Cartilage collagen type II seromarker patterns in axial spondyloarthritis and psoriatic arthritis: associations with disease activity, smoking and HLA-B27.

Abstract

The aim of the study was to assess the possible association between type II collagen turnover seromarkers and disease profile in patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA). Outpatients with axial SpA (n=110) or PsA (n=101) underwent clinical examination including disease activity measures and HLA-B27 typing. The procollagen IIA N-terminal peptide (PIIANP) and a matrix metalloproteinase-generated type II collagen fragment (C2M) were quantified in serum by ELISA. C2M was higher in SpA than in controls, 0.41 versus 0.36ng/ml (p=0.004), while PIIANP did not differ between patients and healthy subjects, 2252 versus 2142ng/ml (p=0.13). However, DMARD-naïve SpA patients had higher PIIANP, 2461ng/ml (p=0.01) and C2M, 0.44ng/ml (p=0.0007) levels than controls, and PIIANP correlated with CRP (ρ=0.34). C2M was lower in SpA smokers, 0.36ng/ml versus non-smokers, 0.43ng/ml (p=0.02), while PIIANP was higher in HLA-B27 positive, 2312ng/ml versus negative patients, 2021ng/ml (p=0.03). In PsA, PIIANP and C2M did not differ between patients and controls, but PIIANP was elevated in patients not receiving DMARDs, 2726ng/ml. In PsA, PIIANP and C2M did not differ according to smoking and HLA-B27. Cartilage degradation assessed by C2M is increased in SpA irrespective of treatment but not in PsA. Cartilage synthesis reflected by PIIANP is increased in untreated SpA and PsA. PIIANP correlates with CRP in SpA while not in PsA. In DMARD-naïve SpA but not in PsA, HLA-B27 positivity and smoking are associated with a chondro-proliferative metabolic pattern.