Lange U, Teichmann J, Stracke H
Kerckhoff Clinic and Foundation, Department of Rheumatology, University Giessen, Ludwig Str. 37-39, D-61231 Bad Nauheim, Germany.
Eur J Med Res. 2000 Dec 29;5(12):507-11.
In patients with established ankylosing spondylitis (AS) and a healthy control group, plasma levels of IGF-1 and TNF-alpha as well as possible connections with biochemical markers of the bone metabolism, humoral inflammatory activity (ESR, CRP), clinical manifestations, and an established clinical activity score (Bath Ankylosing Spondylitis Activity Index = BASDAI) were examined. In AS-patients (men and women) significantly increased TNF-alpha levels were found. Moreover, patients with enthesopathy showed a significantly more frequent increase of CRP and TNF-alpha levels besides an increased urinary pyridinium cross-link excretion. In addition, a significant positive correlation between TNF-alpha, CRP, BASDAI, and urinary pyridinium cross-link excretion was proved, besides a significant negative correlation of IGF-I to urinary pyridinium cross-links and TNF-alpha levels. Summing up, it may be said that TNF-alpha seems to be a reliable surrogate marker in enthesitis. This was proved so far for IgA and endothelium stimulating angiogenic factor only. Besides, the present results argue against a stimulation of osteogenesis. The catabolic situation under high TNF-alpha and low IGF-1 levels may play an important role in the pathogenesis of osteoporosis in AS.
在确诊的强直性脊柱炎（AS）患者和健康对照组中，检测了血浆中胰岛素样生长因子-1（IGF-1）和肿瘤坏死因子-α（TNF-α）的水平，以及它们与骨代谢生化标志物、体液炎症活性（红细胞沉降率、C反应蛋白）、临床表现和既定临床活动评分（巴斯强直性脊柱炎活动指数=BASDAI）之间的可能联系。在AS患者（男性和女性）中，发现TNF-α水平显著升高。此外，附着点病患者除尿吡啶交联排泄增加外，CRP和TNF-α水平升高的频率也显著更高。此外，除了IGF-I与尿吡啶交联和TNF-α水平呈显著负相关外，还证实了TNF-α、CRP、BASDAI和尿吡啶交联排泄之间存在显著正相关。总之，可以说TNF-α似乎是附着点炎中一个可靠的替代标志物。到目前为止，仅对IgA和内皮刺激血管生成因子证明了这一点。此外，目前的结果反对骨生成的刺激。高TNF-α和低IGF-1水平下的分解代谢状态可能在AS骨质疏松症的发病机制中起重要作用。
