The Diagnostic Utility of Serum interleukin-22 in Patients with Suspected Axial Spondyloarthritis

Michal Sagiv¹, Abid Awisat², Aniela Shouval², Regina Peri³, Mohammad Adawi⁴, Firas Sabbah⁴, Itzhak Rosner², Aharon Kessel³ and Gleb Slobodin², ¹Faculty of Medicine, Bar Ilan University, Tel Aviv, Israel, ²Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel, ³Clinical Immunology and Allergy Division, Bnai Zion Medical Center, Haifa, Israel, ⁴Puria Medical Center, Tiberias, Israel

Meeting: ACR Convergence 2021

Keywords: Ankylosing spondylitis (AS), axial spondyloarthritis, Interlekin-22

Session Information

Date: Saturday, November 6, 2021

Title: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes Poster I: Clinical Aspects of Axial Spondyloarthritis (0357–0386)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: There is an unmet need for a reliable biomarker for the diagnosis and differentiation of AxSpA from its multiple mimickers. Serum levels of IL-22, which is tightly involved in the pathogenesis of AxSpA, have been previously found significantly elevated in patients with AxSpA, when compared to healthy individuals or persons with osteoarthritis.

Methods: Consecutive patients with established or suspected AxSpA, followed in the outpatient clinic of Bnai Zion Medical Center, Haifa, were enrolled. The demographic and anamnestic data, as well as results of laboratory and imaging studies and estimates of disease activity were acquired from patients’ charts. The final diagnosis of definite or probable SpA, or alternative diagnoses, based on the existing medical data, was determined by the joint opinion of the treating rheumatologist and a senior author (GS), blinded to the estimates of the serum IL-22, which were examined by Quantikine ELISA Human IL-22 Immunoassay.

Results: Serum levels of IL-22 were significantly higher in patients with definite AxSpA (29 patients) compared to patients with alternative diagnoses (14 patients) and healthy volunteers (16 individuals) (p< 0.001 for both comparisons). Patients with possible AxSpA (7 patients) had a wide range of data distribution, probably reflecting its heterogeneity. The sensitivity and specificity of the serum levels of IL-22 for the AxSpA diagnosis were 0.68 (95% CI 0.49-0.84) and 0.86 (95% CI 0.68-0.95), respectively, for the cut-off of 5 pg/ml, and 0.48 (95% CI 0.29-0.67) and 1 (95% CI 0.85-1) for the cut-off of 10 pg/ml. In patients with AxSpA, serum IL-22 levels did not correlate with mSASSS, BASDAI, ASDAS indices or serum CRP levels, with all results far away from the level of statistical significance.

Conclusion: Serum IL-22 leves are elevated in patients with AxSpA and can serve as an independent biomarker for the differentiation of AxSpA from its non-inflammatory mimickers.

Fig.1 Serum levels of IL_22 in study participants

Disclosures: M. Sagiv, None; A. Awisat, None; A. Shouval, None; R. Peri, None; M. Adawi, None; F. Sabbah, None; I. Rosner, None; A. Kessel, None; G. Slobodin, None.

To cite this abstract in AMA style:

Sagiv M, Awisat A, Shouval A, Peri R, Adawi M, Sabbah F, Rosner I, Kessel A, Slobodin G. The Diagnostic Utility of Serum interleukin-22 in Patients with Suspected Axial Spondyloarthritis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/the-diagnostic-utility-of-serum-interleukin-22-in-patients-with-suspected-axial-spondyloarthritis/. Accessed .

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