Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
Clin Rheumatol. 2018 May;37(5):1401-1405. doi: 10.1007/s10067-017-3938-5. Epub 2018 Jan 8.
Monocytes of patients with ankylosing spondylitis (AS) over-express toll-like receptor (TLR) 4. Tenascin-C (TNC) is an endogenous TLR4 ligand. Thus, we studied the serum and synovial fluid levels of TNC in AS. TNC was measured in serum of 36 AS patients (ASAS 2010 criteria) and 39 healthy controls by ELISA. Twenty-two patients were followed up after 3 months of standard treatment. Five paired serum-synovial fluid samples were also analyzed. Disease activity was assessed by BASDAI, ASDAS, swollen joint count, ESR, and CRP. All values are in median (IQR). Median age was 30 (20-35) years, and disease duration was 5.5 (1.3-10) years. Thirty-one were male. Twenty-five (69.5%) had peripheral arthritis. Median BASDAI was 5.3 (3.3-6.7). HLA B27 was positive in 34 (94.5%) cases. Median serum tenascin C levels were higher in AS [578.5 ng/ml] as compared to healthy controls [32.88 ng/ml, p < 0.0001]. Serum tenascin C levels correlated with ASDAS ESR [r = 0.367, p = 0.028] and ESR [r = 0.39, p = 0.035]. In patients with early disease (duration ≤ 5 years), serum levels had better correlation with ESR [r = 0.59, p = 0.009] and CRP [r = 0.479, p = 0.044]. On ROC analysis for active (PhGA ≥ 6) vs. inactive (PhGA ≤ 4) disease, tenascin-C (AUC = 0.60) performed as well as CRP (AUC = 0.65) and ESR (AUC = 0.73). Synovial fluid levels [11.61 (5.99-176.9) ng/ml] were lower than in serum [627.4 (488.5-779.1) ng/ml, p = 0.008]. Tenascin C fell levels with treatment [n = 11, 630.8 ng/ml to 376.4 ng/ml p = 0.0006] in treatment responders but not in non-responders [n = 11, 562.3 to 445.6, p = 0.33]. Serum TNC levels are raised in AS and may serve as marker of inflammation in early disease.
强直性脊柱炎（AS）患者的单核细胞过度表达 Toll 样受体（TLR）4。Tenascin-C（TNC）是内源性 TLR4 配体。因此，我们研究了 AS 患者血清和滑液中的 TNC 水平。采用 ELISA 法检测 36 例 AS 患者（ASAS2010 标准）和 39 例健康对照者的血清 TNC。22 例患者在标准治疗 3 个月后进行了随访。还分析了 5 对血清-滑液样本。采用 BASDAI、ASDAS、肿胀关节计数、ESR 和 CRP 评估疾病活动度。所有值均为中位数（IQR）。中位年龄为 30（20-35）岁，病程为 5.5（1.3-10）年。31 例为男性。25 例（69.5%）有外周关节炎。中位 BASDAI 为 5.3（3.3-6.7）。34 例（94.5%）HLA-B27 阳性。AS 患者的血清 TNC 水平明显高于健康对照组[578.5ng/ml] [32.88ng/ml，p<0.0001]。血清 TNC 水平与 ASDAS ESR 呈正相关[r=0.367，p=0.028]和 ESR[r=0.39，p=0.035]。在疾病早期（病程≤5 年）患者中，血清水平与 ESR 相关性更好[r=0.59，p=0.009]和 CRP[r=0.479，p=0.044]。ROC 分析表明，在活动性（PhGA≥6）与非活动性（PhGA≤4）疾病之间，TNC（AUC=0.60）的表现与 CRP（AUC=0.65）和 ESR（AUC=0.73）一样好。滑液水平[11.61（5.99-176.9）ng/ml]低于血清[627.4（488.5-779.1）ng/ml，p=0.008]。在治疗反应者中，TNC 水平随着治疗而下降[n=11，630.8ng/ml 至 376.4ng/ml，p=0.0006]，但在无反应者中则没有[n=11，562.3 至 445.6，p=0.33]。AS 患者的血清 TNC 水平升高，可能作为早期疾病炎症的标志物。
