Department of Rheumatology, School of Medicine, The Second Affiliated Hospital of Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China.
Department of Rheumatology, Jinhua Hospital of Traditional Chinese Medicine, Jinhua, China.
Clin Rheumatol. 2019 Apr;38(4):989-995. doi: 10.1007/s10067-018-4356-z. Epub 2018 Nov 15.
To determine the serum levels of Dickkopf-1 (DKK-1) and sclerostin, as well as their correlations with the structural damage assessed by modified stoke ankylosing spondylitis spine score (mSASSS) and the disease activity evaluated by ankylosing spondylitis disease activity score (ASDAS) in patients with ankylosing spondylitis (AS).
Eighty-eight AS patients, 26 rheumatoid arthritis (RA) patients, and 26 age- and gender-matched healthy controls (HC) were collected from rheumatic clinic of the Second Affiliated Hospital of Zhejiang University, School of Medicine, between March 2015 and July 2015. Demographic data, parameters of ASDAS, and image evaluations of spine (i.e., mSASSS) were collected. The serum levels of DKK-1 and sclerostin were measured using commercially available ELISA kits.
Both DKK-1 and sclerostin were significantly higher in the AS patients than in the controls (1855 ± 84.58 vs. 1406 ± 99.76 pg/ml and 106 ± 6.75 vs. 62.78 ± 6.39 pmol/l, respectively, P < 0.05). The correlation analysis suggested a negative correlation between serum sclerostin and mSASSS (P = 0.019, r = 0.062). DKK-1 had a trend of positive correlation with mSASSS, but was not statistically significant (P > 0.05). There was no association between the serum levels of DKK-1 or sclerostin and disease activity assessed by ASDAS (P > 0.05). DKK-1 and sclerostin had a negative correlation (P = 0.013, r = 0.07).
In the present study, the expressions of serum DKK-1 and sclerostin were independent of disease activity. Sclerostin was negatively correlated with the mSASSS, which suggests that sclerostin may be a potential marker indicating the spine ossification process in AS. The specific mechanism remains to be investigated.
测定骨硬化蛋白（sclerostin）和 Dickkopf-1（DKK-1）的血清水平，并分析其与改良的强直性脊柱炎脊柱评分（mSASSS）评估的结构损伤和强直性脊柱炎疾病活动度评分（ASDAS）评估的疾病活动度之间的相关性。
2015 年 3 月至 7 月，收集来自浙江大学医学院第二附属医院风湿科的 88 例强直性脊柱炎（AS）患者、26 例类风湿关节炎（RA）患者和 26 名年龄和性别匹配的健康对照者（HC）。收集人口统计学资料、ASDAS 参数和脊柱影像学评分（即 mSASSS）。采用商业 ELISA 试剂盒检测血清 DKK-1 和骨硬化蛋白水平。
与对照组相比，AS 患者的血清 DKK-1 和骨硬化蛋白水平明显升高（1855 ± 84.58 比 1406 ± 99.76 pg/ml 和 106 ± 6.75 比 62.78 ± 6.39 pmol/l，P < 0.05）。相关性分析提示血清骨硬化蛋白与 mSASSS 呈负相关（P = 0.019，r = 0.062）。DKK-1 与 mSASSS 呈正相关趋势，但无统计学意义（P > 0.05）。血清 DKK-1 或骨硬化蛋白水平与 ASDAS 评估的疾病活动度之间无相关性（P > 0.05）。血清 DKK-1 和骨硬化蛋白之间呈负相关（P = 0.013，r = 0.07）。
本研究中，血清 DKK-1 和骨硬化蛋白的表达与疾病活动度无关。骨硬化蛋白与 mSASSS 呈负相关，提示骨硬化蛋白可能是 AS 脊柱骨化过程的潜在标志物。具体机制尚待研究。
