Distinct impacts of syndesmophyte formation on male and female patients with ankylosing spondylitis

Huang, Wen‐Nan; Tso, Tim K.; Kuo, Yi-Chi; Tsay, Gregory J.

doi:10.1111/j.1756-185x.2011.01687.x

Cited by 31 publications

(25 citation statements)

References 14 publications

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“…On the other hand, a significantly higher proportion of men with AS reported hypertension compared with women. Sex differences as observed in our analysis have been discussed in other studies, highlighting that women may manifest AS differently than men due to different immunologic [22, 23] and genetic [24, 25] responses to the disease. Additionally, enthesitis [26–28] and disease severity [29, 30] were significantly more pronounced in women with AS compared with men in several studies [29–32].…”

Section: Discussionsupporting

confidence: 64%

Real-World Patient Experience on the Path to Diagnosis of Ankylosing Spondylitis

et al. 2019

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Introduction We describe the journey to diagnosis of ankylosing spondylitis (AS) from the patient perspective and examine differences in this journey by sex. Methods US adults aged ≥ 18 years with a self-reported AS diagnosis were recruited online through CreakyJoints, a patient support community, and ArthritisPower, a patient research registry. Respondents completed a web-based survey on sociodemographics, disease burden, and diagnosis history. Results were stratified by sex and time to diagnosis using two-sample t tests and χ 2 tests, respectively, to observe differences across the groups; P < 0.05 was considered statistically significant. Results Among 235 respondents, 174 (74.0%) were female. Mean (SD) ages of female and male respondents were 48.6 (10.6) and 53.1 (10.3) years, respectively. From the time respondents began seeking medical attention, 87 were diagnosed within ≤ 1 year, 71 in 2–9 years, and 77 after ≥ 10 years. Symptoms that led respondents to seek treatment were back pain (73.2%) and joint pain (63.8%); fatigue and difficulty sleeping were more common among respondents with longer times to diagnosis. During the diagnosis process, men with AS tended to receive quicker AS diagnosis compared with women. Overall, commonly reported initial diagnoses among respondents with longer time to AS diagnosis included back problems and psychosomatic disorders. Significantly more women reported misdiagnoses of fibromyalgia (20.7 vs. 6.6%) and psychosomatic disorders (40.8 vs. 23.0%) compared with men. Conclusions Diagnosis delays and misdiagnoses were common among respondents with AS. Increasing awareness about AS among referring providers may minimize diagnosis delay. Funding Novartis Pharmaceuticals Corporation. Plain Language Summary Plain language summary available for this article. Electronic Supplementary Material The online version of this article (10.1007/s40744-019-0153-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 64%

Real-World Patient Experience on the Path to Diagnosis of Ankylosing Spondylitis

et al. 2019

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“…Most scholars believe that this disease is an autoimmune inflammation reaction caused predominantly by genetic factors, in addition to being stimulated by trauma, infection, fatigue and other environmental factors (25)(26)(27). The present results showed that naringin attenuates NF-κB p65 unit, TNF-α, IL-1β and IL-6 activity in AS mice.…”

Section: A B a Bsupporting

confidence: 65%

Protective effect of naringin against ankylosing spondylitis via ossification, inflammation and oxidative stress in mice

Liu

Shi

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Naringin is an abundant flavanone in pomelo, grapefruit as well as lime and its variants, has been shown to exhibit certain antioxidative, anti-inflammatory, anti-cancer and hypoglycemic effects. The aim of the current study was to evaluate the protective effects of naringin against ankylosing spondylitis (AS) and to elucidate the potential underlying mechanism. Firstly, a mouse model of ankylosing spondylitis (AS) was established. Next, osteocalcin (OC), alkaline phosphatase (ALP) and triglyceride (TG) activity values, inflammatory factor and oxidative stress were evaluated in the AS mice. Then, the Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) protein expression levels in the AS mice were investigated using western blot analysis. The results showed that naringin increased OC, ALP and TG activity values in the AS mouse model. Furthermore, inflammatory factor and oxidative stress levels in the AS mice were restrained by treatment with naringin. Furthermore, JAK2 and STAT3 protein expression levels were reduced by treatment with naringin. In conclusion, the present results indicated that the protective effects of naringin against AS are exerted via the induction of ossification, suppression of inflammation and oxidative stress and the downregulation of JAK2/STAT3 in mice.

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“…Specifically, we show that Th1 cell polarization is skewed in patients with AS. Serum IFNg levels are higher in AS patients compared with those in controls; however, the levels in male and female patients are equivalent, as previously reported (19). Additionally, flow cytometric analysis demonstrated a reduction in the number of IFNg1CD41 T cells (Th1 cells), reminiscent of the "reverse IFNg profile" seen in humans and HLA-B27-transgenic rats (20)(21)(22).…”

Section: Discussionsupporting

confidence: 53%

Sexual Dimorphism in the Th17 Signature of Ankylosing Spondylitis

Gracey

Yao

Green

et al. 2016

Arthritis & Rheumatology

144

101

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ObjectiveTo identify an immunologic basis for the male sex bias in ankylosing spondylitis (AS).MethodsCohorts of male and female patients with AS and age‐ and sex‐matched healthy control subjects were selected, and the levels of serum cytokines (interferon‐γ [IFNγ], tumor necrosis factor α, interleukin‐17A [IL‐17A], and IL‐6) were examined by enzyme‐linked immunosorbent assay, the frequencies of Th1 and Th17 cells were assessed by flow cytometry, and whole blood gene expression was analyzed using both microarray and NanoString approaches.ResultsThe frequency of IL‐17A and Th17 cells, both of which are key factors in the inflammatory Th17 axis, was elevated in male patients with AS but not in female patients with AS. In contrast, AS‐associated alterations in the Th1 axis, such as the frequency of IFNγ and Th1 cells in serum, were independent of a patient's sex. Results of microarray analysis supported an altered Th17 axis in male patients, with a specific increase in IL17RA. In addition, male and female patients with AS displayed shared gene expression patterns, while male patients with AS had additional alterations in gene expression that were not seen in female patients with AS. The differential sex‐related immune profiles were independent of HLA–B27 status, clinical disease activity (as measured by the Bath Ankylosing Spondylitis Disease Activity Index), or treatment (with nonsteroidal antiinflammatory drugs or biologic agents), implicating intrinsic sexual dimorphism in AS.ConclusionThe results of this study demonstrate distinct sexual dimorphism in the activation status of the immune system in patients with AS, particularly in the Th17 axis. This dimorphism could underlie sex‐related differences in the clinical features of AS and could provide a rationale for sex‐specific treatment of AS.

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Distinct impacts of syndesmophyte formation on male and female patients with ankylosing spondylitis

Abstract: AS patients with syndesmophytes experienced imbalance of bone metabolism due to inflammatory cytokine release. Male AS patients had high levels of bone resorption markers, cytokines and adhesion molecules, reflecting a disorder of bone metabolism.

Cited by 31 publications

References 14 publications

Real-World Patient Experience on the Path to Diagnosis of Ankylosing Spondylitis

Real-World Patient Experience on the Path to Diagnosis of Ankylosing Spondylitis

Protective effect of naringin against ankylosing spondylitis via ossification, inflammation and oxidative stress in mice

Sexual Dimorphism in the Th17 Signature of Ankylosing Spondylitis

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