Bath Ankylosing Spondylitis Radiology Index Research Articles

Bone morphogenetic proteins and Dickkopf-1 in ankylosing spondylitis

Objectives: To determine bone morphogenetic proteins (BMPs) and Dickkopf homologue-1 (Dkk-1) levels in ankylosing spondylitis (AS).Method: Serum BMPs and Dkk-1 were measured in 72 AS patients and 30 healthy controls. For AS patients, we recorded the demographic data, disease activity, functional index, and global assessment with questionnaires, and image changes with roentgenography. We also measured human leucocyte antigen-B27 and systemic inflammatory reactants.Results: BMPs were higher but Dkk-1 was significantly lower in AS patients than in controls. Dkk-1 was higher in AS patients who received non-steroidal anti-inflammatory drugs (NSAIDs) regularly in the past year (p = 0.001). Serum BMP-7 level and the BMP-7/Dkk-1 ratio correlated significantly with sacroiliitis severity, Bath Ankylosing Spondylitis Radiology Index (BASRI)-total, modified Stoke Ankylosing Spondylitis Spinal Score, and disease duration. There were also significant positive correlations among serum levels of BMP-2, -4, and -6, BASRI-total, and disease duration (p < 0.05). However, BMP-2/Dkk-1 was only significantly correlated with disease duration. The calculated area under the standard receiver operating characteristics curve suggested that BMP-2/Dkk-1 and serum BMP-2 are good indicators to predict disease activity, functional index, and patient global assessment in AS patients.Conclusion: BMPs and BMPs/Dkk-1 were significantly correlated with disease activity, and radiological and functional indices in AS patients. Dkk-1 was lower in AS patients than in controls. Among AS patients, Dkk-1 was higher in those taking NSAIDs regularly. BMP or Dkk-1 may be taken as a biomarker for disease severity or a treatment outcome predictor in AS, but this needs further study.

Disease Activity As a Major Determinant of Quality of Life and Physical Function in Patients With Early Axial Spondyloarthritis.

To describe health-related quality of life (HRQOL) and physical function in patients with early axial spondyloarthritis (SpA) and to assess their associations with disease activity and radiographic damage. This was a cross-sectional study drawing upon baseline data of axial SpA patients (Assessment of SpondyloArthritis international Society criteria) from the ESPERANZA cohort. Linear regression analyses were used to evaluate the associations between disease activity and radiographic damage (spine and sacroiliac joints) with HRQOL, physical function, and spinal mobility. In total, 259 patients were included. The mean ± SD age was 32.2 ± 6.9 years, disease duration was 13.3 ± 6.8 months, Ankylosing Spondylitis Quality of Life score was 5.9 ± 4.8, Bath Ankylosing Spondylitis Functional Index score was 2.4 ± 2.3, Bath Ankylosing Spondylitis Metrology Index score was 1.4 ± 1.3, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was 3.8 ± 2.3, C-reactive protein (CRP) level was 9.7 ± 13.2 mg/liter, and Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s) score was 1.7 ± 1.6. HRQOL was mainly associated with disease activity on univariate analysis (β values for BASDAI 0.646, patient global visual analog scale [VAS] 0.641, night back pain VAS 0.598, physician VAS 0.560, and CRP level 0.275; P < 0.01 for all), whereas the association with radiographic damage was weaker (standardized β for BASRI-s 0.142; P < 0.05). On multivariate models, HRQOL only remained significantly associated with disease activity (standardized β for BASDAI 0.330; P < 0.01, and physician VAS 0.205 and night back pain VAS 0.210; P = 0.01). Similarly, physical function was associated with disease activity and radiographic damage on univariate analysis, but only with disease activity (BASDAI β 0.466; P < 0.01) on multivariate analysis. However, spinal mobility was associated with radiographic damage in both univariate and multivariate analyses. Patients with axial SpA already have impaired quality of life and physical function, albeit mildly, at the beginning of their disease course. Both outcomes are mainly associated with disease activity in these patients.

Sulfasalazine Treatment Suppresses the Formation of HLA-B27 Heavy Chain Homodimer in Patients with Ankylosing Spondylitis.

Human leukocytic antigen-B27 heavy chain (HLA-B27 HC) has the tendency to fold slowly, in turn gradually forming a homodimer, (B27-HC)2 via a disulfide linkage to activate killer cells and T-helper 17 cells and inducing endoplasmic reticulum (ER) stress to trigger the IL-23/IL-17 axis for pro-inflammatory reactions. All these consequences lead to the pathogenesis of ankylosing spondylitis (AS). Sulfasalazine (SSA) is a common medication used for treatment of patients with AS. However, the effects of SSA treatment on (B27-HC)2 formation and on suppression of IL-23/IL-17 axis of AS patients remain to be determined. In the current study, we examine the (B27-HC)2 of peripheral blood mononuclear cells (PBMC), the mean grade of sarcoiliitis and lumbar spine Bath Ankylosing Spondylitis Radiology Index (BASRI) scores of 23 AS patients. The results indicated that AS patients without (B27-HC)2 on PBMC showed the lower levels of mean grade of sarcoiliitis and the lumbar spine BASRI scores. In addition, after treatment with SSA for four months, the levels of (B27-HC)2 on PBMCs were significantly reduced. Cytokines mRNA levels, including TNFα, IL-17A, IL-17F and IFNγ, were also significantly down-regulated in PBMCs. However, SSA treatment did not affect the levels of IL-23 and IL-23R mRNAs.

The relationship between C-reactive protein rs3091244 polymorphism and ankylosing spondylitis.

Previous studies have shown that C-reactive protein (CRP) gene polymorphism can be related to inflammatory changes. The present study aimed to examine the association between CRP gene polymorphism and clinical and laboratory findings in ankylosing spondylitis (AS) patients. A total of 80 patients, 40 with AS and 40 controls, were included in the study. Diagnosis of AS was made according to Assessment in AS International Working Group criteria. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index and Bath Ankylosing Spondylitis Radiology Index scores were evaluated. CRP gene C, A and T alleles were evaluated and were determined using the analysis of melting curves after real time polymerase chain reaction. The odds ratios were calculated for all alleles and haploids of the CRP gene. We investigated the relationship between the CRP polymorphism and clinical and laboratory findings. A, C, T allele frequencies in the control group were 15%, 57.5% and 27.5%. The allele frequencies in the AS group were 38%, 68.8% and 26.2%. While C and T allele frequencies were shown to be similar in the two groups, A allele frequency was higher in the AS group compared to the control group. The CC wild allele was 42.5% in the control group and 47.5% in the AS group (P = 1.0). Odds ratios for the C allele were 1.6, for the CC haploid 1.2 and for the CT haploid 3.7. Chest expansion and finger-to-ground distance was better in the CRP gene polymorphism group compared to the no polymorphism group. The presence of the CRP gene CC wild haploid and C allele in patients may indicate an increased risk for AS.

Serum Fetuin-A Level in Patients With Ankylosing Spondylitis and its Relationship With Clinical Parameters

Objectives: This study aims to investigate the association of serum fetuin-A levels with disease activation and clinical parameters in ankylosing spondylitis (AS) patients. Patients and methods: Forty-seven AS patients (30 males, 17 females; mean age 39.7±11.1 years; range 20 to 69 years) and 30 healthy controls (14 males, 16 females; mean age 42.0±11.5 years; range 19 to 63 years) were included in the study. Erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Radiology Index, and Bath Ankylosing Spondylitis Metrology Index were used in the assessment of AS. Serum fetuin-A levels were measured using ELISA. Results: Mean serum fetuin-A values in AS patients (984±203 ng/mL) were significantly lower compared to controls (1156±218 ng/mL) (p=0.001). While a statistically significant negative correlation was detected in AS patients between fetuin-A values and C-reactive protein (p=0.009, r=-0.377), no significant correlation was detected between erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index or Bath Ankylosing Spondylitis Radiology Index parameters and fetuin-A. Conclusion: Serum fetuin-A levels in AS patients were lower than the control group. However, further research is required to establish the role of serum fetuin-A levels as a surrogate marker of disease activity.

Reliability of Radiographic Scoring Methods in Axial Psoriatic Arthritis

Important differences exist between axial psoriatic arthritis (AxPsA) and ankylosing spondylitis (AS). The Bath Ankylosing Spondylitis Radiology Index (BASRI), the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS), and the Radiographic Ankylosing Spondylitis Spinal Score (RASSS) were developed to score AS, and the Psoriatic Arthritis Spondylitis Radiology Index (PASRI) to score AxPsA. We aimed to develop a computerized scoring application and compare the intra- and interrater reliability of these scoring systems in AS and AxPsA. A computerized scoring application was developed to facilitate the scoring of radiographic features and calculate total scores for established scoring methods for AS and AxPsA. Digital spinal radiographs of 18 patients with AS and 40 patients with AxPsA were read in random order individually by 4 rheumatologists, data were entered into the application, and scores were obtained. The intraclass correlation coefficients (ICC) of the intra- and interrater reliability of scores for each method were then computed. In AS, the intra- and interrater ICC was 0.91 and 0.80 for sacroiliitis grade, 0.96 and 0.86 for BASRI-spine, 0.98 and 0.86 for mSASSS, 0.96 and 0.75 for RASSS, and 0.99 and 0.93 for PASRI, respectively. In AxPsA, the intra- and interrater ICC was 0.81 and 0.67 for sacroiliitis grade, 0.77 and 0.52 for BASRI-spine, 0.91 and 0.65 for mSASSS, 0.90 and 0.68 for RASSS, and 0.92 and 0.88 for PASRI, respectively. Available radiographic scoring systems perform well in AS and have moderate intra- and interrater reliability when applied to AxPsA. However, PASRI may be superior for assessing structural damage in AxPsA.

Elevated Serum Levels of Calprotectin (Myeloid-Related Protein 8/14) in Patients With Ankylosing Spondylitis and Its Association With Disease Activity and Quality of Life

BackgroundCalprotectin is one of the major leukocyte S100 proteins showing both calcium binding and antimicrobial characteristics. The serum level of calprotectin is markedly elevated in patients with inflammatory bowel disease,...

AB0982 Comparison of the Performance of the BASRI and Msasss in Patients with Early Inflammatory Back Pain from the DESIR Cohort

BackgroundFor assessing structural damage in AS on spinal X-rays Bath Ankylosing Spondylitis Radiology Index (BASRI) and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) scoring systems can be usedObjectivesTo present the...

THU0073 The Relationship among Bone Turnover Markers, Vitamin D Levels, Disease Activity, Function and Quality of Life in Patients with Ankylosing Spondylitis

BackgroundOsteoporosis is a common complication of ankylosing spondylitis (AS); but the etiology of osteoporosis has not yet been completely clarified. It is thougt that the immobilization, local proinflammatory cytokines, genetic...

AB0952 Subclinical Left Ventricular Dysfunction in Patients with Ankylosing Spondylitis without Clinically Evident Cardiovascular Disease: A Two-Dimensional Speckle Tracking Echocardiographic Study

BackgroundCardiac involvement is common in ankylosing spondylitis (AS), which has not been previously evaluated by using speckle tracking echocardiography (STE).ObjectivesThe objectives of this study were to evaluate the left ventricle...

Anti-Saccharomyces cerevisiae antibodies and its relationship with radiological damage in ankylosing spondylitis

AimThe presence of anti-Saccharomyces cerevisiae antibodies (ASCA) is controversial in ankylosing spondylitis (AS). In this study, we aimed to investigate the prevalence of ASCA in AS and its relationship with disease activity and radiological damage in patients attending Sharkia governorate hospitals.Patients and methodsThirty AS patients and 30 apparently healthy volunteers were included in the present study. All patients were questioned for Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis metrology Index and Bath Ankylosing Functional Index (BASFI). Total Bath Ankylosing Spondylitis Radiology Index (BASRI-T) and ASCA levels were measured.ResultsASCA IgA level was significantly higher in AS patients than in healthy controls (P < 0.001). The ASCA-positive group, although not significant, tended to have higher BASFI scores. ASCA IgA-positive patients had higher BASRI-T levels (P = 0.037). In AS patients, significant positive correlation was found between ASCA IgA level and BASRI-T and BASFI (r = 0.19 and 0.31, respectively, P < 0.05). Bath Ankylosing Spondylitis Disease Activity Index scores, BASFI and ASCA IgA positivity were significantly associated with increased BASRI-T (P= 0.01, 0.03 and 0.04, respectively). The most significant risk factor for increased BASRI-T is ASCA IgA positivity (P < 0.001).ConclusionASCA IgA was detected more frequently in AS patients than in healthy controls. ASCA IgA could be considered a marker of severe radiological damage. Further studies are recommended to investigate ASCA level versus radiological damage and intestinal involvement in AS patients.

Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis

Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS).Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated.Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively.Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.

Aberrant expression of microRNAs in T cells from patients with ankylosing spondylitis contributes to the immunopathogenesis

Ankylosing spondylitis (AS) is a chronic inflammatory disorder characterized by dysregulated T cells. We hypothesized that the aberrant expression of microRNAs (miRNAs) in AS T cells involved in the pathogenesis of AS. The expression profile of 270 miRNAs in T cells from five AS patients and five healthy controls were analysed by real-time polymerase chain reaction (PCR). Thirteen miRNAs were found potentially differential expression. After validation, we confirmed that miR-16, miR-221 and let-7i were over-expressed in AS T cells and the expression of miR-221 and let-7i were correlated positively with the Bath Ankylosing Spondylitis Radiology Index (BASRI) of lumbar spine in AS patients. The protein molecules regulated by miR-16, miR-221 and let-7i were measured by Western blotting. We found that the protein levels of Toll-like receptor-4 (TLR-4), a target of let-7i, in T cells from AS patients were decreased. In addition, the mRNA expression of interferon (IFN)-γ was elevated in AS T cells. Lipopolysaccharide (LPS), a TLR-4 agonist, inhibited IFN-γ secretion by anti-CD3(+) anti-CD28 antibodies-stimulated normal T cells but not AS T cells. In the transfection studies, we found the increased expression of let-7i enhanced IFN-γ production by anti-CD3(+) anti-CD28(+) lipopolysaccharide (LPS)-stimulated normal T cells. In contrast, the decreased expression of let-7i suppressed IFN-γ production by anti-CD3(+) anti-CD28(+) LPS-stimulated AS T cells. In conclusion, we found that miR-16, miR-221 and let-7i were over-expressed in AS T cells, but only miR-221 and let-7i were associated with BASRI of lumbar spine. In the functional studies, the increased let-7i expression facilitated the T helper type 1 (IFN-γ) immune response in T cells.

SAT0262 Quality of life in early spondyloarthritis and associated factors

BackgroundThe aim of the ESPeranza program was to provide an early and effective access to rheumatologic care for patients with spondyloarthritis (SpA). Specific Rheumatologic Units (SRU) for an early evaluation,...

SAT0261 Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis

BackgroundEnthesitis is a primary clinical feature in Ankylosing spondylitis (AS). It is an inflammatory process that affects the site of insertion of ligaments and tendons into bone. Elevated enthesitis scores...

AB0899 Hip involvement and its predicting factors in turkish ankylosing spondylitis: A single center experience

BackgroundHip involvement is present in 25 to 35 percent of patients with ankylosing spondylitis (AS) and is associated with higher degrees of disability and a worse prognosis. Thus, early detection...

AB0903 Sleep quality and associated factors in ankylosing spondylitis: Relation with disease parameters, psychological status and quality of life

BackgroundDisturbance in sleep quality is important problem in ankylosing spondylitis(AS). Sleep problems may be affected from different aspects.ObjectivesWe aimed to investigate sleep quality and its association with the disease specific...

FRI0281 Physical function in early spondyloarthritis and associated factors

BackgroundThe aim of the ESPeranza program was to provide an early and effective access to rheumatologic care for patients with spondyloarthritis (SpA). Specific Rheumatologic Units (SRU) for an early evaluation,...

FRI0452 Determinants factors of sleep disturbances in spondylarthritis

BackgroundLiterature data suggest that sleep disturbances are prevalent among patients with Spondylarthritis (Spa) and have a close correlation with pain and psychological status.Objectivesour study was designed first to evaluate sleep...

AB0538 Fatigue in patients with spondylarthritis: a sudy of 70 cases

BackgroundFatigue is reported to be a common complaint among patients with Ankylosing Spondylitis (AS). Previous studies have shown that fatigue is associated with inflammatory pain, stiffness and global wellbeing.ObjectivesAssess the...