Perrotta Fabio Massimo, Ceccarelli Fulvia, Barbati Cristiana, Colasanti Tania, Montepaone Monica, Alessandri Cristiano, Valesini Guido, Lubrano Ennio
Dipartimento di Medicina e Scienze della Salute Vincenzo Tiberio, Università del Molise, Campobasso, Italy.
Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia, Sapienza University of Rome, Italy.
Clin Exp Rheumatol. 2017 Mar-Apr;35(2):313-316. Epub 2016 Oct 26.
Several molecules are involved in the pathogenesis of new bone formation in ankylosing spondylitis (AS). The aim of the present study was to evaluate serum levels of semaphoring 3A in AS and to investigate any correlations with radiographic damage, disease activity, function and treatment.
AS patients who fulfilled the modified New York criteria were enrolled for this study. Healthy subjects were also enrolled as control group. BASDAI, ASDAS-CRP, BASMI, BASFI, patients and physician VAS, C-reactive protein and erythrocyte sedimentation rate were evaluated at baseline visit. Radiographs of the spine and pelvis performed within six months from the enrolment in the study were collected in all patients. Spinal damage was assessed using the mSASSS. Serum concentrations of semaphorin3A were assessed at baseline and after four months of therapy in patients who started an anti-TNF.
Twenty healthy subjects and forty AS patients were enrolled in the study. Of these patients, 15 started anti-TNF therapy the day of baseline visit. Semaphorin3A serum concentrations [median (25th-75th)] were similar in AS patients [0.26 (0.20-0.31) ng/ml] and controls [0.28 (0.26-0.3) ng/ml; p=ns). No significant correlation was found between semaphorin 3A serum levels and radiographic damage index. Semaphorin 3A serum levels positively correlated with ESR values (rho=0.37, p=0.049) and with disease activity assessed by the physician VAS (rho=0.47, p<0.01). No differences were found in the semaphorin3A serum levels after 4 months, compared to baseline values.
The results of the present study could contribute to the intriguing topic of bone remodelling in AS.
多种分子参与强直性脊柱炎（AS）新骨形成的发病机制。本研究旨在评估AS患者血清中信号素3A的水平，并研究其与影像学损伤、疾病活动度、功能及治疗的相关性。
纳入符合修订纽约标准的AS患者进行本研究。同时纳入健康受试者作为对照组。在基线访视时评估巴斯强直性脊柱炎疾病活动指数（BASDAI）、基于C反应蛋白的强直性脊柱炎疾病活动评分（ASDAS-CRP）、巴斯强直性脊柱炎脊柱功能指数（BASMI）、巴斯强直性脊柱炎功能指数（BASFI）、患者及医生视觉模拟评分（VAS）、C反应蛋白及红细胞沉降率。收集所有患者在入组研究后6个月内拍摄的脊柱和骨盆X线片。采用改良斯托克强直性脊柱炎脊柱评分（mSASSS）评估脊柱损伤。对开始抗TNF治疗的患者在基线及治疗4个月后评估血清信号素3A浓度。
本研究纳入20名健康受试者和40名AS患者。其中15名患者在基线访视当天开始抗TNF治疗。AS患者血清信号素3A浓度[中位数（第25百分位数-第75百分位数）]为[0.26（0.20-0.31）ng/ml]，与对照组[0.28（0.26-0.3）ng/ml；p=无统计学意义]相似。信号素3A血清水平与影像学损伤指数之间未发现显著相关性。信号素3A血清水平与红细胞沉降率值呈正相关（rho=0.37，p=0.049），与医生VAS评估的疾病活动度呈正相关（rho=0.47，p<0.01）。与基线值相比，4个月后信号素3A血清水平无差异。
本研究结果可能有助于探讨AS中骨重塑这一有趣的话题。
