Department of Rheumatology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
Clin Rheumatol. 2012 Jan;31(1):23-8. doi: 10.1007/s10067-011-1760-z. Epub 2011 May 10.
Atherosclerosis has been shown to be increased in chronic inflammatory diseases including ankylosing spondylitis (AS). Impaired endothelial function, the first step in atherosclerosis, may be reflected by changes in various endothelial biomarkers of hemostasis and the release of several cellular adhesion molecules or cytokines. In this study, we investigated changes in the levels of various possible markers with regard to disease activity and treatment regimen with/without anti-TNF-α drugs. Fifty-six AS patients (44 males) and 27 controls (19 males) with no known cardiovascular risk factors were included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index, and patients were evaluated with the Bath Ankylosing Spondylitis Functional Index and the Bath Ankylosing Spondylitis Disease Activity Index. Cytokines and various endothelial biomarkers were measured in serum samples using commercially available ELISA kits. Age, sex, BMI, waist circumference, fasting glucose, MAP, lipids are all similar between patients and controls. von Willebrand factor (vWF), soluble thrombomodulin (sTM), and urotensin (UT-II) were found to be significantly higher in the sera of the patients compared to the controls. Treatment with anti-TNF-α compared to conventional therapy and disease activity in AS patients seemed to have no effect on the blood levels of UT-II, sTM, CD146, vWF, plasminogen activator inhibitor-1, tissue plasminogen activator, or the thrombin-antithrombin complex. The increased UT-II, sTM, and vWF in AS patient sera regardless of treatment and disease activity suggest an increased tendency for atherosclerosis.
动脉粥样硬化在包括强直性脊柱炎（AS）在内的慢性炎症性疾病中增加。血管内皮功能障碍，即动脉粥样硬化的第一步，可能反映在止血的各种内皮生物标志物和几种细胞黏附分子或细胞因子的释放的变化上。在这项研究中，我们研究了各种可能标志物的水平变化，这些标志物与疾病活动度和治疗方案有关，包括是否使用抗 TNF-α 药物。将 56 例 AS 患者（44 例男性）和 27 名无已知心血管危险因素的对照者（19 例男性）纳入研究。脊柱活动性通过 Bath 强直性脊柱炎计量学指数进行评估，通过 Bath 强直性脊柱炎功能指数和 Bath 强直性脊柱炎疾病活动指数对患者进行评估。使用商业上可获得的 ELISA 试剂盒测量血清样本中的细胞因子和各种内皮生物标志物。患者和对照组之间的年龄、性别、BMI、腰围、空腹血糖、MAP、血脂均相似。与对照组相比，患者血清中的血管性血友病因子（vWF）、可溶性血栓调节蛋白（sTM）和尿皮质素（UT-II）明显升高。与传统治疗相比，抗 TNF-α 治疗和 AS 患者的疾病活动度似乎对 UT-II、sTM、CD146、vWF、纤溶酶原激活物抑制剂-1、组织型纤溶酶原激活物或凝血酶-抗凝血酶复合物的血液水平没有影响。无论治疗和疾病活动度如何，AS 患者血清中升高的 UT-II、sTM 和 vWF 均表明动脉粥样硬化的趋势增加。
