Background:Аnkylosing spondylitis (AS) and inflammatory bowel diseases (IBD) have many common features. Approximately one in two patients with axial spondyloarthritis have subclinical (histologically confirmed) inflammation of the intestine, and 5-10% of subclinical inflammation turns into Crohn’s disease (CD) or Ulcerative colitis (UC) [1]. Colonoscopy is usually used to diagnose IBD, but this procedure is invasive. Laboratory biomarkers, as fecal calprotectin (FC) and serum calprotectin (SC) can used to diagnosis of IBD. But there is no consensus regarding SC clinical utility. SC is exposed to proteolytic enzymes, but its level also increases with inflammation in the intestine and is associated with a higher disease activity [2]. SC levels positively correlate with CRP, ESR, disease activity in AS, but not as obvious as with FC [3,4].Objectives:The aim of this study was to evaluate the possibility of using SC in the diagnosis of IBD in patients with AS.Methods:In the analysis were included 50 patients with AS, fulfilling the modified New York criteria, among them man -36 (72%), woman -14 (28%), mean age of patients was 42.5 ±9.9, mean disease duration – 13.4±8.7 years. All patients were examined with ESR, CRP, FC (range: 100-1800 µg /g), esophagogastroduodenoscopy, colonoscopy and quantitative analysis of the SC level using ELISA (BUHLMANN MRP8/14 ELISA, range: 0.4-3.9 µg /ml).Results:All patients had a high disease activity, mean BASDAI was 5.3 ± 1.8, mean ASDAS CRP 3.7 ± 1.01, mean ASDAS ESR 3.6 ± 1.01. 80 % patients had high FC level (more than 100 µg / g), while only 18% patients had an increase of SC level. IBD were diagnosed in 11 cases: 6 patients (12 %) with CD and 5 patients (10 %) - UC, in the remaining cases (78%) was no intestinal pathology. Only 2 patients with IBD had a high SC level. SC level was more correlated with ESR (r=0.5) and CRP (r=0.5) (p <0.05) levels, than with FC level (r=0.4) (p <0.05).Conclusion:The results showed that there is currently insufficient data to assess the possibility of using SC in the diagnosis of IBD in patients with AS. There is a significant association between the SC, CRP and ESR, but not fecal calprotectin. Potentially SC may be more representative of systemic inflammation than an intestinal inflammation.References:[1]Klingberg, E., Strid, H., Stahl, A.et al. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. Arthritis Res Ther 2017. 19(1):21[2]Kalla R, Kennedy NA, Ventham NT, Boyapati RK, Adams AT, Nimmo ER, Visconti MR, Drummond H, Ho GT, Pattenden RJ, Wilson DC, Satsangi J. Serum Calprotectin: A Novel Diagnostic and Prognostic Marker in Inflammatory Bowel Diseases. Am J Gastroenterol. 2016 Dec;111(12):1796-1805[3]Hu H, Du F, Zhang S, Zhang W. Serum calprotectin correlates with risk and disease severity of ankylosing spondylitis and its change during first month might predict favorable response to treatment. Mod Rheumatol. 2019 Sep;29(5):836-842.[4]Azramezani Kopi T, Shahrokh S, Mirzaei S, Asadzadeh Aghdaei H, Amini Kadijani A. The role of serum calprotectin as a novel biomarker in inflammatory bowel diseases: a review study. Gastroenterol Hepatol Bed Bench. 2019;12(3):183-189.Disclosure of Interests:None declared.

Background:Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine and sacroiliac joints characterized by new bone formation (syndesmophytes) and ankyloses. In AS cases, along with the damage to the musculoskeletal system, impairment of other organs and systems is often observed (uveitis, inflammatory bowel and heart diseases). Pro-inflammatory cytokines (TNF-α, IL-6,-17,-23,-21,-22,-31) and chemokines (IL-8) are key pathogenic markers in AS.Objectives:The aims of the study were to determine the serum levels of IL-6 and IL-8 in AS and investigate their relationship with disease activity.Methods:We studied 140 patients (pts) with AS fulfilled modified New York criteria (1984); (102M/38F); median and interquartile range (25th—75th percentile) of age 43.0; 35.0-51.0 years; disease duration 6.0; 4.0-12.0 years; BASDAI - 5.4; 4.1-6.6; ASDAS ESR - 3.6; 2.6-4.4; ASDAS CRP - 3.8; 2.7-4.5; 86% HLA-27 positive. In 50% of pts with AS, inflammatory bowel diseases (IBD) (Crohn’s disease and ulcerative colitis) were diagnosed. The control group included 17 healthy donors (HC). The serum concentrations of IL-6 and IL-8 were detected by chemiluminescence immunoassay using IMMULATE 1000 analyzer (Siemens Healthcare Diagnostics, USA).Results:AS pts had significantly higher serum level of IL-6 than HC (4.3; 0.1-8.0 pg/ml vs 2.3; 0.1-2.7 pg/ml, p <0.006). The median concentration of IL-8 didn’t differ between AS pts and HC (10.5; 8.3-18.0 pg/ml vs 11.9; 8.2-18.3 pg/ml, p>0.05). The same levels of IL-6 and IL-8 were detected in AS with IBD and AS without signs of IBD (p>0.05). In AS pts, serum IL-6 concentration was positively correlated with ASDAS ESR (r = 0.3), ASDAS CRP (r = 0.3), ESR (r = 0.3) and CRP (r = 0.5) (p <0.05); IL-8 was negatively associated with presence of fecal calprotectin (r = -0.3) (p <0.05).Conclusion:Elevated serum concentration of IL-6 in AS is associated with clinical and laboratory markers of high inflammatory activity of the disease. The levels of IL-8 in the sera of AS patients were negatively correlated with the concentration of fecal calprotectin. Data on the relationship of IL-8 with the activity of the pathological process in AS require further study.Disclosure of Interests:Elena Aleksandrova: None declared, Alexander Novikov: None declared, Polina Kulakova: None declared, Aleksey Dorofeev: None declared, Nadezhda Savenkova: None declared, Evgeniy Volnukhin: None declared, Anton Kovshik: None declared, Galina Lukina Speakers bureau: Novartis, Pfizer, UCB, Abbvie, Biocad, MSD, Roche

No abstract

The resuts of randomized, double-blind, placebo-controlled, prospective trial in parallel groups of evaluation the efficiency safety and tolerability threefold (once a week) intraarticular injection of Spherogel are discussed in the study. It is estimated of positive effect of this medication to simptoms of gonarthritis: reducing of pain and improvement of functional activity of joint with a good tolerability. This effect continuos for least 3 month.

Background:Аnkylosing Spondylitis (AS) is closely associated with inflammatory bowel disease (IBD). About 6-46% of patients with IBD have various lesions of the musculoskeletal system [1]. 5-10% of patients with spondylarthritis (SpA) eventually develop IBD, with Crohn’s disease (CD) being more common than Ulcerative colitis (UC) [2]. Determining the level of fecal calprotectin (FC) is a study that allows to diagnose IBD. The concentration of FC directly depends on the neutrophil infiltration of the intestinal mucosa and has a direct connection with the activity of the inflammatory process [3]. It is known that level of FC increases in 2/3 of patients with AS and is closely related to parameters reflecting higher disease activity [4].Objectives:The aim of this study was to evaluate the frequency of IBD in patients with AS using an assessment of FC level.Methods:In the analysis were included 40 patients with AS, fulfilling the modified New York criteria, among them man -26 (65%), woman -14 (35%), mean age of patients was 41.2 ±10.5, mean disease duration - 13±8.8 years. All patients were examined with ESR, CRP, esophagogastroduodenoscopy, colonoscopy and quantitative analysis of the fecal calprotectin levels using the method of lateral immunochromatography with the BUHLMANN Quantum Blue rapid test. Standart range: 100-1800 µg /g.Results:All patients had a high disease activity, mean BASDAI was 5.2 ± 1.7, mean ASDAS CRP 3.8 ± 1.1. 35 patients (87.5 %) had FC level more than 100 µg / g, the remaining 5 patients (12.5%) less than 100 µg /g. 12 patients (30 %) had FC level more than 1,800 µg / g, 23 (57.5 %) from 101 µg / g to 1800 µg / g. All patients with FC levels more than 100 µg / g showed an increase CRP (mean 28.4 mg / l) and ESR (mean 36.3 mm\h) levels. IBD were diagnosed in 9 cases (22.5%): 5 patients (12.5 %) with CD and 4 patients (10 %) - UC, in the remaining cases (77.5%) was no intestinal pathology.Conclusion:The results showed high frequency of IBD in patients with AS. Patients with high FC levels (more than 100 μg/g) had high disease activity (AS). In most cases, inflammatory bowel disease were diagnosed in patients with FC levels more than 100 µg/g.References:[1] Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001 Apr;96(4):1116-22.[2] Klingberg, E., Strid, H., Stahl, A.et al. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. Arthritis Res Ther 2017. 19(1):21[3] Cypers H, Varkas G, Beeckman S, et al. Elevated calprotectin levels reveal bowel inflammation in spondyloarthritis. Annals of the Rheumatic Diseases. 2016. 75:1357-1362[4] Arzu Duran, Senol Kobak, Nazime Sen, et al. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis. Bosnian Journal of Basic Medical Sciences. 2016. 16 (1):71-4Disclosure of Interests:Galina Lukina Speakers bureau: Novartis, Pfizer, UCB, Abbvie, Biocad, MSD, Roche, Polina Kulakova: None declared, Nadezhda Savenkova: None declared, Evgeniy Volnukhin: None declared, Anton Kovshik: None declared, Elena Alexandrova: None declared, Alexandr Novikov: None declared