylitida diagnóza epidemiologie patologie MeSH
- C-reaktivní protein metabolismus MeSH
- dospělí MeSH
- kohortové studie MeSH
- lidé MeSH
- páteř patologie MeSH
- prevalence MeSH
- průřezové studie MeSH
- rentgendiagnostika MeSH
- rozsah kloubních pohybů MeSH
- sexuální faktory MeSH
- společnosti lékařské MeSH
- spondylartritida klasifikace diagnóza epidemiologie patologie MeSH
- stupeň závažnosti nemoci * MeSH
- tělesná a funkční výkonnost MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
