Tıp Fakültesi / Faculty of Medicine

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

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Subject: 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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    Effects of Infliximab Treatment in Terms of Cardiovascular Risk and Insulin Resistance in Ankylosing Spondylitis Patients
    (2014) Bozkirli, Emine Duygu Ersozlu; Bozkirli, Emre; Yucel, Ahmet Eftal; https://orcid.org/0000-0002-4860-9072; 24252046; E-9887-2014
    Objective. To assess the effects of infliximab treatment on insulin sensitivity and cardiovascular risk factors in patients with ankylosing spondylitis (AS). Methods. In this prospective study, 30 consecutive AS patients (23 men and 7 women) fulfilling the modified 1984 New York criteria for AS were investigated. All patients were treated with intravenous infliximab. A complete biochemical profile and assesments were obtained before and after 12 weeks of infliximab therapy. The Homoeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) was used to measure insulin resistance (IR). Framingham equation was used to assess cardiovascular risk factors. Results. After 12 weeks of infliximab treatment, there was no statistically significant difference in fasting insulin, HOMA-IR, lipid parameters, body-mass index, waist circumference and waist hip ratio, whereas fasting glucose levels (p = 0.001), triglycerides/high-density lipoprotein (HDL) ratio (p = 0.043) and total cholesterol/HDL (p = 0.041) ratio increased significantly from baseline. A significant decrease was observed for both systolic blood pressures (p < 0.001) and diastolic blood pressures (p = 0.003) in the 12th-week visit. A significant decrease was also found in terms of Framingham risk scores (p = 0.028) after treatment. Conclusions. Study results suggest that infliximab treatment may reduce cardiovascular risk and blood pressures without changing IR.
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    Spectral domain optical coherence tomography findings of patients with ankylosing spondylitis
    (2020) Kal, Ali; Ulusoy, Mahmut Oguz; Orturk, Caner; 0000-0001-7544-5790; 32533454; AAJ-4936-2021
    Purpose The aim of this study is to evaluate the possible effects of (ankylosing spondylitis) AS on choroidal thickness (CT) and other retinal layers using spectral domain optical coherence tomography (SD-OCT). Methods This cross-sectional study group comprised 41 AS patients and age and sex-matched 46 control subjects. None of our patients had active anterior uveitis during the measurements. We evaluated and compared CT, retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, focal loss volume (FLV) and global loss volume (GLV) of the participants. Results The CT of the patients at 1500 mu m (286.20 mu m +/- 65.81), 1000 mu m (309.55 mu m +/- 85.33) nasally to the fovea and subfoveal layer (339.93 mu m +/- 69.93) were thicker than in controls (p = 0.007,p = 0.037,p = 0.008). Except nasal layer, all RNFL layers were significantly thinner than controls (p < 0.001). GCC and macular thickness were also thinner than controls (p < 0.001). Conclusion In conclusion, present findings may suggest that the AS disease may affect the choroidal, RNFL and GCC thickness by disease's own inflammatory effect, independently from the uveitis history.
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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.