To determine the levels of Dickkopf-1, sclerostin, bone morphogenetic protein (BMP) -2 and 4, interleukin (IL)-17 and 23, which might contribute to the radiographic progression and disease activity in ankylosing spondylitis (AS). Material and Methods: A cross-sectional study was carried out on 238 AS patients and age and sex-matched control group of 102 individuals. The disease activity was assessed through the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). In both groups Dickkopf-1, BMP-2 and 4, sclerostin, IL-17 and 23 levels were measured. Radiographic changes were calculated based on the modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS). Results: Dickkopf-1, sclerostin, IL-17 and 23 levels were significantly higher in AS group compared to the controls. There was no difference regarding serum BMP-4 levels, whereas BMP-2 levels were significantly higher in the control group (p<0.001). Mean mSASSS was 4.4±6.2 and it was determined that biomarkers alone did not affect this score in the evaluation made by taking all factors under control by variance analysis. However, BMP-2 and 4 values together above the median values affected the mSASSS by 3.3% (p=0.017). In the correlation analysis, a weak negative significant correlation was found between BASDAI and BMP-4 (p<0.05). Conclusion: There are many inflammatory and non-inflammatory pathways that contribute to radiographic progression in ankylosing spondylitis. Both the data in the literature and the results of our study point to the importance of the local level and functionality of markers that may contribute to progression rather than serum levels.
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