Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute, Università degli studi del Molise, Campobasso, Italy.
Dipartimento di Medicina Interna e Specialità Mediche-UOC di Reumatologia-"Sapienza", Università di Roma, Roma, Italy.
J Immunol Res. 2018 May 2;2018:9101964. doi: 10.1155/2018/9101964. eCollection 2018.
Several molecules are involved in the pathogenesis of a new bone formation in ankylosing spondylitis (AS). The aim of this study was to evaluate the serum levels of sclerostin in patients with AS as a possible biomarker and to investigate any correlations with radiographic damage, disease activity, and function.
AS patients fulfilled the modified New York criteria, and healthy controls were enrolled for this study. BASDAI, ASDAS-CRP, BASMI, BASFI, patient and physician VAS, and C-reactive protein were evaluated at baseline visit. Spinal damage was assessed using the mSASSS on radiographs performed within 3 months from baseline. Serum concentrations of sclerostin were assessed at baseline and after four months of therapy in patients who started an anti-TNF.
Twenty healthy subjects and 40 AS patients were enrolled in the study. In our group, serum sclerostin levels (median (25th-75th percentile)) were significantly higher in healthy controls (18.04 (13.6-24) pg/ml) than in AS patients (6.46 (4.5-11.1) pg/ml; value < 0.01). However, no significant correlations were found between serum sclerostin levels and radiographic damage, assessed by mSASSS, and between serum sclerostin levels and clinical indices of activity and disability or with laboratory parameters. Sclerostin levels did not show significant changes after 4 months of anti-TNF therapy.
The results of our study suggest a possible role of sclerostin in the identification of AS patients. Further studies are needed to prove the role of sclerostin as a disease activity biomarker and progression of disease in AS.
几种分子参与了强直性脊柱炎（AS）中新骨形成的发病机制。本研究旨在评估血清骨硬化蛋白（sclerostin）在 AS 患者中的水平，作为一种可能的生物标志物，并探讨其与放射学损伤、疾病活动度和功能的相关性。
符合改良纽约标准的 AS 患者被纳入本研究，同时招募健康对照者。在基线访视时评估 BASDAI、ASDAS-CRP、BASMI、BASFI、患者和医生 VAS 以及 C 反应蛋白。在基线时评估脊柱损伤，并在开始抗 TNF 治疗后 4 个月内对放射照片上的 mSASSS 进行评估。
本研究纳入了 20 名健康对照者和 40 名 AS 患者。在我们的研究组中，健康对照组的血清骨硬化蛋白水平（中位数（25-75 百分位数））明显高于 AS 患者（18.04（13.6-24）pg/ml 比 6.46（4.5-11.1）pg/ml；P 值<0.01）。然而，血清骨硬化蛋白水平与 mSASSS 评估的放射学损伤之间，以及与临床活动和残疾指标或实验室参数之间均未发现显著相关性。抗 TNF 治疗 4 个月后，骨硬化蛋白水平无明显变化。
我们的研究结果表明，骨硬化蛋白可能在识别 AS 患者方面具有一定作用。需要进一步研究来证实骨硬化蛋白作为疾病活动度生物标志物和 AS 疾病进展的作用。
