<div>Serum IL-6 correlates with axial mobility index (Bath Ankylosing Spondylitis Metrology Index) in Brazilian patients with ankylosing spondylitis</div>

Abstract

IntroductionAnkylosing spondylitis (AS) is a chronic disease featuring axial changes, peripheral arthritis and systemic involvement. Proinflammatory cytokines are probably involved in AS pathogenesis. The relationship of circulating cytokines with instruments of AS evaluation is an open field of research.ObjectiveThe aim of this study was to compare serum levels of cytokines in AS patients and healthy controls, and search for correlations of cytokines with indexes of disease activity and quality of life.Patients and methodsIn this cross-sectional study, 32 AS patients and 32 age- and sex- matched controls were evaluated. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Funcional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Disease Activity Score-C reactive protein (ASDAS-CRP), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Ankylosing Spondylitis Quality of Life (ASQol) and Patient Global Assessment score were measured in AS patients. The soluble cytokines IL-6, IL-8, IL-1, IL-10, TNF-α, IL-12p70 and IL-17 were quantified by flow cytometry. IL-23 concentrations were measured using an enzyme-linked immunosorbent assay.ResultsOverall, AS patients were predominantly males (59.4%) and Caucasians (96.9%). Mean age was 46.9±10.7 years. Human leukocyte antigen B27 was present in 70% of cases. Concentrations of IL-6, IL-8, IL-10 and TNF-α were higher in AS cases than controls (p<0.05). Mean concentration of IL-6 correlated with the BASMI, an index of axial mobility (r=0.354, p=0.047). Anti-TNF intake (present in 21 patients, 65.6%) associated with a high BASMI (p=0.042) and lower quality of life as measured using the ASQol scale (p=0.009).ConclusionA proinflammatory cytokine profile predominated in AS patients, but interestingly, the IL-10 concentrations were also elevated, pointing to a suppressive control of inflammation. A defined correlation of serum IL-6 with the BASMI suggests a role for this cytokine in axial disease. Anti-TNF users showed more axial activity and lower quality of life.

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“…AS is a type of rheumatism characterized by chronic inflammation of the axial joint and may involve the internal organs and other tissues [33]. TNF-α, IL-6, IL-8, and IL-17 have been identified to be overexpressed in AS patients [34]. Furthermore, in AS patients, neutrophils are activated so that reactive oxygen species are generated, resulting in oxidative stress [35].…”

Potential Therapeutic Mechanism of Scutellaria baicalensis Georgi against Ankylosing Spondylitis Based on a Comprehensive Pharmacological Model

“…In particular, TNF- α , a classic proinflammatory factor, can mediate an inflammatory cascade and promote the upregulation of various inflammatory factors, such as IL-6, IL-1 β , and IL-8 [ 35 ]. It also can directly stimulate inflammatory cells and catalyze inflammatory reactions to induce tissue cell damage [ 36 , 37 ], which is closely related to the pathological changes in AS. Clinically, biologics targeting TNF- α are important drugs used in western medicine for the treatment of AS.…”

Role of Metrology in Axial Spondyloarthritis: Does It Provide Unique Information in Assessing Patients and Predicting Outcome? Results From the British Society for Rheumatology Biologic Register for Ankylosing Spondylitis

“…In a 5‐year prospective study of 166 patients with axial SpA in Sweden, a high BASMI score predicted radiographic progression, although only in women (44). In a recent meta‐analysis examining factors associated with high interleukin‐23 (IL‐23) levels in patients with axial SpA, including 10 studies with 1,724 patients, the BASMI score was 1 of 2 factors, along with inflammatory markers (ESR and CRP level), to be positively associated (correlation coefficient 0.46 [95% CI 0.03, 0.75]) (45), while a small study of 32 patients with AS in Brazil demonstrated a significant correlation with IL‐6 (46). Mewes et al (2019), in a small study of 55 patients with axial SpA, showed a strong association between a high BASMI score and poor balance, which in turn was linked to a higher risk of falls (47).…”

“…This article is protected by copyright. All rights reserved correlation with IL-6 (46). Mewes et al (2019) in a small study of 55 patients with axSpA showed a strong association between a high BASMI score and poor balance, which in turn was linked to a higher risk of falls (47).…”