Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Ankylosing spondylitis (AS) is a chronic rheumatic disease characterized by sacroiliac and spinal inflammationand new bone formation (syndesmophyte). Molecular mechanisms underlying this process have not been yet fully understood however differentiation of mesenchymal cells into bone-forming osteoblasts appears to be a key pathogenic event. Periostin is an extracellular matrix protein and primarily secreted by osteoblasts. It was shown that periostin has a role in bone anabolism by the regulation of Wnt-β-catenin signaling, therefore it may be one of the pathogenic mechanisms in syndesmophyte formation in AS. To evaluate the serum periostin levels in patients with AS. We also assessed the relationship among periostin levels and other biomarkers of bone formation and the role of periostin in disease outcomes, radiographic changes in particular.
Methods: In total 98 consecutive AS patients (77 males [79%]; with a mean age of 39.3 ± 10.0years) according to the modified New York criteria and 49 healthy controls (37males [76%]; with a mean age of 39.0 ± 5.9 years) from two centers were included in the study. Serum periostin, interleukin (IL)-8, dickkopf-1 (Dkk-1) and sclerostin levels were measured by commercially available ELISA kits. We also determined the serum high-sensitivity C-reactive protein(hs-CRP) levels. Disease related characteristics of patients were assessed by using BASDAI, BASFI, BASMI. Radiographs of the pelvis, cervical and lumbar spine were scored by using the modified New York and modified Stokes ankylosing spondylitis spinal score (mSASSS).
Results: As expected hs-CRP levels and erythrocyte sedimentation rate were higher in AS patients in comparison with controls. Serum periostin and Dkk-1 levels were significantly lower in AS patients compared with controls. Moreover periostin level was particularly lower in patients with active (35.4 ± 25.8 vs 53.9±42.1 ng/mL and P=0.014) disease (BASDAI>4). There was also a trend towards higher periostin levels in patients with syndesmophyte, hip involvement and sacroiliac ankylosis however these were not reached statistical significance. Regression analysis showed that serum periostin levels were independently predicted by Dkk-1, IL-8 levels.
Conclusion: Our results suggested that periostin may be down regulated in AS patients with active disease and the increase in periostin in inactive phase may contribute to the new bone formation along with the Wnt signalling.
|
|
AS patients (n=98) |
Controls (n=49) |
P |
|
Age at disease onset |
27.7 ± 8.6 |
N/A |
N/A |
|
Mean BASDAI |
4.2 ± 2.1 |
N/A |
N/A |
|
Mean BASFI |
3.4 ± 2.4 |
N/A |
N/A |
|
Mean BASMI |
3.8 ± 1.7 |
N/A |
N/A |
|
ASDAS-CRP |
3.0 ± 0.9 |
N/A |
N/A |
|
Median m SASSS score |
6 (0-72) |
N/A |
N/A |
|
Serum periostin (ng/mL) |
43.8 ± 35.0 |
72.5 ± 50.0 |
0.001 |
|
Dkk-1 (ng/mL) |
48.9 ± 35.1 |
68.6 ± 37.8 |
0.040 |
|
IL-8 (pg/mL) |
103.9 ±270.9 |
66.9 ± 60.1 |
0.390 |
|
hsCRP (μg/mL) |
5.2 ± 8.4 |
0.7 ± 1.3 |
<0.001 |
|
Creatinine (mg/dL) |
0.76 ± 0.15 |
0.82 ± 0.14 |
0.017 |
Disclosure:
S. Akar,
None;
S. Uslu,
None;
L. D. Kozaci,
None;
G. Can,
None;
N. Karaca,
None;
E. F. Tarhan,
None;
M. Ozmen,
None;
D. Solmaz,
None.
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