Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis

Abstract

With the growing awareness of the impact of chronic back pain and axial spondyloarthritis and recent breakthroughs in genetics and the development of novel treatments which may impact best on early disease, the need for markers that can facilitate early diagnosis and profiling those individuals at the highest risk for a bad outcome has never been greater. The genetic basis of ankylosing spondylitis has been considerably advanced, and HLA-B27 testing has a role in the diagnosis. Knowledge is still incomplete of the rest of the genetic contribution to disease susceptibility, and it is likely premature to use extensive genetic testing (other than HLA-B27) for diagnosis. Serum and plasma biomarkers have been examined extensively in assessing disease activity, treatment response, and as predictors or radiographic severity. For assessing disease activity, other than C-reactive protein and erythrocyte sedimentation rate, the most work has been in examining cytokines (particularly interleukin 17 and 23), matrix metalloproteinase (MMP) markers (particularly MMP3). For assessing those at the highest risk for radiographic progression, biomarkers of bony metabolism, cartilage and connective tissue degradation products, and adipokines have been most extensively assessed. The problem is that no individual biomarkers has been reproducibly shown to assess disease activity or predict outcome, and this area still remains an unmet need, of relevance to industry stakeholders, to regulatory bodies, to the healthcare system, to academic investigators, and finally to patients and providers.

I‑BET151 inhibits expression of RANKL, OPG, MMP3 and MMP9 in ankylosing spondylitis in�vivo and in�vitro

“…Association between RNKL expression and bone destruction was confirmed in inflammatory joints using animal model and the inflammatory cytokines of RANKL/OPG axis showed essential roles in AS process (4,17). In addition, MMPs upregulation, especially for MMP3, has been detected in AS serum and thus could be used as biomarkers for AS diagnosis (6,18).…”

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

“…IL-6 in a great extent participates in initiation and maintenance of inflammation, and is involved in the production of acute phase reactants, including C-reactive protein (CRP). Besides, initiation and progression of AS, determined by the adaptive T cell immunity 58 . The 1,25 Dihydroxyvitamin D (1,25(OH) 2 D), operates as a regulator by reducing the aforementioned proinflammatory cytokines 59,60 .…”

Platelet Indices Are Associated with Disease Activity Scores and the Severity of Sacroiliitis on Magnetic Resonance Imaging in Axial Spondyloarthritis Patients

“…The ASDAS combines patient-reported assessments with measurements of acute phase reactant (C-reactive protein [CRP] or erythrocyte sedimentation rate [ESR]) levels; however, it is based largely on subjective measures. Thus, despite biomarkers that reproducibly assess disease activity in axSpA are needed, there is no reliable and specific biomarker for axSpA [5].…”