Diaconu Alexandra-Diana, Șorodoc Laurențiu, Pomîrleanu Cristina, Foia Liliana Georgeta, Șorodoc Victorița, Lionte Cătălina, Russu Mara, Lăpuște Vladia, Ghemiș Larisa, Ancuța Codrina
Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
2nd Internal Medicine Department, "Sf. Spiridon" Clinical Emergency Hospital, 700111 Iasi, Romania.
J Clin Med. 2025 Aug 7;14(15):5605. doi: 10.3390/jcm14155605.
: Axial spondyloarthritis (axSpA) is a chronic immune-mediated inflammatory disorder affecting the spine and sacroiliac joints, with variable clinical expression. This study assessed serum levels of inflammatory (TNF-α, IL-17A) and metabolic (leptin, adiponectin) biomarkers and their associations with disease activity, inflammation, structural damage, and comorbidities. : This prospective cross-sectional study assessed 89 axSpA patients using clinical, laboratory, and radiological evaluations. Disease activity was measured using ASDAS-CRP and BASDAI scores. Radiographic damage was quantified using the Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Serum concentrations of TNF-α, IL-17A, leptin, and adiponectin were quantified by enzyme-linked immunosorbent assay (ELISA). Clinical and imaging correlations were analyzed. : Serum leptin levels correlated significantly with higher disease activity scores, inflammatory markers (CRP, ESR), radiographic progression (syndesmophyte formation, mSASSS), and arterial hypertension. Adiponectin levels were inversely associated with disease activity, structural damage, and arterial hypertension, suggesting anti-inflammatory, bone- and cardio-protective properties. TNF-α levels showed an association with inflammatory markers and were higher in patients with peripheral enthesitis. IL-17A levels were weakly correlated with disease activity and structural severity and were significantly lower in patients with a history of anterior uveitis. : Leptin and adiponectin may serve as complementary biomarkers in axSpA, reflecting both inflammatory burden and structural damage. While TNF-α and IL-17A remain key therapeutic targets, their correlation with structural changes appears limited. Biomarker profiling could support personalized disease monitoring. Longitudinal studies are needed to validate prognostic implications.
轴性脊柱关节炎（axSpA）是一种慢性免疫介导的炎症性疾病，影响脊柱和骶髂关节，临床表现多样。本研究评估了炎症（TNF-α、IL-17A）和代谢（瘦素、脂联素）生物标志物的血清水平及其与疾病活动、炎症、结构损伤和合并症的关联。
本前瞻性横断面研究对89例axSpA患者进行了临床、实验室和影像学评估。使用ASDAS-CRP和BASDAI评分来衡量疾病活动度。使用改良斯托克强直性脊柱炎脊柱评分（mSASSS）对影像学损伤进行量化。通过酶联免疫吸附测定（ELISA）对TNF-α、IL-17A、瘦素和脂联素的血清浓度进行量化。分析了临床和影像学相关性。
血清瘦素水平与较高的疾病活动评分、炎症标志物（CRP、ESR）、影像学进展（骨桥形成、mSASSS）和动脉高血压显著相关。脂联素水平与疾病活动、结构损伤和动脉高血压呈负相关，表明具有抗炎、保护骨骼和心脏的特性。TNF-α水平与炎症标志物相关，在外周附着点炎患者中更高。IL-17A水平与疾病活动和结构严重程度弱相关，在前葡萄膜炎病史患者中显著降低。
瘦素和脂联素可能作为axSpA的补充生物标志物，反映炎症负担和结构损伤。虽然TNF-α和IL-17A仍然是关键的治疗靶点，但它们与结构变化的相关性似乎有限。生物标志物分析可以支持个性化的疾病监测。需要进行纵向研究来验证预后意义。
