Date: Sunday, November 5, 2017
Session Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Monocytes of patients with Ankylosing Spondylitis (AS) over-express Toll-like receptor (TLR) 4 on their monocytes. Tenascin-C (TNC) is an extracellular-matrix-glycoprotein and acts as an endogenous TLR4 ligand. Thus we studied the serum and synovial fluid levels of TNC in adults with AS.
TNC was measured in serum of 36 AS patients (ASAS 2009 criteria) and 10 healthy controls by ELISA. 22 patients were followed-up after 3 months of standard of care treatment. Five paired serum-synovial fluid samples were also analyzed. Disease activity was assessed by BASDAI, ASDAS, tender and swollen joint count; enthesitis score, ESR and CRP. All values are in median (IQR).
Median age was 30 (20-35) years and disease duration 5.5(1.3-10) years. 31 were male and 5 female. 25 cases had peripheral arthritis (69.5%). Median BASDAI was 5.3(3.3-6.7). HLA B27 was positive in 34 (94.5%) cases.
Median serum Tenascin C levels were higher in AS [554.6ng/ml] as compared to healthy controls [32.88 ng/ml, p<0.00001]. Serum TNC levels correlated with ASDAS ESR [r=0.367, p=0.028] and ESR [r=0.39, p=0.035]; but not with other disease activity measures. In patients with disease duration less than 5 years (early disease) serum levels had better correlation with ESR [r=0.59, p=0.009] and CRP [r=0.479, p=0.044]. On ROC analysis for active (PhGA≥6) vs. inactive (PhGA≤4) disease, TNC (AUC=0.60) performed as well as CRP (AUC=0.65) and ESR (AUC=0.73). The synovial fluid levels [11.61(5.99-176.9) ng/ml] were lower than in the serum [627.4 (488.5-779.1) ng/ml, p=0.008].
TNC levels fell with treatment [630.8 ng/ml to 376.4 ng/ml p=0.0006] in treatment responders (n=11) but not in non- responders (n=11) [562.3 to 445.6,p=0.33].
Serum TNC levels are significantly raised in AS and can serve as marker of inflammation in early disease. Treatment reduces the TNC levels, probably due to control of disease activity.
To cite this abstract in AMA style:Gupta L, Bhattacharya S, Aggarwal A. Tenascin-C, a TLR 4 Endogenous Ligand Levels Are Increased in Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/tenascin-c-a-tlr-4-endogenous-ligand-levels-are-increased-in-ankylosing-spondylitis/. Accessed March 28, 2023.
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