AB0076 THE ROLE OF MACROPHAGE MIGRATION INHIBITORY FACTOR IN ACTIVITY AND PROGRESSION OF ANKYLOSING SPONDYLITIS

Abstract

Background:Ankylosing Spondylitis (AS) is a chronic inflammatory form of arthritis that predominantly affects the axial joints and has a global prevalence of 1%. Disease progression is marked by osteoproliferation and bone fusion in the axial joints, causing considerable loss of mobility. Migration Inhibitory Factor (MIF) is a potent pro-inflammatory cytokine implicated in several diseases. Elevated serum MIF levels have been reported in AS the role of MIF in bone formation has been a subject of controversy.Objectives:Detection the level of Migration Inhibitory Factor in Ankylosing Spondylitis patients and correlate the level with disease activity and progression.Methods:This cross-sectional case-control study were concluded upon 70 randomly selected people from internal medicine department in Kobry El-kobba Military Hospital and from rheumatology and rehabilitation department in EL-Hussein university hospital. The population study were divided into two groups: Group A: (50) Patients with Ankylosing Spondylitis (AS) who met the European Spondyloarthropathy Study Group (ESSG) criteria for AS (30) and Group B: (20) Healthy controls. Serum MIF by ELISA were measured. X-rays cervical &lumbosacral vertebrae (dorsal, lateral) views were obtained. m-SASS score (based on radiographic findings to detect progression) were assessed. MSK U/S on Tendo Achilles affected in AS patients were done.Results:the mean age of all patients was (38.2 ± 8.4) years. Regarding gender of the patients, the majority (65.7%) of patients were males, while (34.3%) were females. (88%) of AS patients had cervical erosion or sclerosis, (46%) had dorsal erosion or sclerosis, (92%) had lumbosacral erosion or sclerosis, with m-SASS score of (11 ± 6.1). Regarding musculoskeletal U/S, (72%) had evidence of inflammation and erosion. Highly significant increase in ESR, CRP and MIF levels in A group; compared to control B group; with highly significant statistical difference (p < 0.01). the increase in smoking, ESR and MIF level; had an independent effect on increasing the probability of progression occurrence; with significant statistical difference (p < 0.05 respectively). MIF level at a cutoff point (>51) predicted patients with progression, with fair accuracy (74%), sensitivity= 53% and specificity= 94% (p = 0.0056).Conclusion:MIF ply an important role in the pathogenesis of Ankylosing Spondylitis and has a link between chronic inflammation, new bone formation and disease progression and can be used as indicator for activity and disease progression.Disclosure of Interests:None declared