Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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search.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/openAccessSubject: search.filters.subject.Ankylosing spondylitis

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    Anti-Tumor Necrosis Factor Alpha Treatment Does Not Influence Serum Levels of the Markers Associated with Radiographic Progression in Ankylosing Spondylitis
    (2023) Ozdemirel, Ali Erhan; Guven, Serdar Can; Doganci, Alper; Surmeli, Zuhre Sari; Ozyuvali, Ayla; Kurt, Mehmet; Rustemova, Diana; Hassan, Selin; Sayin, Ayse Peyman Yalcin; Tutkak, Huseyin; Ataman, Sebnem; 37235120
    Objectives: The study aimed to determine the levels of change of the markers related to radiographic progression, such as Dickkopf-1 (DKK-1), sclerostin (SOST), bone morphogenetic protein (BMP)-2 and -4, and interleukin (IL)-17 and -23, in ankylosing spondyloarthritis (AS) during anti-tumor necrosis factor alpha (TNF-alpha) treatment. Patients and methods: Fifty-three anti-TNF-alpha naive AS patients (34 males, 19 females; median: 38 years; range, 20 to 52 years) refractory to conventional treatments meeting the modified New York criteria or Assessment of SpondyloArthritis International Society classification criteria were enrolled to this cross-sectional, controlled study between October 2015 and January 2017. Fifty healthy volunteers (35 males, 15 females; median: 36 years; range, 18 to 55 years) with similar age and sex characteristics were recruited. Serum DKK-1, BMP-2, BMP-4, SOST, IL-17, and IL-23 levels were measured in both groups. The serum levels of the markers were measured again after about two years (mean follow-up duration of 21.7 +/- 6.4 months) in AS patients who started anti-TNF-alpha treatment. Demographic, clinical characteristics, and laboratory parameters were recorded. The disease activity at the time of inclusion was assessed through the Bath Ankylosing Spondylitis Disease Activity Index. Results: Serum DKK-1, SOST, IL-17, and IL-23 levels in the AS group before anti-TNF-alpha treatment were significantly higher compared to the control group (p<0.01 for DKK-1, p<0.001 for others). There was no difference regarding serum BMP-4 levels, whereas BMP-2 levels were significantly higher in the control group (p<0.01). Forty (75.47%) AS patients had serum marker levels measured after anti-TNF-alpha treatment. No significant change was observed in the serum levels of these 40 patients measured 21.7 +/- 6.4 months after the initiation of anti-TNF-alpha treatment (p>0.05 for all). Conclusion: In AS patients, there was no change in DKK-1/SOST, BMP, and IL-17/23 cascade with anti-TNF-alpha treatment. This finding may suggest that these pathways act independently of each other, and their local effects are not influenced by systemic inflammation.
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    The relationship of serum vitamin D receptor levels with disease activity and clinical parameters in patients with ankylosing spondylitis
    (2019) Kultur, Turgut; Oztas, Dilek; Keskin, Dilek; Keskin, Goksal; Inal, Ali; Kara, Halil; 31893276
    Objectives: The aim of this study was to investigate the relationship between serum vitamin D receptor (SVDR) levels and disease activity parameters in patients with ankylosing spondylitis (AS). Patients and methods: Between July 2016 and January 2017, a total of 62 patients (51 males, 11 females; mean age 36.5 +/- 12.8 years; range, 23 to 49 years) with AS and 32 healthy volunteers (25 males, 7 females; mean age 41.57 +/- 13.6 years; range, 26 to 48 years) were included in the study. The SVDR levels were measured using the enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) levels were recorded. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were used to assess disease activity. Results: Although there was no significant difference between the patient and control groups (p=0.66), SVDR levels were significantly elevated in patients with active AS (BASDAI score >= 4) (p=0.01). The SVDR levels significantly increased in AS patients with peripheral joint involvement and enthesitis (p=0.01, p=0.05, respectively). The SVDR levels significantly elevated in patients treated with non-steroidal anti-inflammatory drugs, compared to those treated with biological agents and control group (p=0.01, p=0.03, respectively). The SVDR levels were positively correlated with the BASDAI, CRP and ESR in the patient group (p=0.01, r=0.751; p=0.01, r=0.75; p=0.01, r=0.81, respectively). Conclusion: Our study results suggest that serum SVDR levels are associated with the disease activity and clinical parameters in patients with AS. Based on these findings, SVDR level may be used as a marker of disease activity in AS.