Association of Serum Interleukin-17 and Interleukin-23 Levels with Disease Activity, Function, Mobility, Enthesitis Index in Patients with Ankylosing Spondylitis

Abstract

Aim: More and more studies have demonstrated that the interleukin (IL)-23/IL-17 axis is highly associated with immune dysfunction and activated autoimmune inflammation. The purposes of this study were to determine the serum levels of IL-17 and IL-23 in ankylosing spondylitis (AS) patients compared with healthy controls and evaluate these cytokine levels based on disease-related characteristics. Material and Methods: Eighty-six consecutive AS patients and 70 sex and age-matched healthy controls were included in the study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Ankylosing Spondylitis Disease Activity Score (ASDAS)-erythrocyte sedimentation rate (ESR), ASDAS-C reactive protein, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index, the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and Achilles pain VAS scores were recorded. Serum IL-17 and IL-23 levels were examined by enzyme-linked immunosorbent assay. Results: The serum levels of IL-17, IL-23 and CRP as well as ESR values were significantly increased in AS patients compared with controls (1.94 vs. 0.28 pg/mL p ˂ 0.001; 82.9 vs. 44.3 pg/mL p ˂ 0.001; 0.48 vs. 0.30 mg/dL, p=0.001; 12±13.9 vs. 8±6.8 mm/h, p=0.003, respectively). In AS patients, serum IL-17 levels were significantly correlated with the ASDAS-ESR and ASDAS-CRP (r=0.244, p=0.024; r=0.258, p=0.017), but not with ESR, CRP, BASDAI, function, mobility, quality of life, enthesitis index or Achilles pain scores (all p>0.05). Serum IL-23 levels demonstrated a significant correlation with Achilles pain VAS, but not with other disease-related parameters (all p>0.05). Conclusions: AS patients had increased serum IL-17 and IL-23 levels compared with healthy controls, and serum IL-17 levels were associated with disease activity. Our study results support the hypothesis that the IL17/23 pathway plays an important role in the pathogenesis of AS.

Zusammenfassung

Ziel der Arbeit: Immer mehr Studien zeigen, dass die Interleukin(IL)-23/IL-17-Achse in hohem Maße mit einer Immundysfunktion und einer aktivierten Autoimmunentzündung assoziiert ist. Ziel dieser Studie war die Bestimmung der Serumspiegel von IL-17 und IL-23 bei Patienten mit ankylosierender Spondylitis (AS) im Vergleich zu gesunden Kontrollprobanden und die Bewertung dieser Zytokinspiegel anhand von krankheitsbezogenen Merkmalen. Material und Methoden: Sechsundachtzig konsekutive AS-Patienten und 70 gesunde Kontrollprobanden gleichen Geschlechts und Alters wurden in die Studie eingeschlossen. Dokumentiert wurden der Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), der Ankylosing Spondylitis Disease Activity Score (ASDAS)-Erythrozytensedimentationsrate (ESR), ASDAS-C-reaktives Protein (CRP), der Bath Ankylosing Spondylitis Functional Index (BASFI), der Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis-Index, der Bath Ankylosing Spondylitis Metrology Index (BASMI), der Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) sowie Achillessehnenschmerz-Scores (VAS). Die Serumspiegel von IL-17 und IL-23 wurden mithilfe eines enzymgebundenen Immunadsorptionstests untersucht. Ergebnisse: Die Serumspiegel von IL-17, IL-23 und CRP sowie die ESR-Werte waren bei AS-Patienten im Vergleich zu den Kontrollen signifikant erhöht (1,94 vs. 0,28 pg/ml, p ˂ 0,001; 82,9 vs. 44,3 pg/ml, p ˂ 0,001; 0,48 vs. 0,30 mg/dl, p=0,001; 12±13,9 vs. 8±6,8 mm/h, p=0,003). Bei AS-Patienten korrelierten die IL-17-Spiegel im Serum signifikant mit ASDAS-ESR und ASDAS-CRP (r=0,244, p=0,024; r=0,258, p=0,017), aber nicht mit ESR, CRP, BASDAI, Funktion, Mobilität, Lebensqualität, Enthesitis-Index oder Achillessehnenschmerz-Scores (alle p>0,05). Die Serum-IL-23-Spiegel zeigten eine signifikante Korrelation mit der VAS Achillessehnenschmerz, aber nicht mit anderen krankheitsbezogenen Parametern (alle p>0,05). Schlussfolgerung: AS-Patienten hatten im Vergleich zu den gesunden Kontrollpersonen erhöhte IL-17- und IL-23-Serumspiegel und die IL-17-Serumspiegel waren mit der Krankheitsaktivität assoziiert. Unsere Studienergebnisse unterstützen die Hypothese, dass der IL17/23-Signalweg eine wichtige Rolle bei der Pathogenese von AS einnimmt.

Key words

ankylosing spondylitis - interleukin-17 - interleukin-23

Schlüsselwörter

Interleukin-17 - Interleukin-23 - ankylosierende Spondylitis

Publikationsverlauf

Artikel online veröffentlicht:
23. November 2022

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