Extra-Articular Symptoms in Constellation with Selected Serum Cytokines and Disease Activity in Spondyloarthritis

Abstract

Objectives. In this study, we assessed the extra-articular symptoms in constellation with selected serum cytokines and disease activity in spondyloarthritis (SpA). Patients and Methods. We studied 287 SpA patients: 131 had AS, 110 had PsA, and 46 had SAPHO. We assessed extra-articular symptoms in all cases. In 191 SpA patients, we measured serum interleukin-6 (IL-6), interleukin-18 (IL-18), interleukin-23 (IL-23), endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). Results. Patients with acute anterior uveitis (AAU) had higher VAS (P = 0.0008), BADSDAI (P = 0.0001), ASDAS-ESR (P = 0.04), CRP (P = 0.006), IL-6 (P = 0.02), and IL-18 (P = 0.03) levels. Patients with inflammatory bowel disease (IBD) had higher VAS (P = 0.03), CRP (P = 0.0009), and IL-6 (P = 0.0003) levels. Patients with skin psoriasis had lower VAS (P = 0.001) and BASDAI (P = 0.00007) levels. Patients with psoriatic onycholysis had lower VAS (P = 0.006), BASDAI (P = 0.00001), and CRP (P = 0.02) and higher IL-23 (P = 0.04) levels. Patients with PPP had lower BASDAI (P = 0.04) and higher ET-1 (P = 0.001) levels. Conclusions. SpA patients with increased serum IL-18 and decreased serum ET-1 had an increased risk of extra-articular symptoms. In SpA patients, increased disease activity was associated with an increased risk of AAU and IBD and a decreased risk of skin psoriasis, psoriatic onycholysis, and PPP.

Serum Interleukin-23 in Polish Patients with Systemic Lupus Erythematosus: Association with Lupus Nephritis, Obesity, and Peripheral Vascular Disease

“…The analysis of the role of selected proinflammatory and angiogenic cytokines in SpA patients [ 14 , 15 , 32 , 33 ] showed higher levels of IL-23 in ankylosing spondylitis in comparison with the controls and revealed the association with selected clinical characteristics such as psoriatic onycholysis and the use of nonsteroid anti-inflammatory drugs [ 14 , 15 ].…”

“…The IL-23-IL-17 axis is emerging as a critical regulatory system that bridges the innate and adaptive arms of the immune system and plays a critical role in development of autoimmune inflammatory diseases [ 10 ]. In fact, there are reports showing increased serum levels of IL-23 in systemic sclerosis [ 11 ], rheumatoid arthritis [ 12 ], primary antiphospholipid syndrome (PAPS) [ 13 ], spondyloarthropathies [ 14 , 15 ], and inflammatory bowel diseases [ 16 ]. IL-23 has also been implicated in SLE [ 17 – 20 ], atherosclerosis [ 21 , 22 ], and obesity [ 23 ].…”

Cytokines in uveitis

“…In humans, elevated serum levels of IL-23 have been identified in patients with VKH [38] and BSCR [39]. Elevated serum IL-23 has also been identified as a risk factor for developing uveitis in spondyloarthropathy patients [40]. The data from intraocular studies are mixed.…”

Interleukin-18 Polymorphisms Impose Considerable Impacts on Ankylosing Spondylitis Occurrence

“…Fortunately, published article records that serum IL-18 level in AS patients is obviously higher than that of the controls [24]. IL-18 is also signi cantly associated with ESR, CRP, BASFI and BASMI which are as indicators of disease activity for AS [25], and also shows the positive association with TNF-α level in AS. We guess that IL-18 level not only re ects disease activity of AS patients, but participants in regulating some in ammatory cytokines expression such as TNF-α so as to affect AS development.…”