Serum HMGB1 Serves as a Novel Laboratory Indicator Reflecting Disease Activity and Treatment Response in Ankylosing Spondylitis Patients.

Chenqiong Wang,Fang Zheng,Wei Sun,Xuefen Wu,Mengchen Sun,Lingli Dong,Ye Miao,Yingzi Zhu,Yishu Huang

doi:10.1155/2016/6537248

Abstract

Objective. High mobility group box 1 (HMGB1) is a late inflammatory factor participating in the pathogenesis of various autoimmune and inflammatory diseases. In the current study, we analyzed the association between serum levels of HMGB1 and clinical features of AS patients before and during treatment. Methods. Serum HMGB1 was detected in 147 AS patients and 61 healthy controls using ELISA. We evaluated the association between HMGB1 and extra-articular manifestations as well as disease severity indices. Among these AS patients, 41 patients received close follow-up at 1, 3, and 6 months after treatment. This group comprised 25 patients treated with anti-TNF-α biologics and 16 patients receiving oral NSAIDs plus sulfasalazine. Results. The serum HMGB1 of AS patients was significantly higher than in healthy controls and positively correlated with BASDAI, BASFI, ASDAS-ESR, ASDAS-CRP, ESR, and CRP, but not with HLA-B27, anterior uveitis, and recurrent diarrhea. There was no significant difference between patients with radiographic damage of hip joints and those without. We observed that serum HMGB1 paralleled disease activity after treatment. Conclusion. Serum level of HMGB1 is higher in AS patients, and to some extent, HMGB1 can reflect the activity of AS and be used as a laboratory indicator to reflect the therapeutic response.

Highlights

Ankylosing spondylitis (AS) is a chronic inflammatory disease, characterized by the inflammation of sacroiliac joints and the spine, which mainly affects young males including disability and decreased quality of life [1]
We examined the trend of High mobility group box 1 (HMGB1) in AS patients during six-month follow-up, including 25 patients who were treated by anti-TNF-α block therapy and 16 patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and SASP
The HMGB1 level was positively correlated with Bath AS Disease Activity Index (BASDAI) (r = 0.304), Bath AS Functional Index (BASFI) (r = 0.184), Table 1: Baseline characteristics of 147 ankylosing spondylitis patients

Summary

Introduction

Ankylosing spondylitis (AS) is a chronic inflammatory disease, characterized by the inflammation of sacroiliac joints and the spine, which mainly affects young males including disability and decreased quality of life [1]. Recent genome-wide association studies (GWASs) have identified that some single nucleotide polymorphisms (SNPs) were associated with AS. Many of these gene loci assemble in dissimilar immunoregulatory pathways [4], which are related to NF-κB signaling, IL-23 pathway, and T cell phenotype as well as antigen presentation [5, 6]. Abnormal inflammation and immunity are considered as major etiological factors, involving the upregulation of the inflammatory cytokines including tumor necrosis factor-alpha (TNF-α), IL-23, and IL-17 [7], and anti-IL17 agents showed similar therapeutic efficacy to TNF blockers in clinical trials [8].

Methods

Results

Conclusion