骨硬化蛋白和抗骨硬化蛋白抗体血清水平可预测炎症性肠病患者中存在中轴型脊柱关节炎。
Sclerostin and Antisclerostin Antibody Serum Levels Predict the Presence of Axial Spondyloarthritis in Patients with Inflammatory Bowel Disease.
机构信息
From the Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; Centro di Epidemiologia e Biostatistica, Università Politecnica delle Marche; Dipartimento Gastroenterologico e dei Trapianti, Polo Didattico Ospedaliero "Umberto I-G.M. Lancisi-G.Salesi," Ancona; Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli Studi di Palermo, Palermo, Italy.
M.M. Luchetti, MD, Assistant Professor, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; F. Ciccia, MD, Assistant Professor, Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli Studi di Palermo; C. Avellini, PhD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; D. Benfaremo, MD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; G. Guggino, MD, Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli Studi di Palermo; A. Farinelli, MD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; M. Ciferri, PhD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; M. Rossini, MD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; S. Svegliati, PhD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; T. Spadoni, PhD, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica; L. Bolognini, MD, Dipartimento Gastroenterologico e dei Trapianti, Polo Didattico Ospedaliero "Umberto I-G.M. Lancisi-G. Salesi;" G. Fava, MD, Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli Studi di Palermo; P. Mosca, MD, Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli Studi di Palermo; R. Gesuita, MD, Associate Professor, Centro di Epidemiologia e Biostatistica, Università Politecnica delle Marche; E. Skrami, MD, Centro di Epidemiologia e Biostatistica, Università Politecnica delle Marche; G. Triolo, MD, Full Professor, Centro di Epidemiologia e Biostatistica, Università Politecnica delle Marche; A. Gabrielli, MD, Full Professor, Dipartimento Scienze Cliniche e Molecolari, Clinica Medica.
出版信息
J Rheumatol. 2018 May;45(5):630-637. doi: 10.3899/jrheum.170833. Epub 2018 Feb 1.
OBJECTIVE
The early diagnosis of inflammatory bowel disease (IBD)-associated spondyloarthritis (SpA/IBD) in patients affected by IBD represents a major topic in clinical practice; in particular, to date there are no available serum biomarkers revealing the presence of joint inflammation in these patients. Sclerostin (SOST), an antagonist of the Wnt/β-catenin pathway, and antisclerostin-immunoglobulin G (anti-SOST-IgG) have been recently studied in patients with ankylosing spondylitis (AS) as a putative marker of disease activity.
METHODS
SOST and anti-SOST-IgG serum levels were assayed in 125 patients with IBD, 85 with axial or peripheral SpA, and in control groups (patients with AS and rheumatoid arthritis, and healthy individuals). The diagnostic performance in discriminating the presence of SpA/IBD was assessed for both candidate biomarkers.
RESULTS
Patients affected by SpA/IBD with axial involvement displayed significantly lower levels of SOST and higher levels of anti-SOST-IgG compared to patients with only peripheral arthritis, IBD, and controls. Moreover, SOST and anti-SOST-IgG serum levels were inversely correlated and were associated with the duration of articular symptoms. Both biomarkers showed good accuracy in predicting the presence of axial SpA in patients with IBD.
CONCLUSION
We demonstrated that in patients with IBD, SOST and anti-SOST-IgG might represent novel biomarkers to assess the presence of axial joint involvement. Moreover, the development of anti-SOST-IgG and the subsequent decrease of SOST serum levels could play a role in the pathogenesis of SpA/IBD.
目的
在患有炎症性肠病（IBD）的患者中，早期诊断与 IBD 相关的脊柱关节炎（SpA/IBD）是临床实践中的一个主要课题；特别是，迄今为止，还没有可用的血清生物标志物可以揭示这些患者关节炎症的存在。骨硬化蛋白（SOST）是 Wnt/β-连环蛋白通路的拮抗剂，抗 SOST-免疫球蛋白 G（anti-SOST-IgG）最近在强直性脊柱炎（AS）患者中作为疾病活动的潜在标志物进行了研究。
方法
在 125 例 IBD 患者、85 例轴性或外周性 SpA 患者和对照组（AS 和类风湿关节炎患者及健康个体）中检测了 SOST 和 anti-SOST-IgG 血清水平。评估了这两种候选生物标志物在鉴别 SpA/IBD 存在方面的诊断性能。
结果
与仅有外周关节炎、IBD 和对照组的患者相比，患有轴性 SpA/IBD 的患者的 SOST 水平明显降低，anti-SOST-IgG 水平升高。此外，SOST 和 anti-SOST-IgG 血清水平呈负相关，且与关节症状的持续时间相关。这两种生物标志物在预测 IBD 患者轴性 SpA 的存在方面都具有良好的准确性。
结论
我们证明，在患有 IBD 的患者中，SOST 和 anti-SOST-IgG 可能是评估轴性关节受累存在的新型生物标志物。此外，anti-SOST-IgG 的产生和随后的 SOST 血清水平降低可能在 SpA/IBD 的发病机制中发挥作用。
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