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Sample records for resembling ankylosing spondylitis

  1. Ankylosing Spondylitis

    OpenAIRE

    McGregor, Marion

    1982-01-01

    Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA), which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when...

  2. Ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mukesh Edavalath

    2010-01-01

    Full Text Available Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA, which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when intervention is started in its early stages. Niruha basthi with Balaguduchyadi yoga, combined by Shamana treatment with Rasnerandadi kwatha and Simhanada guggulu have been found effective in curbing its progression. This article presents a single case report in which these treatments achieved considerable success.

  3. Imaging in ankylosing spondylitis

    NARCIS (Netherlands)

    Maksymowych, Walter P.; Landewé, Robert

    2006-01-01

    The introduction of symptomatically highly effective anti-tumour necrosis factor alpha therapies for ankylosing spondylitis (AS) has generated interest in the use of imaging to evaluate the potential structure-modifying properties of these agents. Several approaches have been developed to score the

  4. Imaging in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Lambert, Robert G W

    2012-01-01

    Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography...... and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes...

  5. Mortality in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lie, Elisabeth; Lindström, Ulf

    2016-01-01

    OBJECTIVES: Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population. METHODS: Nationwide cohorts of patients with AS diagnosed at rheumatology...... mortality and predictors for death in the AS cohort. RESULTS: There were 496 deaths in the AS cohort and 1533 deaths in the control cohort resulting in an age-adjusted and sex-adjusted HR of 1.60 (95% CI 1.44 to 1.77), with increased mortality for men (age-adjusted HR=1.53, 95% CI 1.36 to 1.72) and women...... (age-adjusted HR=1.83, 95% CI 1.50 to 2.22). Within the AS cohort, statistically significant predictors for death were a lower level of education, general comorbidities (diabetes, infections, cardiovascular, pulmonary and malignant diseases) and previous hip replacement surgery. CONCLUSIONS: Mortality...

  6. Medical Treatment of Ankylosing Spondylitis

    Science.gov (United States)

    Kim, Young-Tae

    2014-01-01

    The diagnosis of ankylosing spondylitis is often delayed due to ambiguous clinical manifestations and strict diagnostic criteria. However, imaging techniques such as magnetic resonance imaging have been found effective for the early diagnosis of non-radiographic sacroiliitis. New tumor necrosis factor alpha (TNF-α) inhibitors have good efficacy for patients with persistently high disease activity despite conventional nonsteroidal anti-inflammatory drug treatment. Thus, early diagnosis and aggressive treatments are essential for ankylosing spondylitis patients. Because many patients complain of musculoskeletal pains, especially around the sacroiliac joint area, hip specialists should be informed of up-to-date knowledge. In this review, we discuss new diagnostic criteria for ankylosing spondylitis, administration methods of TNF-α inhibitors, and the long-term follow-up results for patients treated with TNF-α inhibitors. PMID:27536570

  7. Evolution of Juvenile Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Ye.V. Prohorov

    2013-02-01

    Full Text Available Evolution of juvenile ankylosing spondylitis tend to follow a more frequent involvement in the pathological process of elbow and ankle joints, development of enthesiopathies, changes of intraarticular meniscal horns, forming of Baker’s cysts, cartilage flaps and systemic osteoporosis, and total value of all these signs 13 times exceeds thereof in patients with with the debut of disease in adulthood, but for juvenile ankylosing spondylitis vertebral lesion is less common. Age dimorphism of the use of certain groups of drugs and physiotherapy facilities is observed.

  8. Ankylosing spondylitis and bowel disease

    NARCIS (Netherlands)

    Rudwaleit, Martin; Baeten, Dominique

    2006-01-01

    Between 5 and 10% of cases of ankylosing spondylitis (AS) are associated with inflammatory bowel disease (IBD), either Crohn's disease or ulcerative colitis. A much larger percentage of AS patients have subclinical gut inflammation manifested either by endoscopic findings or by histology. The

  9. Genetics Home Reference: ankylosing spondylitis

    Science.gov (United States)

    ... for making a protein that plays an important role in the immune system. The HLA-B gene is part of a ... with ankylosing spondylitis . Although these genes play critical roles in the immune system, it is unclear how variations in these genes ...

  10. Genomics of ankylosing spondylitis.

    Science.gov (United States)

    Thomas, Gethin P; Brown, Matthew A

    2010-09-01

    Ankylosing spondylitis (AS) is the prototypic and most prevalent and debilitating spondyloarthropathy, a group of arthritides where the spine and pelvis are specifically targeted. Unlike many other forms of arthritis in which joint damage is mediated through tissue destruction, in AS uncontrolled bone formation occurs, frequently resulting in joint fusion and consequently significant disability. It is estimated that there are 2.4 million spondyloarthritis sufferers in the U.S., twice as many as rheumatoid arthritis. The pathogenesis of AS is very poorly understood and both genetics and gene expression profiling approaches have been utilized to elucidate the underlying mechanisms and pathways that drive the disease. Using powerful genome-wide association study approaches a number of candidate genes have been found to be associated with AS. However, although such approaches can identify genes that can contribute to the disease process, they do not inform us of the actual changes in gene/cell activity at any point in the disease process. Expression profiling allows us to take a "snapshot" of cellular activity and what gene activity changes are underlying those changes. A number of expression profiling studies have been undertaken in AS, looking at both circulating cells and tissues from affected joints. The results to date have been somewhat disappointing with little consensus on gene activity changes due to the low power of the studies undertaken. Some more recent better powered studies have identified diagnostic expression profiles that do point to a possible role for expression profiling in early AS diagnosis. Future studies will require collaborative approaches to target specific disease stages and sites with larger numbers of samples.

  11. Cardiopulmonary Manifestations of Ankylosing Spondylitis

    Science.gov (United States)

    Momeni, Mahnaz; Taylor, Nora; Tehrani, Mahsa

    2011-01-01

    Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS). AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, interstitial lung disease, ventilatory impairment due to chest wall restriction, sleep apnea, and spontaneous pneumothorax. They are many reports detailing pathophysiology, hypothesized mechanisms leading to these derangements, and estimated prevalence of such findings in the AS populations. At this time, there are no clear guidelines regarding a stepwise approach to screen these patients for cardiovascular and pulmonary complications. PMID:21547038

  12. Overview of Ankylosing Spondylitis

    Science.gov (United States)

    ... Contact Us Community Message Boards & Forums Support Groups Orlando Living with Spondylitis Your Stories The Faces of ... with tears of joy as I left a meeting room this afternoon. Here is the story... Read ...

  13. [Interdisciplinary rehabilitation in patients with ankylosing spondylitis].

    Science.gov (United States)

    Hegedűs, Béla; Varga, János; Somfay, Attila

    2016-07-01

    Complex pulmonary assessment related to respiratory manifestation in patients with ankylosing spondylitis may contribute to adaptation of an appropriate rehabilitation program. To examine the relationship between lung function, exercise physiological variables and change in quality of life after rehabilitation in patients with ankylosing spondylitis. 5 patients in Seyfried's Stage 2 and 11 patients in Stage 3 underwent spinal physiotherapy, ultrasound, massage and paraffin Pack, 15 times each, followed by a high-intensity cycling 3 times a week for 8 weeks. The Bath Ankylosing Spondylitis Disease Activity and Bath Ankylosing Spondylitis Functional Indexes were recorded before and after rehabilitation. Lung function with exercise physiological variables were examined after rehabilitation. Both indexes showed a post-treatment significant improvement compared to the initial scores (pankylosing spondylitis. Orv. Hetil., 2016, 157(28), 1126-1132.

  14. Decreased central corneal thickness in ankylosing spondylitis.

    Science.gov (United States)

    Ortak, Huseyin; Inanır, Ahmet; Demir, Selim; Uysal, Alper; Şahin, Şafak; Sağcan, Mustafa; Önder, Yalçın; Alim, Sait; Demir, Ayşe Kevser

    2014-04-01

    Central corneal thickness and dry eye tests were evaluated in a study population consisting of 68 ankylosing spondylitis patients diagnosed according to the modified New York criteria, and 61 age-matched controls without ankylosing spondylitis. A full ophthalmological evaluation was performed on each subject. All subjects were screened for age, gender, HLA-B27, tear break-up time test, Schirmer test, and duration of disease. Central corneal thickness was measured under topical anesthesia with an ultrasonic pachymeter. The mean central corneal thickness was 537.3 ± 30.6 μm, range 462-600 μm, in ankylosing spondylitis patients, whereas it was 551.7 ± 25.2 μm, range 510-620 μm, in controls (p = 0.005). The Schirmer test result was 7.3 ± 5.9 mm for the ankylosing spondylitis patients and 11.7 ± 5.8 mm for the control group (p = 0.002). Tear break-up time was 7.3 ± 3.2 s for the ankylosing spondylitis patients and 14.0 ± 4.5 s for the control group (p ankylosing spondylitis. In addition, attention must be given to lower dry eye tests in surgical interventions such as photorefractive keratectomy and laser in situ keratomileusis in ankylosing spondylitis patients.

  15. Scintigraphic findings in ankylosing spondylitis.

    Science.gov (United States)

    Lentle, B C; Russell, A S; Percy, J S; Jackson, F I

    1977-06-01

    A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50% of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40% of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy.

  16. Disease modification in ankylosing spondylitis.

    Science.gov (United States)

    Maksymowych, Walter P

    2010-02-01

    The concept of disease modification in ankylosing spondylitis (AS) incorporates aspects of inflammation, bone destruction and new bone formation. The degree to which inflammation and new bone formation are linked remains conjectural, but data from MRI studies of spinal inflammation support the concept of such coupling; however, these studies also suggest a role for the involvement of noninflammatory pathways, such as those involving bone morphogenetic proteins, wingless proteins and Dickkopf-1, in the formation of new bone. The main clinical outcome that reflects disease modification is the modified Stoke Ankylosing Spondylitis Spine Score, which assesses abnormalities in the anterior vertebral corners of the cervical and lumbar spine. However, radiographic progression can only be reliably detected using this method after at least 2 years, and this delay precludes the conduct of placebo-controlled trials on ethical grounds. Preliminary data using this scoring tool suggest that cyclooxygenase-2-selective NSAIDs might reduce disease progression if used continuously over 2 years. By contrast, three different anti-tumor necrosis factor therapies have shown no impact on radiographic progression. Therapeutic trials recruiting patients early in their disease course and at high risk of radiographic progression constitute a high priority for clinical research in AS.

  17. Ankylosing Spondylitis: a Reflection and a Question

    Directory of Open Access Journals (Sweden)

    Annia Deysi Hernández Martín

    2014-07-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease that affects the synovial membrane, joint entheses and para-articular structures of the spine, including the sacroiliac joints and limbs. We present a case of ankylosing spondylitis that had evolved for 12 years despite the relatively early diagnosis and treatment, showing flexion deformity and limitation of spinal movements. On radiological examination an early evolution to ankylosis was observed, which motivated us to make a reflection and a question.

  18. Erectile dysfunction in ankylosing spondylitis patients.

    Science.gov (United States)

    Santana, Thiago; Skare, Thelma; Delboni, Vitor Steil; Simione, Juliana; Campos, Ana Paula B; Nisihara, Renato

    2017-01-01

    Rheumatic diseases such as ankylosing spondylitis (AS) may be associated with sexual dysfunction. To study erectile function of a group of Brazilian AS patients comparing them with controls. This was a cross sectional study approved by the local Committee of Ethics in Research. The questionnaire IIEF (International Index of Erectile Function) was applied to 40 AS patients and 40 healthy controls. AS patients had determination of disease activity (through BASDAI or Bath Ankylosing Spondylitis Disease activity index), ASDAS (Ankylosing Spondylitis Disease Activity Score, MASES or Maastricht Ankylosing Spondylitis Score and SPARCC or Spondyloarthritis Research Consortium of Canada), function (through BASFI or Bath Ankylosing Spondylitis Functional Index and HAQ or Health Assessment Questionnaire) and BASMI (Bath Ankylosing Spondylitis Metrological Index). AS patients had a median score on IIEF of 22.0 (IQR=18-25) while controls had 29 (IQR=27-30) with p<0.0001 Only 17.5% of the AS patients had no erectile dysfunction, in opposite to 87.5% of controls (p<0.0001). IIEF scores had a negative association with BASDAI (p<0.0001), HAQ (p=0.05), body mass index (P=0.03), MASES (P=0.02) and SPARCC (P=0.02) in a univariate analysis. Multiple regression showed that BASDAI was the only variable independently associated with IIEF. There is a high prevalence of erectile dysfunction among AS patients that is associated with disease activity measured by BASDAI. Copyright® by the International Brazilian Journal of Urology.

  19. Spinal pseudarthrosis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Chan, F.L.; Ho, E.K.W.; Fang, D.; Hsu, L.C.S.; Leong, J.C.Y.; Ngan, H.

    Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occured at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation.

  20. Wnt signaling in ankylosing spondylitis.

    Science.gov (United States)

    Corr, Maripat

    2014-06-01

    The mechanisms that lead to bony fusion in ankylosing spondylitis (AS) are yet to be fully defined. In recent years, there have been several advances in our understanding of this complex disease. Here, the potential impact of the Wnt signaling pathway will be discussed. This pathway is involved in bone morphogenesis and homeostasis. Perturbations in the normal regulation have been implicated in abnormal bone formation (e.g., osteophytes). Levels of Wnt regulatory proteins like Dickkopf have been investigated as potential biomarkers of disease. This pathway might be involved in other aspects of this disease including T cell activation and differentiation, and in bone marrow adipogenesis. The pathways leading to the unique pathology and bony fusion in AS are complex and the Wnt pathway might play a critical contributing role.

  1. Spinal instability in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Badve Siddharth

    2010-01-01

    Full Text Available Background: Unstable spinal lesions in patients with ankylosing spondylitis are common and have a high incidence of associated neurological deficit. The evolution and presentation of these lesions is unclear and the management strategies can be confusing. We present retrospective analysis of the cases of ankylosing spondylitis developing spinal instability either due to spondylodiscitis or fractures for mechanisms of injury, presentations, management strategies and outcome. Materials and Methods: In a retrospective analysis of 16 cases of ankylosing spondylitis, treated surgically for unstable spinal lesions over a period of 12 years (1995-2007; 87.5% (n=14 patients had low energy (no obvious/trivial trauma while 12.5% (n=2 patients sustained high energy trauma. The most common presentation was pain associated with neurological deficit. The surgical indications included neurological deficit, chronic pain due to instability and progressive deformity. All patients were treated surgically with anterior surgery in 18.8% (n=3 patients, posterior in 56.2% (n=9 patients and combined approach in 25% (n=4 patients. Instrumented fusion was carried out in 87.5% (n=14 patients. Average surgical duration was 3.84 (Range 2-7.5 hours, blood loss 765.6 (± 472.5 ml and follow-up 54.5 (Range 18-54 months. The patients were evaluated for pain score, Frankel neurological grading, deformity progression and radiological fusion. One patient died of medical complications a week following surgery. Results: Intra-operative adverse events like dural tears and inadequate deformity correction occurred in 18.7% (n=3 patients (Cases 6, 7 and 8 which could be managed conservatively. There was a significant improvement in the Visual analogue score for pain from a pre-surgical median of 8 to post-surgical median of 2 (P=0.001, while the neurological status improved in 90% (n=9 patients among those with preoperative neurological deficit who could be followed-up (n =10. Frankel

  2. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.

    Science.gov (United States)

    Kobak, Senol; Yalçin, Murat; Karadeniz, Muamer; Oncel, Guray

    2013-01-01

    Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

  3. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

    Directory of Open Access Journals (Sweden)

    Şenol Kobak

    2013-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

  4. Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis

    DEFF Research Database (Denmark)

    Glintborg, Bente; Sørensen, Inge J; Østergaard, Mikkel

    2017-01-01

    OBJECTIVE: To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders....../disease duration/TNFi-type/smoking/baseline disease activity) on TNFi adherence and response [e.g., Bath Ankylosing Spondylitis Activity Index (BASDAI) 50%/20 mm]. RESULTS: The study included 1250 TNFi-naive patients with axSpA (29% nr-axSpA, 50% AS, 21% lacked radiographs of sacroiliac joints). Patients...

  5. Employment perspectives of patients with ankylosing spondylitis

    NARCIS (Netherlands)

    Chorus, A.M.J.; Boonen, A.; Miedema, H.S.; Linden, S. van der

    2002-01-01

    Objectives: To assess the labour market position of patients with ankylosing spondylitis (AS) in relation to disease duration and to identify potential factors in relation to withdrawal from the labour force. Methods: A cross sectional mail survey was conducted among 658 patients with AS.

  6. Radon within therapeutic strategies of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Herold, M.; Lind-Albrecht, G.

    2008-01-01

    For more than fifty years patients with rheumatic diseases have been treated in the thermal gallery of Bad Gastein, main indication is ankylosing spondylitis. Experiences of this kind of spa treatment on several hundred patients and randomised controlled clinical trials document the positive treatment effect of spa therapy with Radon which lasts for up to 40 weeks. (author) [de

  7. Radiation-induced leukemias in ankylosing spondylitis

    International Nuclear Information System (INIS)

    Toolis, F.; Potter, B.; Allan, N.C.; Langlands, A.O.

    1981-01-01

    Three cases of leukemia occurred in patients with ankylosing spondylitis treated by radiotherapy. In each case, the leukemic process exhibited bizarre features suggesting that radiation is likely to induce atypical forms of leukemia possessing unusual attributes not shared by spontaneously developing leukemia. The likely distinctive aspects of radiation-induced leukemia are discussed

  8. Ankylosing spondylitis and bowel disease.

    Science.gov (United States)

    Rudwaleit, Martin; Baeten, Dominique

    2006-06-01

    Between 5 and 10% of cases of ankylosing spondylitis (AS) are associated with inflammatory bowel disease (IBD), either Crohn's disease or ulcerative colitis. A much larger percentage of AS patients have subclinical gut inflammation manifested either by endoscopic findings or by histology. The association with HLA-B27 is less strong in IBD-associated AS than in idiopathic AS, and there is evidence for an association between gut inflammation in AS with the Crohn's-disease-related CARD15 mutations. Despite the different genetics, the immunopathology suggests common inflammatory pathways in gut and joint inflammation in AS, and in gut inflammation in AS and IBD. Although this observation is of interest to unravel the pathophysiology of the disease, systematic screening of AS patients by ileocolonoscopy is not indicated in the absence of gut symptomatology as only a small proportion of AS patients with subclinical gut inflammation will develop overt IBD over time. Treatment of AS associated with IBD with non-steroidal anti-inflammatory drugs (NSAIDs) is problematic because of concerns of potential re-activation of IBD by NSAIDs. Major advances have been made in recent years with the establishment of anti-tumour necrosis factor (TNF) therapy in AS, the other spondyloarthritides and IBD. Anti-TNF agents are of particular relevance to AS patients with concomitant IBD who are at risk of exacerbation of the underlying bowel disease when treated with NSAIDs. In IBD, infliximab, unlike etanercept, is effective in treating clinical symptoms, inducing and maintaining remission, and mucosal healing. Adalimumab appears to be effective in treating both AS and IBD; however, official approval is pending. Currently, infliximab is the drug of choice for the treatment of patients with active AS associated with IBD.

  9. Quantitative metagenomics reveals unique gut microbiome biomarkers in ankylosing spondylitis

    OpenAIRE

    Le Chatelier, Emmanuelle; He, Zhixing; Zhong, Wendi; Fan, Yongsheng; Zhang, Linshuang; Li, Haichang; Wu, Chunyan; Hu, Changfeng; Xu, Qian; Zhou, Jia; Cai, Shunfeng; Wang, Dawei; Huang, Yun; Breban, Maxime; Qin, Nan

    2017-01-01

    Background The assessment and characterization of the gut microbiome has become a focus of research in the area of human autoimmune diseases. Ankylosing spondylitis is an inflammatory autoimmune disease and evidence showed that ankylosing spondylitis may be a microbiome-driven disease. Results To investigate the relationship between the gut microbiome and ankylosing spondylitis, a quantitative metagenomics study based on deep shotgun sequencing was performed, using gut microbial DNA from 211 ...

  10. Plantar pressure distribution in patients with ankylosing spondylitis.

    Science.gov (United States)

    Aydin, Elif; Turan, Yasemin; Tastaban, Engin; Kurt Omurlu, Imran; Sendur, Omer Faruk

    2015-03-01

    Ankylosing spondylitis is one of the most common inflammatory rheumatic diseases and is associated with alterations in posture. The aim of this study was to investigate the pedobarographic changes among ankylosing spondylitis patients, in an attempt to understand whether the alterations in the posture affect the plantar pressure distribution. The study population consisted of 38 patients with ankylosing spondylitis and 33 healthy volunteers. The static and dynamic pedobarographic measurements were performed to determine the plantar pressure distribution. Moreover, the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire and Bath Ankylosing Spondylitis Metrology Index were used to assess the clinical state of the patients. The static pedobarographic measurements did not reveal any intergroup difference. There were differences between the groups in the results of dynamic peak pressure measurements under the metatarsal areas and under the midfoot region. The percentage of the midfoot in the dynamic plantar contact area was higher in ankylosing spondylitis patients in comparison to the controls. No clinically significant correlation was found between the clinical scores and static pedobarographic measurements. The plantar pressures under the metatarsal heads, medial and lateral heel regions declined with increasing disease activity according to the Bath Ankylosing Spondylitis Disease Activity Index scores. The lower peak pressures on the forefoot and rearfoot, were associated with the higher Bath Ankylosing Spondylitis Metrology Index scores of the patients. The alterations in the posture may have effects on the plantar pressures in patients with ankylosing spondylitis, especially during dynamic activities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    OpenAIRE

    Alfonse T. Masi; Kalyani Nair; Brian J. Andonian; Kristina M. Prus; Joseph Kelly; Jose R. Sanchez; Jacqueline Henderson

    2011-01-01

    Ankylosing spondylitis (AS) is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally...

  12. The genomics and genetics of ankylosing spondylitis

    OpenAIRE

    Thomas GP; Kenna TJ; Davidson SI

    2011-01-01

    Tony J Kenna, Stuart I Davidson, Gethin P ThomasUniversity of Queensland Diamantina Institute, Brisbane, AustraliaAbstract: The spondyloarthropathies are a group of arthritides which specifically target the spine and pelvis with ankylosing spondylitis (AS) being the most prevalent and debilitating of these conditions. Unique to AS is the progression to excessive uncontrolled bone formation following an initial inflammatory phase that can result in joint fusion and significant disability. Spon...

  13. Secukinumab, an Interleukin-17A Inhibitor, in Ankylosing Spondylitis

    NARCIS (Netherlands)

    Baeten, Dominique; Sieper, Joachim; Braun, Jürgen; Baraliakos, Xenofon; Dougados, Maxime; Emery, Paul; Deodhar, Atul; Porter, Brian; Martin, Ruvie; Andersson, Mats; Mpofu, Shephard; Richards, Hanno B.; van den Bosch, Filip; Nzeusseu, Adrien; de Vlam, Kurt; Geusens, Piet; Oparanov, Boycho; Rashkov, Rasho; Batalov, Anastas; Goranov, Ivan; Kazmin, Ivan; McCarthy, Tim; Inman, Robert; Rahman, Proton; Schaeverbeke, Thierry; N'Guyen, Minh; Bertin, Philippe; Frediani, Bruno; Adami, Silvano; Foti, Rosario; Triolo, Giovanni; Fusaro, Enrico; Franceschini, Franco; Zazueta, Beatriz; Maradiaga, Marco; Avila, Hilario; Garza, Mario; Bijlsma, Hans; Berrocal, Alfredo; Garro, Boris; Gamboa, Rocio; Castaneda, Oswaldo; Becerra, Felipe; Stanislav, Marina; Salnikova, Tatyana; Maslyanskiy, Alexey; Ershova, Olga; Izmozherova, Nadezda; Lesniak, Olga; Tseng, Jui-Cheng; Wei, Cheng-Chung; Ozdogan, Huri; Kisacik, Bunyamin; Onen, Fatos; Tahir, Hasan; Ostor, Andrew; Barkham, Nick; Kay, Lesley; Braun, Juergen; Dahmen, Georg; Rubbert-Roth, Andrea; Wassenberg, Siegfried; Oelzner, Peter; Nuesslein, Hubert; Moericke, Ruediger; Rech, Juergen; Kivitz, Alan; Aelion, Jacob; Kohen, Michael; Knibbe, William; LaSalle, Sean; Zang, Song; Cohen, Stanley; Brooks, Michael; Graninger, Winfried; Jorg, Rieger; Zamani, Omid; Bessette, Louis; Cohen, Martin; Beaulieu, Andre; Pavelka, Karel; Galatikova, Dagmar; Dokoupilova, Eva; Leirisalo-Repo, Marjatta; Paimela, Leena; Järvinen, Pentti; Sokka-Isler, Tuulikki; Rouhe, Esa; keskussairaala, Seinäjoen; Pellerito, Raffaele; Trofimov, Vasiliy; Vezikova, Natalia; Zotkin, Eugeny; Mosesova, Nino; Lee, Lui Nai; Cheung, Peter; Balsa, Alejandro; Blanco, Ricardo; Blanco, Francisco J.; Gonzalez, Carlos; Bannert, Bettina; Daniela, Benz; Dudler, Jean; Ciurea, Adrian; Marzo-Ortega, Helena; Gaffney, Karl; Mackay, Kirsten; Codding, Christine; Dorman, Walter; Legerton, Clarence; Khan, Mohamed; Lee, Eric; Caldron, Paul; Wolfe, J. Frederick; Swarup, Areena; Singhal, Atul; Tony, Hans-Peter

    2015-01-01

    BACKGROUND Secukinumab is an anti-interleukin-17A monoclonal antibody that has been shown to control the symptoms of ankylosing spondylitis in a phase 2 trial. We conducted two phase 3 trials of secukinumab in patients with active ankylosing spondylitis. METHODS In two double-blind trials, we

  14. Quantitative metagenomics reveals unique gut microbiome biomarkers in ankylosing spondylitis.

    Science.gov (United States)

    Wen, Chengping; Zheng, Zhijun; Shao, Tiejuan; Liu, Lin; Xie, Zhijun; Le Chatelier, Emmanuelle; He, Zhixing; Zhong, Wendi; Fan, Yongsheng; Zhang, Linshuang; Li, Haichang; Wu, Chunyan; Hu, Changfeng; Xu, Qian; Zhou, Jia; Cai, Shunfeng; Wang, Dawei; Huang, Yun; Breban, Maxime; Qin, Nan; Ehrlich, Stanislav Dusko

    2017-07-27

    The assessment and characterization of the gut microbiome has become a focus of research in the area of human autoimmune diseases. Ankylosing spondylitis is an inflammatory autoimmune disease and evidence showed that ankylosing spondylitis may be a microbiome-driven disease. To investigate the relationship between the gut microbiome and ankylosing spondylitis, a quantitative metagenomics study based on deep shotgun sequencing was performed, using gut microbial DNA from 211 Chinese individuals. A total of 23,709 genes and 12 metagenomic species were shown to be differentially abundant between ankylosing spondylitis patients and healthy controls. Patients were characterized by a form of gut microbial dysbiosis that is more prominent than previously reported cases with inflammatory bowel disease. Specifically, the ankylosing spondylitis patients demonstrated increases in the abundance of Prevotella melaninogenica, Prevotella copri, and Prevotella sp. C561 and decreases in Bacteroides spp. It is noteworthy that the Bifidobacterium genus, which is commonly used in probiotics, accumulated in the ankylosing spondylitis patients. Diagnostic algorithms were established using a subset of these gut microbial biomarkers. Alterations of the gut microbiome are associated with development of ankylosing spondylitis. Our data suggest biomarkers identified in this study might participate in the pathogenesis or development process of ankylosing spondylitis, providing new leads for the development of new diagnostic tools and potential treatments.

  15. Endothelial progenitor cell biology in ankylosing spondylitis.

    Science.gov (United States)

    Verma, Inderjeet; Syngle, Ashit; Krishan, Pawan

    2015-03-01

    Endothelial progenitor cells (EPCs) are unique populations which have reparative potential in overcoming endothelial damage and reducing cardiovascular risk. Patients with ankylosing spondylitis (AS) have increased risk of cardiovascular morbidity and mortality. The aim of this study was to investigate the endothelial progenitor cell population in AS patients and its potential relationships with disease variables. Endothelial progenitor cells were measured in peripheral blood samples from 20 AS and 20 healthy controls by flow cytometry on the basis of CD34 and CD133 expression. Disease activity was evaluated by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional ability was monitored by using Bath Ankylosing Spondylitis Functional Index (BASFI). EPCs were depleted in AS patients as compared to healthy controls (CD34(+) /CD133(+) : 0.027 ± 0.010% vs. 0.044 ± 0.011%, P < 0.001). EPC depletions were significantly associated with disease duration (r = -0.52, P = 0.01), BASDAI (r = -0.45, P = 0.04) and C-reactive protein (r = -0.5, P = 0.01). This is the first study to demonstrate endothelial progenitor cell depletion in AS patients. EPC depletions inversely correlate with disease duration, disease activity and inflammation, suggesting the pivotal role of inflammation in depletion of EPCs. EPC would possibly also serve as a therapeutic target for preventing cardiovascular disease in AS. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  16. Genetics and the Causes of Ankylosing Spondylitis.

    Science.gov (United States)

    Hanson, Aimee; Brown, Matthew A

    2017-08-01

    Ankylosing spondylitis (AS) is a common inflammatory arthritis in which genetic factors are the primary determinants of disease risk and severity. Substantial progress has been made in identifying genetic pathways involved in the disease, and in translating those discoveries to drug discovery programs. Recently discovered novel disease pathways include those involved in control of DNA methylation, bacterial sensing, and mucosal immunity. Additional pathways are likely to be identified as a higher proportion of the genetic risk of AS is determined. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Spinal fractures in patients with ankylosing spondylitis.

    Science.gov (United States)

    Leone, Antonio; Marino, Marzia; Dell'Atti, Claudia; Zecchi, Viola; Magarelli, Nicola; Colosimo, Cesare

    2016-10-01

    The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance. Even in the presence of symptomatic clinical vertebral fractures, the diagnosis can be overruled by attributing the pain to disease activity. Furthermore, given the highly abnormal structure of the spine, vertebral fracture diagnosis can be difficult on the basis of radiography alone. CT can show the fractures in detail. Magnetic resonance imaging is considered the method of choice for the imaging of spinal cord injuries, and a reasonable option for exclusion of occult fractures undetected by CT. Since it is equally important for radiologists and clinicians to have a common knowledge base rather than a compartmentalized view, the aim of this review article was to provide the required clinical knowledge that radiologists need to know and the relevant radiological semiotics that clinicians require in diagnosing clinically significant injury to the ankylosed spine.

  18. T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis

    Science.gov (United States)

    WANG, CHENGGONG; LIAO, QIANDE; HU, YIHE; ZHONG, DA

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of α-globulin, γ-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-γ and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-γ and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis. PMID:25452811

  19. T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis.

    Science.gov (United States)

    Wang, Chenggong; Liao, Qiande; Hu, Yihe; Zhong, DA

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of α-globulin, γ-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-γ and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-γ and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis.

  20. Arthritis of the middle ear in ankylosing spondylitis.

    OpenAIRE

    Magarò, M; Ceresia, G; Frustaci, A

    1984-01-01

    A case of ankylosing spondylitis with aortic valve disease and hearing loss is described. A series of radiographic and audiometric investigations showed the hearing loss to be of a conductive type. It seemed most likely that the hearing loss was related to an inflammatory involvement of the ossicular joints due to the primary disease. No other case of conductive hearing loss has previously been reported due to otoarthritis in ankylosing spondylitis. This is important both theoretically and pr...

  1. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis...

  2. Decreased clinical response to infliximab in ankylosing spondylitis is correlated with anti-infliximab formation

    NARCIS (Netherlands)

    de Vries, Mirjam K.; Wolbink, Gerrit Jan; Stapel, Steven O.; de Vrieze, Henk; van Denderen, J. Christiaan; Dijkmans, Ben A. C.; Aarden, Lucien A.; van der Horst-Bruinsma, Irene E.

    2007-01-01

    OBJECTIVES: Correlation of serum trough infliximab levels and antibodies to infliximab (anti-infliximab) with clinical response in ankylosing spondylitis. METHODS: In accordance with the international ASsessment in Ankylosing Spondylitis (ASAS) consensus statement, patients were treated with

  3. Ankylosing spondylitis is indigenous to Mesoamerica.

    Science.gov (United States)

    Martínez-Lavín, M; Mansilla, J; Pineda, C; Pijoán, C

    1995-12-01

    Paleopathology helps to define the origin and the migration of diseases. It has been established that genetic and environmental factors play a role in the pathogenesis of ankylosing spondylitis (AS). We investigated whether AS was present in Mesoamerica before contact with the European civilization. We studied the collection of Mesoamerican human skeletal remains preserved at the National Museum of Anthropology of Mexico, searching for features of AS. We found one incomplete specimen of a man of the Postclassic period (900-1521 AD). It showed fusion of the vertebral column from T8 to L5 due to ankylosis of the apophyseal joints and of the spinal processes. The pelvis was not preserved. Radiographs demonstrated ossification of both supraspinous and interspinous ligaments. Our findings suggest AS was present in Mesoamerica before the arrival of Europeans.

  4. Ankylosis in ankylosing spondylitis: current concepts.

    Science.gov (United States)

    Haroon, Nigil

    2015-06-01

    Ankylosing spondylitis (AS) is the most common form of spondyloarthritis and is characterized by both inflammation and new bone formation. Despite many years of arduous efforts, we still do not clearly understand the pathogenesis of AS. The mechanisms behind new bone formation have been especially challenging to decipher due to the difficulty in obtaining tissue from spinal joints. The link between inflammation and bone formation looks obvious, but how inflammation drives spinal fusion is not evident. There are now two genes linked to prostaglandins (PG) that could be involved in AS pathogenesis. The first one is PTGER4 that codes for the EP4 receptor for PGE2 and the other one is PTGS1 that codes for prostaglandin-endoperoxide syntase 1 or cyclogenase 1. The bone morphogenic protein and Wnt signaling pathways could be important in signaling increased bone formation in AS. The disease-modifying potential of anti-inflammatories and tumor necrosis factor alpha inhibitors is discussed.

  5. Predicting the outcome of ankylosing spondylitis therapy

    Science.gov (United States)

    Vastesaeger, Nathan; van der Heijde, Désirée; Inman, Robert D; Wang, Yanxin; Deodhar, Atul; Hsu, Benjamin; Rahman, Mahboob U; Dijkmans, Ben; Geusens, Piet; Vander Cruyssen, Bert; Collantes, Eduardo; Sieper, Joachim; Braun, Jürgen

    2011-01-01

    Objectives To create a model that provides a potential basis for candidate selection for anti-tumour necrosis factor (TNF) treatment by predicting future outcomes relative to the current disease profile of individual patients with ankylosing spondylitis (AS). Methods ASSERT and GO–RAISE trial data (n=635) were analysed to identify baseline predictors for various disease-state and disease-activity outcome instruments in AS. Univariate, multivariate, receiver operator characteristic and correlation analyses were performed to select final predictors. Their associations with outcomes were explored. Matrix and algorithm-based prediction models were created using logistic and linear regression, and their accuracies were compared. Numbers needed to treat were calculated to compare the effect size of anti-TNF therapy between the AS matrix subpopulations. Data from registry populations were applied to study how a daily practice AS population is distributed over the prediction model. Results Age, Bath ankylosing spondylitis functional index (BASFI) score, enthesitis, therapy, C-reactive protein (CRP) and HLA-B27 genotype were identified as predictors. Their associations with each outcome instrument varied. However, the combination of these factors enabled adequate prediction of each outcome studied. The matrix model predicted outcomes as well as algorithm-based models and enabled direct comparison of the effect size of anti-TNF treatment outcome in various subpopulations. The trial populations reflected the daily practice AS population. Conclusion Age, BASFI, enthesitis, therapy, CRP and HLA-B27 were associated with outcomes in AS. Their combined use enables adequate prediction of outcome resulting from anti-TNF and conventional therapy in various AS subpopulations. This may help guide clinicians in making treatment decisions in daily practice. PMID:21402563

  6. Bone Mineral Density in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Bahar Çakmak

    2003-12-01

    Full Text Available Ankylosing Spondylitis (AS, a chronic inflammatory rheumatic disease. One of the most frequent and important complications in these patients is osteoporosis. There are controversial studies on the correlation of osteoporosis and disease duration, activity and functional status. Twenty-one male and five female patients diagnosed as AS according to Modified New York, ESSG( European Spondyloartropaties Study Group and Amor criteria were included in this study. Disease duration and age-sex of the patients was assessed. Patients with ankylosed lumbar spine in late stages of the disease were excluded. Bone mineral density (BMD was measured by DEXA( Hologic at lumbar and femoral neck regions. BASDAI was used for evaluation of disease activity and BASFI index for functional status evaluation.Correlation of BMD with disease duration, BASDAI and BASFI indexes was assessed. BMD at lumbar spine and femoral neck regions was found to be osteoporotic in 11,5 % of the patients. In the lumbar region there was no correlation between BMD and disease duration, BASFI and BASDAI indexes. BMD values of femoral neck showed a weak inverse correlation with disease duration, while no correlation was found between BMD and BASFI and BASDAI. As a conclusion in AS patients osteoporosis besides the disease itself many secondarily influence disease prognosis and complications. Therefore osteoporosis should be evaluated in the management and follow-up of AS patients.

  7. Corneal biomechanical features in patients with ankylosing spondylitis.

    Science.gov (United States)

    Cabuk, Kubra Serefoglu; Üstün, Emine Isil; Atalay, Kursat; Kirgiz, Ahmet; Aydin, Rukiye

    2017-01-01

    To evaluate the corneal biomechanical features and central corneal thickness in ankylosing spondylitis patients and to evaluate correlations of these parameters with disease activity. The study included 51 patients diagnosed with ankylosing spondylitis (mean age, 40.80 ± 13.15 years; range, 18-72 years) and 34 age- and sex-matched healthy controls (mean age, 42.00 ± 12.32 years; range, 18-60 years). All underwent a complete ophthalmological and physical examination, including visual acuity testing and biomicroscopic anterior and posterior segment examinations. Corneal hysteresis, corneal resistance factor, Goldmann-correlated intraocular pressure, and corneal compensated intraocular pressure were evaluated with an ocular response analyzer, and the central corneal thickness was measured with Sirius® corneal tomography. The Bath Ankylosing Spondylitis Disease Activity Index, Functional Index, and Metrology Index scores were recorded. In the ankylosing spondylitis patients, the mean disease duration was 7.73 ± 6.05 (range, 1-30) years. There was no statistically significant difference between the patients and controls in the corneal biomechanical features. The Goldmann-correlated intraocular pressure and corneal compensated intraocular pressure both showed positive correlations with age (p=0.003 and p=0.001, res-pectively). There was a negative correlation between corneal hysteresis and disease duration (p=0.002), and between central corneal thickness and the Bath Ankylosing Spondylitis Metrology Index score (p=0.003). This study demonstrated a significant negative correlation between corneal hysteresis and disease duration in ankylosing spondylitis patients. Furthermore, the central corneal thickness value decreased with an increase in Bath Ankylosing Spondylitis Metrology Index score, which may result in an underestimate of intraocular pressure readings and thus an inaccurate risk assessment of glaucoma.

  8. Scoring radiographic progression in ankylosing spondylitis: should we use the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) or the Radiographic Ankylosing Spondylitis Spinal Score (RASSS)?

    NARCIS (Netherlands)

    Ramiro, Sofia; van Tubergen, Astrid; Stolwijk, Carmen; Landewé, Robert; van de Bosch, Filip; Dougados, Maxime; van der Heijde, Désirée

    2013-01-01

    ABSTRACT: INTRODUCTION: Radiographic damage is one of the core outcomes in axial SpA and is usually assessed with the modified Stoke Ankylosing Spondylitis (AS) Spine Score (mSASSS). Alternatively, the Radiographic AS Spinal Score (RASSS) is proposed, which includes the lower thoracic vertebrae,

  9. The genomics and genetics of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Thomas GP

    2011-12-01

    Full Text Available Tony J Kenna, Stuart I Davidson, Gethin P ThomasUniversity of Queensland Diamantina Institute, Brisbane, AustraliaAbstract: The spondyloarthropathies are a group of arthritides which specifically target the spine and pelvis with ankylosing spondylitis (AS being the most prevalent and debilitating of these conditions. Unique to AS is the progression to excessive uncontrolled bone formation following an initial inflammatory phase that can result in joint fusion and significant disability. Spondyloarthritis is estimated to affect 1%–2% of the population, twice as many as rheumatoid arthritis and thus constitutes a significant health problem. Currently AS pathogenesis is very poorly understood but recent large-scale genetics and gene expression profiling studies have identified some of the underlying mechanisms and pathways contributing to the disease. Genome-wide association studies have identified a number of candidate genes associated with AS sharing the same pathways which are now being targeted for therapeutic intervention. However, although such approaches can identify genes contributing to the disease process and are very informative as to disease aetiopathogenesis, they cannot profile the actual changes in gene/cell activity at any point in the disease process or possibly more importantly at specific sites. Such information is generated using expression profiling. A number of expression profiling studies have been undertaken in AS, looking at both circulating cells and tissues from affected joints. Although some common genes/pathways have been identified, overall the results to date have been somewhat disappointing due to differences in experimental design and tissue source as well as the low power of the studies. More recent better powered studies have shown some potential in developing gene expression profiling as a diagnostic tool in AS. True future success will rely on larger genetic and genomic studies and the combination of these

  10. Magnetic resonance imaging for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Bollow, M.

    2002-01-01

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [de

  11. The relationship between inflammation and new bone formation in patients with ankylosing spondylitis

    OpenAIRE

    Baraliakos, Xenofon; Listing, Joachim; Rudwaleit, Martin; Sieper, Joachim; Braun, Juergen

    2008-01-01

    Introduction Spinal inflammation as detected by magnetic resonance imaging and new bone formation as identified by conventional radiographs are characteristic of ankylosing spondylitis. Whether and how spondylitis and syndesmophyte formation are linked are unclear. Our objective was to investigate whether and how spinal inflammation are associated with new bone formation in ankylosing spondylitis. Methods Spinal magnetic resonance images and conventional radiographs from 39 ankylosing spondyl...

  12. The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients.

    Science.gov (United States)

    Kasapoglu Aksoy, Meliha; Birtane, Murat; Taştekin, Nurettin; Ekuklu, Galip

    2017-04-01

    Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton which can lead to structural and functional impairments. It has a negative impact on the person's daily life activities. Early diagnosis, exercise and patient education are factors playing a major role on prognosis. The purpose of the study was to compare the structured theoretical and exercise educational program with routine clinic educational efforts on the parameters of the disorder over a 3 month follow up. This randomized, educational intervention study was performed on 41 AS patients. A 5 day structured education and exercise program was applied to the first group of patients (Group 1) in subgroups consisting 4-5 patients each. Patients had group exercises throughout the education program. The second group followed routine clinical care. The effectiveness of the treatment was assessed by Bath ankylosing spondylitis functional (BASFI), Bath ankylosing spondylitis disease activity (BASDAI), Bath ankylosing spondylitis global (BAS-G), Bath ankylosing spondylitis metrology indices (BASMI), chest expansion, short form-36 (SF-36), ankylosing spondylitis quality of life scale (ASQoL) and laboratory parameters in all patients. Patients were evaluated on initiation and after 3 months. Significant improvements in BASFI, BASDAI and BAS-G, chest expansion, SF-36 and ASQoL indices were observed in Group 1 No difference could be found in BASMI and chest expansion. A structured educational and exercise intervention had a positive effect on the functional status,disease activity, and general well-being and quality of life. It also, shows that education programs should be within the routine treatment program for AS.

  13. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Alfonse T. Masi

    2011-01-01

    Full Text Available Ankylosing spondylitis (AS is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.

  14. Surgical orodental implications in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdizadeh

    2012-01-01

    Full Text Available Temporomandibular joint and the pelvic complex are bidirectionally related. Ankylosing spondylitis (AS is a seronegative arthropathy with the key feature of bony fusion of lumbar vertebrae. A 39 year old known case of AS was presented to private office for left lower impacted third molar surgical removal. Previously, he was rejected to receive oral care for pulpectomy and extraction due to limited mouth opening. Prior to the surgery, lateral neck radiography was obtained to exclude any subluxation of fracture of cervical vertebrae. Neck was supported to insure neck stability during surgical forces. In addition, considering consumption of immunosuppressive medications including corticosteroids, procedure was performed with a great care, with attention to higher possibility of infection and fracture. Access to the surgical site was not desirable, though surgery accomplished without any significant event and the patient discharged with routine analgesic and antibiotics recommendation. Sometimes, impaired access to the oral cavity in patients with AS leads to receive suboptimal or minimal orodental care. Long list of dental implications in these patients may be simplified by considering of careful neck and jaw support, applying at least possible forces and great attention to the infection control rules. It is wised to be performed under patient and skilled hands.

  15. Ankylosing Spondylitis: From Cells to Genes

    Science.gov (United States)

    Zambrano-Zaragoza, José Francisco; Agraz-Cibrian, Juan Manuel; González-Reyes, Christian; Durán-Avelar, Ma. de Jesús; Vibanco-Pérez, Norberto

    2013-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology, though it is considered an autoimmune disease. HLA-B27 is the risk factor most often associated with AS, and although the mechanism of involvement is unclear, the subtypes and other features of the relationship between HLA-B27 and AS have been studied for years. Additionally, the key role of IL-17 and Th17 cells in autoimmunity and inflammation suggests that the latter and the cytokines involved in their generation could play a role in the pathogenesis of this disease. Recent studies have described the sources of IL-17 and IL-23, as well as the characterization of Th17 cells in autoimmune diseases. Other cells, such as NK and regulatory T cells, have been implicated in autoimmunity and have been evaluated to ascertain their possible role in AS. Moreover, several polymorphisms, mutations and deletions in the regulatory proteins, protein-coding regions, and promoter regions of different genes involved in immune responses have been discovered and evaluated for possible genetic linkages to AS. In this review, we analyze the features of HLA-B27 and the suggested mechanisms of its involvement in AS while also focusing on the characterization of the immune response and the identification of genes associated with AS. PMID:23970995

  16. Rosuvastatin improves endothelial dysfunction in ankylosing spondylitis.

    Science.gov (United States)

    Garg, Nidhi; Krishan, Pawan; Syngle, Ashit

    2015-06-01

    Enhanced cardiovascular risk in ankylosing spondylitis (AS) provides a strong rationale for early therapeutical intervention. In view of the proven benefit of statins in atherosclerotic vascular disease, we aimed to investigate the effect of rosuvastatin on endothelial dysfunction (ED) and inflammatory disease activity in AS. In a single-blind, placebo-controlled, parallel study, 32 AS patients were randomized to receive 24 weeks of treatment with rosuvastatin (10 mg/day, n = 17) and placebo (n = 15) as an adjunct to existing stable antirheumatic drugs. Flow-mediated dilatation (FMD) was assessed by AngioDefender™ (Everest Genomic Ann Arbor, USA). Inflammatory measures (BASDAI, BASFI, CRP and ESR) and pro-inflammatory cytokines (tumour necrosis factor-alpha [TNF-α], interleukin-6 [IL-6] and interleukin-1 [IL-1]) were measured at baseline and after treatment. Lipids and adhesion molecules (intracellular adhesion molecule [ICAM-1] and vascular cell adhesion molecule [VCAM-1]) were estimated at baseline and after treatment. At baseline, inflammatory measures, pro inflammatory cytokines and adhesion molecules were elevated among both groups. After treatment with rosuvastatin, FMD improved significantly (p pathways. Rosuvastatin can mediate modest but clinically apparent anti-inflammatory effects with modification of vascular risk factors in the context of high-grade autoimmune inflammation of AS.

  17. Integrative structural biomechanical concepts of ankylosing spondylitis.

    Science.gov (United States)

    Masi, Alfonse T; Nair, Kalyani; Andonian, Brian J; Prus, Kristina M; Kelly, Joseph; Sanchez, Jose R; Henderson, Jacqueline

    2011-01-01

    Ankylosing spondylitis (AS) is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.

  18. Ankylosing spondylitis and a diagnostic dilemma: coccydynia.

    Science.gov (United States)

    Deniz, R; Ozen, G; Yilmaz-Oner, S; Aydin, S Z; Erzik, C; Gunduz, O H; Inanc, N; Direskeneli, H; Atagunduz, P

    2014-01-01

    Coccydynia is defined as pain in or around the tail bone area. The most common cause of coccydynia is either a trauma such as a fall directly on to the coccyx or repetitive minor trauma. The etiology remains obscure in up to 30% of patients. The literature on the contribution of rheumatic diseases to coccydynia is scarce. Our objective was to investigate the prevalence of coccydynia in ankylosing spondylitis (AS) patients. One hundred and seven consecutive patients with AS were evaluated for coccydynia were enrolled between January and November 2012 for a cross-sectional analysis. Seventy-four consecutive patients were followed for mechanical back pain as controls and the AS patients were interviewed for the presence of coccydynia. The data collected was evaluated on SPSS® version 11.5 and Microsoft Excel® Programmes. Prevalence of coccydynia in AS (38.3%) was significantly higher than the control group (ppain. Our observation may implicate that inflammatory diseases have a role in the etiology of coccydynia, especially in those without a history of recent or past trauma and coccydynia may be a factor associated with the severity of AS as well.

  19. Ankylosing Spondylitis and Pregnancy: A Literature Review.

    Science.gov (United States)

    Giovannopoulou, Eirini; Gkasdaris, Grigorios; Kapetanakis, Stylianos; Kontomanolis, Emmanuel

    2017-01-01

    Ankylosing Spondylitis (AS) is the prototype of a group of systemic rheumatic diseases collectively referred to as Spondylarthitides (SpA). It has now become clear that AS is not as rare as previously thought and, although it has an early onset in life affecting patients in their reproductive years, it has not been proved to adversely affect fertility in females. The aim of this review is to summarize all the recent data on AS and pregnancy in terms of fertility, disease course and pregnancy outcome from a clinical perspective. A literature research was conducted based on the following medical databases: Pubmed/ Medline and the Cochrane Library. We searched for randomized controlled studies, casecontrol studies, cohort studies, patient and drug registers in relation to pregnancy and AS. The existing data do not support a causal relationship between AS and infertility. The state of pregnancy is not associated with reduced disease activity in patients with AS. Additionally, AS tends to adversely affect health-related quality of life during pregnancy, in comparison with normal population and patients with rheumatoid arthritis. As far as the obstetrical outcome is concerned, there is no consensus on the significant association between AS and specific pregnancy, delivery and fetal complications. Previous studies are highly heterogenous and mainly retrospective and thus, the existing data are controversial and inconclusive. Subsequent studies are required to enlighten our knowledge on the interaction between AS and pregnancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ju Seop; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonbuk National University, Iksan (Korea, Republic of)

    2000-09-15

    A 31-year-old male with severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no faical swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the both condylar heads. Labortory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the labortary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

  1. Perinatal characteristics, older siblings, and risk of ankylosing spondylitis

    DEFF Research Database (Denmark)

    Lindström, Ulf; Forsblad-d'Elia, Helena; Askling, Johan

    2016-01-01

    BACKGROUND: The effect of circumstances and exposures early in life on the risk of developing ankylosing spondylitis (AS) is largely unknown. The purpose of this study was to determine whether perinatal characteristics predict development of AS. METHODS: AS cases (n = 1960; 59 % men) were defined...

  2. Ankylosing spondylitis: a case report with review of literature ...

    African Journals Online (AJOL)

    Materials and Methods: A case report of a 60 year old Libyan male who has Ankylosing spondylitis and then review the available literature. Results: The patient has been having a chronic low back pain and stiffness for the last 26 years. His symptoms are most severe in morning and improve with movement. He developed ...

  3. Cost-of-illness of rheumatoid arthritis and ankylosing spondylitis

    NARCIS (Netherlands)

    Franke, A.C.; Ament, A.J.H.A.; Laar, M.A.F.J.; Boonen, A.; Severens, J.L.

    2009-01-01

    Objective. To assess, quantify and summarise the cost of illness of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) from the societal perspective Methods. Original studies reporting costs of RA or AS were searched systematically. Both cost-of-illness studies and economic evaluations of

  4. Aerobic capacity and its correlates in patients with ankylosing spondylitis.

    Science.gov (United States)

    Hsieh, Lin-Fen; Wei, James Cheng-Chung; Lee, Hsin-Yi; Chuang, Chih-Cheng; Jiang, Jiunn-Song; Chang, Kae-Chwen

    2016-05-01

    To evaluate aerobic capacity in patients with ankylosing spondylitis (AS) and determine possible relationships between aerobic capacity, pulmonary function, and disease-related variables. Forty-two patients with AS and 42 healthy controls were recruited in the study. Descriptive data, disease-related variables (grip strength, lumbosacral mobility, occiput-to-wall distance, chest expansion, finger-to-floor distance, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hemoglobin), and chest and thoracic spine x-rays were collected in each patient with AS. All subjects took standard pulmonary function and exercise tolerance tests, and forced vital capacity (FVC) and aerobic capacity were recorded. Both aerobic capacity and FVC in patients with AS were significantly lower than those in normal subjects (P < 0.05). AS patients with BASFI scores of < 3 or BASDI scores of < 4 had a higher aerobic capacity. There was significant correlation between aerobic capacity, vital capacity, chest expansion, Schober's test, cervical range of motion, and BASFI in patients with AS. Neither aerobic capacity nor vital capacity correlated with disease duration, ESR, CRP, and hemoglobin. Significantly reduced aerobic capacity and FVC were observed in patients with AS, and there was significant correlation between aerobic capacity, vital capacity, chest expansion, and BASFI. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  5. Ankylosant spondylitis association and diffuse idiopathic skeletal hyperostosis (DISH)

    International Nuclear Information System (INIS)

    Medina, Yimi; Restrepo Suarez, Jose Felix; Calvo Paramo, Enrique

    2000-01-01

    We are presenting a 66 year-old patient complaining of low back pain for the last 3 months and cervical pain for the last 45 days, Review of systems showed long standing lumbar and cervical stiffness, Radiological studies were compatible with ankylosing spondylitis and DISH (Diffuse idiopathic Skeletal Hyperostosis). Associations of those diseases are uncommon and reported only few times in the literature

  6. Fractures of the dens complicating ankylosing spondylitis with atlantooccipital fusion.

    Science.gov (United States)

    Miller, F H; Rogers, L F

    1991-05-01

    Patients with ankylosing spondylitis are prone to fractures. Fractures tend to occur in the lower cervical spine disc space. We describe 2 patients with odontoid fractures. Both patients had atlantooccipital fusion which may have increased their susceptibility for dens fractures. One patient had Crohn's disease.

  7. The image diagnosis of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Xian Jianxing; Zhao Jihong

    2005-01-01

    Objective: To research the image change of JAS and improve the knowledge of this case. Method: 12 patients in this group, 11 males and 1 female. The morbidity age is between 9-16 years old and in average is 13 years old. All the cases use the pelvis platform and R F, HLA-B27 check. Four of them has made the CT and MRI level. Result: In this group, the case is extended over the sacroiliac joint. Among them, there are 5 samples that are referred to both of the coxa articution. The X-rays shows that under the sacroiliac joint, there has 2/3 sclerotin sclerotized and the side of sacroiliac shows this phenomenon especially. The sacroiliac joint is fuzziness and the size of articulation clearance is different, it shows as the sawtooth. When it refers to the coxa articulation, it shows as the acetabular and at the same time the articulation become abnormally. When it refers to the lumber, it shows as that the lumber articulation fuzziness while the articulation clearance disappear. CT level: when affected with this sickness it show that the size of the clearance is different. MRI level: T 1 WI shows that when affected with this case, it express that the size of the clearance is different and at the side of sacroiliac joint can see the low signal which can change into high signal when put it under the T 2 Wi, HLA-B27 is masculine. Conclusion: Because JAS is lack of the adjust ankylosing spondylitis special clinical in the early stage, so it is always be misdiagnosed as the Juvenile rheumatoid arthritis. In fact they are two different cases and treatment is also different. The authors should improve our knowledge about this case. In our opinion, checking of the image and HLA-B27 can diagnose this sickness earlier and correctly. (authors)

  8. Selection of a method for scoring radiographs for ankylosing spondylitis clinical trials, by the Assessment in Ankylosing Spondylitis Working Group and OMERACT

    NARCIS (Netherlands)

    van der Heijde, Désirée; Landewé, Robert

    2005-01-01

    Radiographs are important for assessing structural damage in patients with ankylosing spondylitis (AS); this technology was selected by the international ASsessment in Ankylosing Spondylitis (ASAS) Working Group as an important domain for assessing outcome in clinical trials. The selection of a

  9. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci

    OpenAIRE

    Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran

    2010-01-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P < 10−800), we found associa...

  10. Five Potentially Modifiable Factors Predict Poor Quality of Life in Ankylosing Spondylitis: Results from the Scotland Registry for Ankylosing Spondylitis.

    Science.gov (United States)

    Dean, Linda E; Macfarlane, Gary J; Jones, Gareth T

    2018-01-01

    A chronic inflammatory condition manifesting in young adulthood, ankylosing spondylitis (AS) affects both physical and emotional quality of life (QOL). To inform future intervention strategies, this study aimed to (1) assess the QOL of patients with AS, and (2) identify potentially modifiable factors associated with reporting poor QOL. The Scotland Registry for Ankylosing Spondylitis collects clinical and patient-reported data on clinically diagnosed patients with AS across Scotland. QOL is measured using the ASQoL questionnaire [range: 0 (high) to 18 (poor)]. Potentially modifiable factors associated with reporting poor QOL (score 12-18) were examined using Poisson regression models, adjusted for a variety of demographic characteristics, plus various nonmodifiable factors. Results are given as risk ratios (RR) with 95% CI. Data were available on 959 patients: 74% male, mean age 52 years (SD 13), median ASQoL 7.0 (interquartile range 2-12). Although many factors were univariately associated with poor QOL, 5 were identified as independent predictors: reporting moderate/severe fatigue (RR 1.60, 95% CI 1.13-2.28), poor physical function [Bath Ankylosing Spondylitis Functional Index (BASFI) ≥ 4: 3.46, 1.76-6.82], chronic widespread pain (CWP; 1.92, 1.33-2.75), high disease activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4: 1.52, 1.09-2.12], and poor spinal mobility [Bath Ankylosing Spondylitis Metrology Index (BASMI) ≥ 4: 1.52, 0.93-2.50]. For these factors, population-attributable risks ranged between 20% (disease activity) and 56% (physical function). We have identified 5 potentially modifiable factors independently associated with poor QOL. These findings provide evidence that in addition to traditional clinical targets (BASDAI, BASFI, and BASMI), focus on nonspecific symptoms (CWP and fatigue), perhaps with nonpharmacological therapies, may yield important improvements in QOL.

  11. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan

    2015-01-01

    INTRODUCTION: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic...... factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009...... arthritis (21.7% versus 15.3%, P oral corticosteroids (14.0% versus 10.4% in 2009, P 

  12. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci

    Science.gov (United States)

    Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran; Duncan, Emma L; Farrar, Claire; Hadler, Johanna; Harvey, David; Karaderi, Tugce; Mogg, Rebecca; Pomeroy, Emma; Pryce, Karena; Taylor, Jacqueline; Savage, Laurie; Deloukas, Panos; Kumanduri, Vasudev; Peltonen, Leena; Ring, Sue M; Whittaker, Pamela; Glazov, Evgeny; Thomas, Gethin P; Maksymowych, Walter P; Inman, Robert D; Ward, Michael M; Stone, Millicent A; Weisman, Michael H; Wordsworth, B Paul; Brown, Matthew A

    2011-01-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P ankylosing spondylitis risk and identifies a major role for the interleukin (IL)-23 and IL-1 cytokine pathways in disease susceptibility. PMID:20062062

  13. The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis.

    Science.gov (United States)

    Ersözlü-Bozkırlı, E D; Keşkek, S O; Bozkırlı, E; Yücel, A E

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory disease which physically, psychologically, and socially affects the patient's life. Previous studies have reported a correlation between ankylosing spondylitis and depression. In this study we investigated the effect of infliximab on depression in ankylosing spondylitis patients. A total of 29 patients with ankylosing spondylitis were enrolled in this prospective study. Infliximab was administered intravenously at a dose of 5 mg/kg at baseline, weeks 2 and 6. The measurements of morning stiffness, modified Schober's test, chest expansion, erythrocyte sedimentation rate, C-reactive protein, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression inventory scores were compared with baseline and 12th week. The modified Schober's test and chest expansion increased, the morning stiffness duration, erythrocyte sedimentation rate and C-reactive protein levels decreased after infliximab treatment (p ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression invantory scores of patients after 12 weeks (p ankylosing spondylitis..

  14. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci.

    Science.gov (United States)

    Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran; Duncan, Emma L; Farrar, Claire; Hadler, Johanna; Harvey, David; Karaderi, Tugce; Mogg, Rebecca; Pomeroy, Emma; Pryce, Karena; Taylor, Jacqueline; Savage, Laurie; Deloukas, Panos; Kumanduri, Vasudev; Peltonen, Leena; Ring, Sue M; Whittaker, Pamela; Glazov, Evgeny; Thomas, Gethin P; Maksymowych, Walter P; Inman, Robert D; Ward, Michael M; Stone, Millicent A; Weisman, Michael H; Wordsworth, B Paul; Brown, Matthew A

    2010-02-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P ankylosing spondylitis risk and identifies a major role for the interleukin (IL)-23 and IL-1 cytokine pathways in disease susceptibility.

  15. Treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Marina Amaral de Ávila Machado

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD and tumor necrosis factor blockers (anti-TNF drugs. METHODS This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription. Odds ratio (OR with 95% confidence intervals (95%CI were calculated by logistic regression models to estimate the patients’ chances of persisting in their therapies after the first and after the two first years of follow-up. RESULTS The study included 11,642 patients with rheumatoid arthritis – 2,241 of these started on anti-TNF drugs (+/-DMARD and 9,401 patients started on DMARD – and 1,251 patients with ankylosing spondylitis – 976 of them were started on anti-TNF drugs (+/-DMARD and 275 were started on DMARD. In the first year of follow-up, 63.5% of the patients persisted in their therapies with anti-TNF drugs (+/-DMARD and 54.1% remained using DMARD in the group with rheumatoid arthritis. In regards to ankylosing spondylitis, 79.0% of the subjects in anti-TNF (+/-DMARD group and 41.1% of the subjects in the DMARD group persisted with their treatments. The OR (95%CI for therapy persistence was 1.50 (1.34-1.67 for the anti-TNF (+/-DMARD group as compared with the DMARD group in the first year for the patients with rheumatoid arthritis, and 2.33 (1.74-3.11 for the patients with ankylosing spondylitis. A similar trend was observed at the end of the second year. CONCLUSIONS A general trend of higher rates of therapy persistence with anti-TNF drugs (+/-DMARD was observed as compared to DMARD in the study period. We observed higher persistence rates for anti-TNF drugs (+/-DMARD in patients with ankylosing

  16. Current treatment approaches in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Bilal Elbey

    2015-03-01

    Full Text Available Ankylosing spondylitis (AS is a chronic, inflammatory, rheumatic disease that mainly affects sacroiliac joints and spine. AS predominantly occurs more often in males and typically begins in the second or third decade. The mainstay of therapy in AS are nonsteroidal anti-inflammatory drugs, which reduce inflammation and pain. Disease modifying antirheumatic drugs (DMARD did not have enough evidence to prove their effect in AS treatment. The use of DMARD may not sufficient to improve the treatment and symptoms. Currently, TNF-blockers such as, Golimumab Etanersept Adalimumab İnfliksimab have promising results in the treatment of AS. TNF-blockers improve the clinical signs and symptoms, and improve the patients’ physical function and quality of life. This manuscript is focused that Current pharmacological treatments in patients with ankylosing spondylitis.

  17. [Effectiveness of the tenoxicam in patients with ankylosing spondylitis].

    Science.gov (United States)

    Gaydukova, I Z; Aparkina, A V; Khondkaryan, E V; Rebrov, A P

    2018-01-01

    To study the changes in pain syndrome and its characteristic in patients with ankylosing spondylitis (AS) who received tenoxicam after non-effective treatment with NSAIDs on the 'on-demand' basis. Forty patients with AS, who had BASDAI ≥4.0 at baseline and after 52 weeks of NSAIDs on the 'on-demand' basis, were randomized into 2 groups: 30 patients were prescribed 20 mg of tenoxicam oraly per day, 10 patients continued previous therapy. The BASDAI, ASDAS indices were calculated in 52 and 56 weeks. BASDAI and ASDAS indices decreased in patients treated with tenoxicam, the AS activity in patients with on-demand NSAID intake did not change. The change of the ineffective long-term NSAID intake in the 'on-demand' basis to permanent drug intake was associated with a rapid (within 4 weeks) decrease in the clinical activity of ankylosing spondylitis.

  18. The ongoing quest for biomarkers in Ankylosing Spondylitis.

    Science.gov (United States)

    Danve, Abhijeet; O'Dell, James

    2015-11-01

    Ankylosing Spondylitis poses significant challenges in terms of early diagnosis, assessment of disease activity, predicting response to the treatment and monitoring radiographic progression. With better understanding of underlying immunopathogenesis, effective targeted therapies are available which improve symptoms, quality of life and possibly slow the radiographic progression. There has been a growing interest in the discovery of biomarkers for defining various aspects of disease assessment and management in Ankylosing Spondylitis. The C-reactive protein and HLA-B27 are most commonly used biomarkers. This review describes many other newer biomarkers which have potential clinical applications in this chronic inflammatory disease. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  19. Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

    Directory of Open Access Journals (Sweden)

    E. Filippucci

    2011-06-01

    Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

  20. X-ray therapy in the treatment of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Windeyer, B.

    1976-01-01

    The results of the treatment of a randomly selected series of 277 patients is presented and some consideration is given to the complications and sequelae of the X-ray therapy here described. There is particular reference to the risk of leukaemogenesis, the decline in the use of X-ray therapy and the present position in Britain of the management of ankylosing spondylitis. (orig./MG) [de

  1. Atlantoaxial instability: An exceptional complication of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Zeineb Alaya

    2018-04-01

    Full Text Available Background: Atlantoaxial instability (AAI and more rarely odontoid pannus formation, similar to the one observed in Rheumatoid Arthritis, are seldom reported in ankylosing spondylitis (AS. We report a new case of a patient with AS with a pannus in the atlanto-axial region and cervical C1-C2 instability. Case presentation: The patient, now aged 41, was diagnosed with AS in 2010. She was put on different non steroidal anti inflammatory treatments with persistent spinal pain. She was referred to our department in 2015 with severe cervical pain and stiffness since 3 months. On examination, the patient had severely limited cervical spine movements. Lumbar spine movements were moderately affected. There was no neurological deficit. Her Bath Ankylosing Spondylitis Disease Activity Index (BASDAI was 4.9/10 and Bath Ankylosing Spondylitis Functional Index (BASFI was 5/10. Plain Radiographs of the pelvis showed bilateral grade 4 sacroilitis and bilateral coxitis. Dorsal and lumbar spine plain radiographs showed squaring of vertebral bodies. Cervical spine radiographs showed an increased atlanto-axial distance. Spinal MRI confirmed the atlantoaxial subluxation with an anterior distance of 8 mm, with marked intraspinal pannus formation and synovitis around the odontoid peg. Synovial thickening exerted an anterior mark on the bulbo-medullary junction with no evidence of oedema signs. Posterior zygapophysial ankylosis involving all cervical levels was also observed. The patient had a cervical collar with anti-tumor necrosis factor-α (cerolizumab-pegol prescription with favorable outcome. Conclusion: Odontoid pannus formation is rare in AS. Clinical and radiological follow-up are important to assess the impact on the cervical spine. Keywords: Ankylosing spondylitis, Atlantoaxial instability, MRI, Cerolizumab-pegol

  2. Ankylosing Spondylitis: Patterns of Spinal Injury and Treatment Outcomes

    OpenAIRE

    Altun, Idiris; Yuksel, Kas?m Zafer

    2016-01-01

    Study Design Retrospective review. Purpose We retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients. Overview of Literature Because of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability. Methods Between Janu...

  3. Are there new emerging drugs for ankylosing spondylitis or spondyloarthritis?

    Science.gov (United States)

    Wendling, Daniel

    2013-03-01

    New emerging drugs in the treatment of ankylosing spondylitis (AS), and spondyloarthritis in general, should be compared to anti-TNF agents, which provided clear evidence of efficacy in these conditions. To date, other biologic agents used in rheumatoid arthritis failed to demonstrate efficacy in AS, even in anti-TNF naïve patients. Some new potential options may target cytokines such as IL-17, or molecules involved in entheseal ossification or signaling pathways, but need confirmatory evaluation.

  4. Prevalence of fibromyalgia in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Aref Hosseinian Amiri

    2014-01-01

    Full Text Available Introduction: Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the peripheral and axial skeletal system, causing pain, arthritis, low back pain and functional incapacity. Questionnaires are used to assess disease activity bath ankylosing spondylitis disease activity index (BASDAI to measure the effect of AS on patient′s life quality, functional incapacity bath ankylosing spondylitis functional index (BASFI; and Ankylosing Spondylitis quality of life (ASQoL. Fibromyalgia (FM is one of the most common causes of generalized pain and fatigability and can coexist with other diseases; it can be assessed by the FM impact questionnaire (FIQ. There are few studies that demonstrated correlations between FM and AS. The present study obtained data regarding the epidemiologic profile of patients with AS and FM and evaluated the prevalence of FM in patients with AS. The FM influence on BASDAI, BASFI and ASQoL test scores was assessed. Materials and Methods: A total of 36 patients with AS, diagnosed according to the modified New York criteria, were studied. Clinical and functional assessment was performed and BASDAI, BASFI and ASQoL tests were applied. Patients with a diagnosis of FM were evaluated through the FIQ. Results: Seven patients met the criteria for FM; thus a FM prevalence of 19.4% was observed among patients with AS. FM was more prevalent among women (2.5:1. Age at disease onset (AS was 24.3 years. The human leukocyte antigen-B27 antigen was positive in most of them (83.2%. When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P < 0.01 among patients with FM. We concluded that the coexistence of FM with AS is associated with disease activity aspects including pain, as well as functional disability and quality of life.

  5. Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

    Science.gov (United States)

    Özgür, Abdulkadir; Serdaroğlu Beyazal, Münevver; Terzi, Suat; Coşkun, Zerrin Özergin; Dursun, Engin

    2016-10-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

  6. Nursing and safety of silver needle diathermy treating ankylosing spondylitis.

    Science.gov (United States)

    Ning, Huaxiu; Wang, Yun; Yuan, Yiwen; Ning, Huaying

    2015-03-01

    This paper aims to discuss the nursing and safety of silver needle diathermy in the treatment for ankylosing spondylitis. We nursed 46 patients with ankylosing spondylitis treated with silver needle diathermy. Specific nursing was focused on physical condition evaluation and mental nursing before treatment, observation during and after treatment, diet nursing, needle eye nursing, functional training and propaganda and education when discharged. The result suggested that all the patients received mental nursing, diet guide, skin care, health education, functional training and follow-up visit from the nurse and all of them could endure silver needle diathermy as discomfort or drug allergy was barely found, so were slight scald and skin infection nearby the needle eye caused by fainting during acupuncture, accidental puncture or overheat. Follow-up visit showed that no patient suffered obvious untoward effect and the pain, joint range of motion and living condition were distinctly improved a week after discharging. In conclusion, during the treatment for ankylosing spondylitis applying silver needle diathermy, the nursing before, during and after the treatment can obviously reduce the complication, accelerate the recovery, which is highly safe.

  7. Update on ankylosing spondylitis: current concepts in pathogenesis.

    Science.gov (United States)

    Smith, Judith A

    2015-01-01

    Ankylosing spondylitis is an insidiously progressive and debilitating form of arthritis involving the axial skeleton. The long delay in diagnosis and insufficient response to currently available therapeutics both advocate for a greater understanding of disease pathogenesis. Genome-wide association studies of this highly genetic disease have implicated specific immune pathways, including the interleukin (IL)-17/IL-23 pathway, control of nuclear factor kappa B (NF-κB) activation, amino acid trimming for major histocompatibility complex (MHC) antigen presentation, and other genes controlling CD8 and CD4 T cell subsets. The relevance of these pathways has borne out in animal and human subject studies, in particular, the response to novel therapeutic agents. Genetics and the findings of autoantibodies in ankylosing spondylitis revisit the question of autoimmune vs. autoinflammatory etiology. As environmental partners to genetics, recent attention has focused on the roles of microbiota and biomechanical stress in initiating and perpetuating inflammation. Herein, we review these current developments in the investigation of ankylosing spondylitis pathogenesis.

  8. Taylor Approach of Spinal Anaesthesia in a case of Ankylosing Spondylitis for Hip Fracture Surgery

    Directory of Open Access Journals (Sweden)

    Urmila Palaria

    2011-11-01

    Full Text Available Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease primarily affecting the axial joints manifesting as stiffnesss of the spine. Patient with ankylosing spondylitis is a challenge to anaesthesiologists in terms of airway management and neuraxial blocks. Modified paramedian approach (Taylor approach of spinal anaesthesia can be used as an alternative to technically difficult cases in patients undergoing lower limb surgeries.

  9. Atividade sexual na espondilite anquilosante Sexual activity in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Andrea Lopes Gallinaro

    2012-12-01

    Full Text Available OBJETIVO: Analisar a atividade sexual em pacientes com espondilite anquilosante, correlacionando com índices funcionais e de atividade da doença. PACIENTES E MÉTODOS: Foram analisados quanto a dor, fadiga, questionários de atividade de doença (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI, funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI e atividade sexual (utilizando imagens de sete posições sexuais 32 pacientes com diagnóstico de espondilite anquilosante e 32 controles saudáveis. Após a entrevista, os pacientes foram divididos em dois grupos: grupo A (com atividade sexual e grupo B (sem atividade sexual. RESULTADOS: O grupo B apresentou associação estatística com maior duração da doença (P = 0,01, pior funcionalidade (P = 0,0007 e maior atividade de doença (P = 0,03. Não houve correlação entre idade e capacidade funcional. O homem deitado de costas e a mulher sobre ele foi a posição mais frequente, agradável e menos dolorosa. A figura com a mulher de costas e o homem deitado sobre ela foi a posição menos escolhida. Indivíduos-controle relataram maior frequência e duração mais longa das relações sexuais, menos fadiga e dor, embora a frequência de orgasmos tenha sido semelhante nos dois grupos. CONCLUSÃO: A natureza crônica da espondilite anquilosante, com pior capacidade funcional e maior atividade da doença, interferiu no comportamento sexual dos pacientes. Quando o sexo se tornou possível, orgasmo e satisfação sexual não diferiram dos controles saudáveis.OBJECTIVE: To assess the sexual activity of patients with ankylosing spondylitis, correlating it with disease activity and functional indices. PATIENTS AND METHODS: Thirty-two patients with ankylosing spondylitis and 32 healthy controls were assessed regarding pain, fatigue, sexual activity (by use of pictures of seven sexual positions, disease activity (by use of Bath Ankylosing Spondylitis Disease Activity Index

  10. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study.

    Science.gov (United States)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan; Eriksson, Jonas K; Forsblad-d'Elia, Helena; Neovius, Martin; Turesson, Carl; Kristensen, Lars Erik; Jacobsson, Lennart T H

    2015-05-09

    Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.

  11. Outcome of active disease in ankylosing spondylitis: a prospective study.

    Science.gov (United States)

    Martindale, J; Smith, J; Grennan, D; Goodacre, L; Goodacre, J A

    2010-03-01

    People with ankylosing spondylitis (AS) typically experience episodic exacerbations, but the extent to which they subsequently experience a sustained reduction in disease markers below recognized thresholds for active disease is unclear. To investigate changes in, and associations between, disease markers over 18 months in people with active AS. Within a cohort of 89 participants with AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of 4 or higher were used to identify those with active disease. Standard assessment tools were used to monitor participants prospectively at four consecutive six-monthly intervals. Participants received standard treatments but none received anti-tumor necrosis factor-alpha (TNFalpha) medication during the study. The median age of the cohort was 50 years (inter-quartile range [IQR] 38.5-55.5), the median age of disease onset was 25 years (IQR 18-33) and the median disease duration was 18 years (IQR 13-27). Forty-seven (53%) participants had a BASDAI score of 4 or higher on the first assessment, of whom 45 (51%) scored 4 or higher on all subsequent assessments. Furthermore, 38 (43%) and 16 (18%) participants scored BASDAI 5 or 6, respectively, or higher, throughout. BASDAI scores correlated strongly with Bath Ankylosing Spondylitis Functional Index (BASFI) scores. Compared with 19 (21%) participants whose BASDAI scores were consistently below 4 throughout, participants with persistently high BASDAI scores showed higher scores for anxiety and depression, and some evidence of functional deterioration during the study period. In this cohort, disease markers in most people with active AS were sustained above the standard threshold for active disease. This has important implications for planning care pathways and for optimal utilization of anti-TNFalpha treatment.

  12. Progress of genome-wide association studies of ankylosing spondylitis

    Science.gov (United States)

    Li, Zhixiu; Brown, Matthew A

    2017-01-01

    Ankylosing spondylitis (AS) is an immune-mediated arthritis which primarily affects the spine and sacroiliac joints. Significant progress has been made in discovery of genetic associations with AS by genome-wide association studies (GWAS) over past decade. These findings have uncovered novel pathways involved pathogenesis of the disease and have led to introduction of novel therapeutic treatments for AS. In this Review, we discuss the genetic variations associated with AS identified by GWAS, the major pathways revealed by these AS-associated variations and critical cell types involved in AS development. PMID:29333268

  13. Adherence to treatment in patients with ankylosing spondylitis.

    Science.gov (United States)

    Arturi, Pablo; Schneeberger, Emilce Edith; Sommerfleck, Fernando; Buschiazzo, Emilio; Ledesma, César; Maldonado Cocco, José Antonio; Citera, Gustavo

    2013-07-01

    This study aims to determine the level of adherence to treatment in ankylosing spondylitis (AS) patients and to identify possible factors associated to lack of adherence. We included consecutive AS patients (NY modified criteria). Sociodemographic and clinical data were collected. Patients answered auto-reported questionnaires: Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life, and Center for Epidemiological Studies Depression scale. Patients with rheumatoid arthritis (RA) (ACR'87 criteria) were assessed as the control group. The adherence of the studied groups to medical treatment and exercises was measured by means of two questionnaires: Compliance Questionnaire on Rheumatology (CQR) and Exercise Attitude Questionnaire-18 (EAQ-18). The study included 59 patients with AS and 53 patients with RA. Of the AS patients, 43 (72.9%) were male, median age 47 years (interquartile range (IQR) 33-57) and median disease duration of 120 months (IQR 33-57). Of the RA patients, 37 (69.8%) were female, had a median age of 56 years (IQR 43.5-60) and a median disease duration of 156 months (IQR 96-288). There were no significant differences in the results of the adherence questionnaires between both groups, with a total median of 68.42 for the CQR in both groups and of 40.7 in AS vs. 42.6 in RA for the EAQ. When dichotomizing patients as adherent and non-adherent, taking as good adherence a cut value in the CQR and EAQ higher than 60, adherence to pharmacological treatment was significantly higher in RA vs. AS (92.5 vs. 74.6%, p = 0.01) and there were no differences in the EAQ. On the uni- and multivariate analysis, lack of adherence to treatment was not associated to sex, age, disease duration, education, health insurance, depressive status, and disease activity parameters in neither group of patients. AS have an acceptable adherence to pharmacological treatment, although it is lower than RA

  14. Progress of genome-wide association studies of ankylosing spondylitis.

    Science.gov (United States)

    Li, Zhixiu; Brown, Matthew A

    2017-12-01

    Ankylosing spondylitis (AS) is an immune-mediated arthritis which primarily affects the spine and sacroiliac joints. Significant progress has been made in discovery of genetic associations with AS by genome-wide association studies (GWAS) over past decade. These findings have uncovered novel pathways involved pathogenesis of the disease and have led to introduction of novel therapeutic treatments for AS. In this Review, we discuss the genetic variations associated with AS identified by GWAS, the major pathways revealed by these AS-associated variations and critical cell types involved in AS development.

  15. Left ventricular non-compaction in a patient with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mehrnoush Toufan

    2016-12-01

    Full Text Available A 58 years old male with a long-standing history of HLA-B27 positive ankylosing spondylitis presented with increasing fatigue and dyspnea on exertion. He had left ventricular dysfunction and enlargement, flail right coronary leaflet of aortic valve with severe eccentric aortic insufficiency along with left ventricular non-compaction in echocardiography. The most common cardiac manifestations of ankylosing spondylitis are aortic insufficiency and conduction disturbances. Involvement of myocardium, in the form of dilated cardiomyopathy and restrictive cardiomyopathy, has also been reported. This case presents a very rare association of ankylosing spondylitis with non-compaction cardiomyopathy.

  16. Ankylosing Spondylitis and Posture Control: The Role of Visual Input

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    Alessandro Marco De Nunzio

    2015-01-01

    Full Text Available Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1 ± 13.2 years and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO and with eyes closed (EC on a baropodometric platform. The oscillation of the centre of feet pressure (CoP was acquired. Indices of stability and balance control were assessed by the sway path (SP of the CoP, the frequency bandwidth (FB1 that includes the 80% of the area under the amplitude spectrum, the mean amplitude of the peaks (MP of the sway density curve (SDC, and the mean distance (MD between 2 peaks of the SDC. Results. In severe AS patients, the MD between two peaks of the SDC and the SP of the center of feet pressure were significantly higher than controls during both EO and EC conditions. The MP was significantly reduced just on EC. Conclusions. Ankylosing spondylitis exerts negative effect on postural stability, not compensable by visual inputs. Our findings may be useful in the rehabilitative management of the increased risk of falling in AS.

  17. Detection of Chlamydia pneumoniae in Ankylosing Spondylitis Patients

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    Dunya Fareed Salloom

    2018-03-01

    Full Text Available Ankylosing spondylitis is a complex debilitating disease because its pathogenesis is not clear. This study aims at detecting some pathogenesis factors that lead to induce the disease. Chlamydia pneumoniae is one of these pathogenesis factors which acts as a triggering factor for the disease. The study groups included forty Iraqi Ankylosing spondylitis patients and forty healthy persons as a control group. Immunological and molecular examinations were done to detect Chlamydia. pneumoniae in AS group. The immunological results were performed by Enzyme-Linked Immunosorbent Assay (ELISA to detect anti-IgG and anti-IgM antibodies of C. pneumoniae revealed that five of forty AS patients' samples (12.5% were positive for anti-IgG and IgM C. pneumoniae antibodies compared to controls which revealed seronegative. Molecular detection included 16srRNA and HSP-70 genes were to ensure the serological examination for detection of bacteria in the five blood samples which were positive; therefore, these results improved that C. pneumoniae played a role in the pathogenesis of the disease.

  18. Transcriptome network analysis reveals potential candidate genes for ankylosing spondylitis.

    Science.gov (United States)

    Zhu, Z-Q; Tang, J-S; Cao, X-J

    2013-12-01

    Ankylosing spondylitis (AS) is a chronic, inflammatory arthritis and autoimmune disease. The main symptom of AS is inflammatory spinal pain; with time, some patients develop ankylosis and spinal immobility. We aim to find cure available for ankylosing spondylitis. We used the GSE11886 series to identify potential genes that related to AS to construct a regulation network. In the network, some of TFs and target genes have been proved related with AS in previous study, such as NFKB1, STAT1, STAT4, TNFSF10, IL2RA, and IL2RB. We also found some new TFs (Franscription Factors) and target genes response to AS, such as BXDC5, and EGFR. Further analysis indicated some significant pathways are associated with AS, including antigen processing and presentation and cytokine-cytokine receptor interaction, etc.; although not significant, there was evident that they play an important role in AS progression, such as apoptosis and systemic lupus erythematosus. Therefore, it is demonstrated that transcriptome network analysis is useful in identification of the candidate genes in AS.

  19. Indirect comparison between subcutaneous biologic agents in ankylosing spondylitis.

    Science.gov (United States)

    Migliore, Alberto; Bizzi, Emanuele; Bernardi, Mauro; Picchianti Diamanti, Andrea; Laganà, Bruno; Petrella, Lea

    2015-01-01

    There are four efficacious subcutaneous anti-tumor necrosis factor alpha (TNF-alpha) agents used for the therapy of ankylosing spondilitis (AS), but apparently little or no differences in their effectiveness was proven. By this study, we aimed to compare Assessment in Ankylosing Spondylitis Response Criteria 20 response patterns (ASAS20) between subcutaneous approved biological agents in patients affected by ankylosing spondylitis by means of a mixed treatment comparison of different randomized controlled trials (RCTs) on the efficacy of biological therapies. A search in scientific literature was performed to identify the most complete collection of RCTs available on the selected topic. Similarly designed double-blind, randomized, placebo-controlled trials investigating the efficacy of the subcutaneous and approved TNF-alpha inhibitors such as etanercept, certolizumab pegol, golimumab and adalimumab in the treatment of ankylosing spondylitis patients were identified. The endpoint of interest was ASAS20 response criterium at 12 weeks. Results were analysed simultaneously using Bayesian mixed treatment comparison techniques. Results were expressed as odds ratio (OR) of positive ASAS20 response and associated 95 % credible intervals (CrIs). The probability of being the best treatment was also reported. Only five RCTs matched the inclusion criteria for consequent data extraction and analysis. Mixed treatment comparison of data from such RCTs demonstrated that all subcutaneous anti-TNF-alpha agents are more effective in inducing an ASAS20 response than placebo. Data from 24 weeks' follow-up were not taken into account as early escape granted in some of the studies made results at 24 weeks unmatchable. In our analysis, golimumab proved to be the drug that more probably represents the best choice for achieving ASAS20 response at 12 weeks, although no differences were observed when comparing directly every single subcutaneous anti-TNF-alpha agent against another. Even if

  20. Clinical Risk Factors for the Presence and Development of Vertebral Fractures in Patients With Ankylosing Spondylitis

    NARCIS (Netherlands)

    Maas, Fiona; Spoorenberg, Anneke; van der Slik, Boukje P. G.; van der Veer, Eveline; Brouwer, Elisabeth; Bootsma, Hendrika; Bos, Reinhard; Wink, Freke R.; Arends, Suzanne

    IntroductionTo investigate the prevalence and incidence of radiographic vertebral fractures and the association with patient characteristics, clinical assessments, and medication use in a large prospective cohort of patients with ankylosing spondylitis (AS) in daily clinical practice.

  1. Adaptation of the Bath measures on disease activity and function in ankylosing spondylitis into Danish

    DEFF Research Database (Denmark)

    Pedersen, Ole Birger; Hansen, G O; Svendsen, Anders Jørgen

    2007-01-01

    in Denmark. METHODS: The BASDAI, BASFI, and BASG were translated into Danish and subsequently field-tested among 17 AS patients for relevance, face, and content validity. Reliability and validity were assessed by administering the new measures and a comparator instrument to 113 AS patients on two occasions....... RESULTS: Test-retest reliability was high (>0.90) and the random measurement error was within+/-2.0 for the BASG and within approximately+/-1.5 for BASDAI and BASFI, which is acceptable for most clinical settings. The measures have good internal consistency and are able to discriminate between functional......OBJECTIVE: Adaptation of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Global Score (BASG), and the Bath Ankylosing Spondylitis Functional Index (BASFI) for defining disease status in ankylosing spondylitis (AS) and related diseases for use...

  2. Significance of Plain Radiography of the Pelvis for the Diagnosis of Ankylosing Spondylitis in Clinical Practice

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    А.V. Smirnov

    2015-08-01

    Full Text Available Diagnosis of ankylosing spondylitis is based on characteristic clinical picture of the disease and mandatory identification of sacroiliitis on pelvis X-ray. However, case reports of the radiographic stages of sacroiliac joint disorder available in literature are less informative and often lead to misinterpretation of radiographic changes. Based on many years of experience, the authors present the extended explanations of standard radiographic stages of sacroiliitis and other radiological signs that can facilitate diagnostic search in ankylosing spondylitis.

  3. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  4. Human leukocyte antigen-B27 alleles in Xinjiang Uygur patients with ankylosing spondylitis.

    Science.gov (United States)

    Zou, H-Y; Yu, W-Z; Wang, Z; He, J; Jiao, M

    2015-05-25

    We investigated the distribution of human leukocyte antigen (HLA)-B27 subtypes in Uygur ankylosing spondylitis patients in Xinjiang. B27-positive patients with ankylosing spondylitis were subtyped by using polymerase chain reaction-sequence-based typing. The HLA-B27 subtype frequencies of Uygur patients were compared with those in Han patients in Xinjiang and the other areas of China. B*2705 was the predominant subtype in Uygur patients with a frequency of 58.95%, which was much higher than that in Han patients in Xinjiang (31.58%, P ankylosing spondylitis patients; B*2704 was the main (61.18%) subtype in Han patients in Xinjiang, followed by B*2705 (31.58%) and was similar to the characteristics of Han patients in the other areas of China. B*2724 in Han ankylosing spondylitis patients has not been previously reported. Additionally, the B*2702/B*2705 homozygote was identified in Uygur patients. B*2702/B*2704, B*2704/B*2705, and B*2705/B*2705 homozygotes were identified in 3 Han patients. The distribution of HLAB27 subtypes in Uygur ankylosing spondylitis patients in Xinjiang significantly differed from that in Han patients. Understanding the distribution of HLAB27 subtypes in ethnic minority populations of Xinjiang is important for anthropological genetic studies and for analyzing the impact of genetic background on ankylosing spondylitis susceptibility.

  5. Oral Anaerobic Bacteria in the Etiology of Ankylosing Spondylitis

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    Mesut Öğrendik

    2017-06-01

    Full Text Available Ankylosing spondylitis (AS is associated with periodontitis. Anti– Porphyromonas gingivalis and anti– Prevotella intermedia antibody titers were higher in patients with spondyloarthritis than in healthy people. Sulfasalazine is an effective antibiotic treatment for AS. Moxifloxacin and rifamycin were also found to be significantly effective. The etiology hypothesis suggests that oral anaerobic bacteria such as Porphyromonas spp and Prevotella spp contribute to the disease. These bacteria have been identified in AS, and we will discuss their pathogenic properties with respect to our knowledge of the disease. Periodontal pathogens are likely to be responsible for the development of AS in genetically susceptible individuals. This finding should guide the development of more comprehensive and efficacious treatment strategies for AS.

  6. Virtual reality: towards a novel treatment environment for ankylosing spondylitis.

    Science.gov (United States)

    Li, Shijuan; Kay, Stephen; Hardicker, Nicholas R

    2007-01-01

    The objective of this paper is to outline the project that eventually seeks to visualize clinical knowledge found within the record; the immediate task being to create a model that can be deployed for therapeutic purposes. How therapies for a certain type of chronically ill patient can benefit from Virtual Reality (VR) tools is investigated. Ankylosing Spondylitis (AS) is selected as a test condition. VR is expected to provide a novel treatment environment for AS sufferers, in which they can relax, manage their pain and take part in the routine exercise more effectively and efficiently by using the VR tools. An integral part of this model's construction will be to elicit evaluative detail from the literature and the patients' perspective. The purpose is to understand the inevitable challenges facing this proposed intervention if the design prototype is to successfully move from the research domain and become an integral part of established therapeutic practice.

  7. Urolithiasis as an extraarticular manifestation of ankylosing spondylitis.

    Science.gov (United States)

    Korkmaz, Cengiz; Cansu, Döndü Üsküdar; Sayer, John A

    2017-12-01

    Ankylosing spondylitis (AS) affects sacroiliac and axial joints as well as extraarticular organs, such as the eye, lung, bowel, and heart. Although examples of renal involvement in AS, such as IgA nephropathy, amyloidosis, and glomerulonephritis, have been reported, it has not been emphasized that urolithiasis is frequently formed in the clinical course of AS. Growing evidence indicates that urolithiasis may be observed in AS patients and is more frequent than other extraarticular features. In this review, we will discuss frequency and predictors of AS-related urolithiasis and summarize the possible underlying genetic and biochemical mechanisms. We believe an increased awareness of urolithiasis as a complication of AS will encourage future studies that will shed light on disease mechanisms and preventative therapies.

  8. Ankylosing spondylitis and central core disease: case report

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    Scola Rosana Herminia

    2003-01-01

    Full Text Available Ankylosing spondylitis (AS is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

  9. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?

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    Amal Akassou

    2018-01-01

    Full Text Available The association of HLA-B27 with ankylosing spondylitis (AS remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27–based effects especially in HLA-B27(+ patients with AS. This review will focus in the examination of published reports regarding the influence of HLA-B27 status on the demographic and clinical features in AS, with specific interest to its role on AS severity.

  10. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?

    Science.gov (United States)

    Akassou, Amal; Bakri, Youssef

    2018-01-01

    The association of HLA-B27 with ankylosing spondylitis (AS) remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27–based effects especially in HLA-B27(+) patients with AS. This review will focus in the examination of published reports regarding the influence of HLA-B27 status on the demographic and clinical features in AS, with specific interest to its role on AS severity. PMID:29343996

  11. Ankylosing spondylitis: A state of the art factual backbone

    Science.gov (United States)

    Ghasemi-rad, Mohammad; Attaya, Hosam; Lesha, Emal; Vegh, Andrea; Maleki-Miandoab, Tooraj; Nosair, Emad; Sepehrvand, Nariman; Davarian, Ali; Rajebi, Hamid; Pakniat, Abdolghader; Fazeli, Seyed Amirhossein; Mohammadi, Afshin

    2015-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS. PMID:26435775

  12. Pathogenesis of ankylosing spondylitis - recent advances and future directions.

    Science.gov (United States)

    Ranganathan, Vidya; Gracey, Eric; Brown, Matthew A; Inman, Robert D; Haroon, Nigil

    2017-06-01

    Over the past 5 years, advances in high-throughput techniques and studies involving large cohorts of patients have led to considerable advances in the identification of novel genetic associations and immune pathways involved in ankylosing spondylitis (AS). These discoveries include genes encoding cytokine receptors, transcription factors, signalling molecules and transport proteins. Although progress has been made in understanding the functions and potential pathogenic roles of some of these molecules, much work remains to be done to comprehend their complex interactions and therapeutic potential in AS. In this Review, we outline the current knowledge of AS pathogenesis, including genetic risk associations, HLA-B27-mediated pathology, perturbations in antigen-presentation pathways and the contribution of the type 3 immune response.

  13. Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept

    Directory of Open Access Journals (Sweden)

    Valderilio Feijó Azevedo

    2014-01-01

    Full Text Available Relapsing polychondritis (RP is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few similar cases have been described in the literature. However, they show a possible association between the use of biological inhibitors of tumor necrosis factor (anti-TNFα, which potentially produces autoantibodies, and the development of RP. The treatment was based on data in the literature and included the cessation of biological therapy and the addition of corticosteroids with substantial improvement.

  14. EXACERBATION OF ANKYLOSING SPONDYLITIS AFTER LOW-DOSE METHOTREXATE THERAPY

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    A. V. Orlov-Morozov

    2014-01-01

    Full Text Available Background: Efficacy of methotrexate in ankylosing spondylitis (AS is disputable. Nevertheless, methotrexate is still used for disease-modifying therapy of AS. Aim: To assess efficacy and safety of methotrexate in AS patients. Materials and methods: It was an open comparative study of efficacy of methotrexate (n=12 versus standard therapy (n=12 in AS patients. Results: Negative results of methotrexate therapy were obtained. In the majority of patients methotrexate therapy was associated with increased joint pain, swelling and morning stiffness as well as elevation of erythrocyte sedimentation rate, fever and visceritis. Worsening of symptoms was regarded as exacerbation of inflammatory process. The study was terminated prematurely. Conclusion: Methotrexate demonstrated no therapeutic effect in AS patients. In AS, methotrexate should be administrated under close physician control in order to ensure treatment safety

  15. Late effects of x-ray treatment of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Smith, P.G.

    1984-01-01

    Following a single course of x-ray treatment, patients with ankylosing spondylitis have suffered a mortality rate from leukemia about five times higher than that of the general population. The peak risk occurs 3 to 5 years after irradiation and subsequently declines, such that by 20 years after exposure the risk may be near normal levels, though more data will be necessary to confirm this. There is no clear relationship between the excess risk of leukemia and the estimated mean bone marrow dose of radiation. The excess risk of a radiation-induced leukemia appears to be greater for patients irradiated at an older age compared to the risk experience by patients irradiated at a younger age (but it should be noted that children were not included in the study)

  16. Vitamin D in ankylosing spondylitis: review and meta-analysis.

    Science.gov (United States)

    Cai, Guoqi; Wang, Li; Fan, Dazhi; Xin, Lihong; Liu, Li; Hu, Yanting; Ding, Ning; Xu, Shengqian; Xia, Guo; Jin, Xingzhong; Xu, Jianhua; Zou, Yanfeng; Pan, Faming

    2015-01-01

    The role of vitamin D in ankylosing spondylitis (AS) is largely unknown. This paper aims to examine the association between serum vitamin D levels and susceptibility and disease activity of AS. We searched the relevant literatures in PubMed, Elsevier Science Direct, Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI) and Wanfang (Chinese) Database published before June 2014. Eight independent case-control studies with a total of 533 AS patients and 478 matching controls were selected into this meta-analysis. Standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the levels of serum vitamin D, parathyroid hormone (PTH), serum calcium and alkaline phosphatase (ALP) in cases and controls, respectively. Correlation coefficients (CORs) have been performed to value the correlationship between vitamin D and disease activity (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) of AS patients. Meta-analysis results suggested that vitamin D may play a protective role in AS (for total vitamin D: SMD=-0.71, P<0.001; for 25OHD: SMD=-0.66, P=0.002; for 1,25OHD: SMD=-0.72, P=0.19). Differences in PTH and serum calcium levels were not significant in AS (SMD=-0.10, P=0.67; SMD=0.12, P=0.17 respectively), while ALP was associated with AS susceptibility (SMD=0.20, P=0.04). The relationship between serum vitamin D levels and disease activity was statistically significant except for 25OHD versus (vs.) CRP or BASDAI (for CRP vs. 25OHD: COR=-0.22, P=0.08; for BASDAI vs. 25OHD: COR=-0.20, P=0.06, respectively). The higher levels of serum vitamin D were associated with a decreased risk of AS, and showed an inverse relationship with AS activity. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Machado, Marina Amaral de Ávila; Moura, Cristiano Soares de; Ferré, Felipe; Bernatsky, Sasha; Rahme, Elham; Acurcio, Francisco de Assis

    2016-08-22

    To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD) and tumor necrosis factor blockers (anti-TNF drugs). This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription. Odds ratio (OR) with 95% confidence intervals (95%CI) were calculated by logistic regression models to estimate the patients' chances of persisting in their therapies after the first and after the two first years of follow-up. The study included 11,642 patients with rheumatoid arthritis - 2,241 of these started on anti-TNF drugs (+/-DMARD) and 9,401 patients started on DMARD - and 1,251 patients with ankylosing spondylitis - 976 of them were started on anti-TNF drugs (+/-DMARD) and 275 were started on DMARD. In the first year of follow-up, 63.5% of the patients persisted in their therapies with anti-TNF drugs (+/-DMARD) and 54.1% remained using DMARD in the group with rheumatoid arthritis. In regards to ankylosing spondylitis, 79.0% of the subjects in anti-TNF (+/-DMARD) group and 41.1% of the subjects in the DMARD group persisted with their treatments. The OR (95%CI) for therapy persistence was 1.50 (1.34-1.67) for the anti-TNF (+/-DMARD) group as compared with the DMARD group in the first year for the patients with rheumatoid arthritis, and 2.33 (1.74-3.11) for the patients with ankylosing spondylitis. A similar trend was observed at the end of the second year. A general trend of higher rates of therapy persistence with anti-TNF drugs (+/-DMARD) was observed as compared to DMARD in the study period. We observed higher persistence rates for anti-TNF drugs (+/-DMARD) in patients with ankylosing spondylitis as compared to rheumatoid arthritis; and a higher

  18. MRI of cervical spine injuries complicating ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  19. The Role of MicroRNAS in Ankylosing Spondylitis

    Science.gov (United States)

    Li, Zheng; Wong, Sunny H.; Shen, Jianxiong; Chan, Matthew T.V.; Wu, William Ka Kei

    2016-01-01

    Abstract Ankylosing spondylitis (AS) is a common and genetically heterozygous inflammatory rheumatic disease characterized by new bone formation, ankylosis and inflammation of hip, sacroiliac joints and spine. Until now, there is no method for early diagnosis of AS and the effective treatment available for AS patients remain largely undefined. We searched articles indexed in PubMed (MEDLINE) database using Medical Subject Heading (MeSH) or Title/Abstract words (“microRNA” and “ankylosing spondylitis”) from inception up to November 2015. Genetic polymorphisms of miRNAs and their targets might alter the risk of AS development whereas certain miRNAs exhibit correlation with inflammatory index. Let-7i and miR-124 were upregulated whereas miR-130a was downregulated in circulating immune cells of AS patients. These deregulated miRNAs could modulate key immune cell functions, such as cytokine response and T-cell survival. miRNA deregulation is key to AS pathogenesis. However, clinical utilization of miRNAs for management of AS patients requires further support from future translational studies. PMID:27057910

  20. Favorable effect of rehabilitation on balance in ankylosing spondylitis: a quasi-randomized controlled clinical trial.

    Science.gov (United States)

    Demontis, Alessandra; Trainito, Sabina; Del Felice, Alessandra; Masiero, Stefano

    2016-03-01

    Balance impairment is a frequent and undertreated manifestation in ankylosing spondylitis, leading to increased risk of falls and lower quality of life. Our aim was to assess supervised training and home-based rehabilitation efficacy on balance improvement in ankylosing spondylitis subjects on biologic agents. This was a single-blinded, quasi-randomized parallel study in a single outpatient Rehabilitation Clinic of a tertiary referral center. Subjects with ankylosing spondylitis on biologic agents were assigned either to supervised training and home-based rehabilitation program (rehabilitation group) plus educational-behavioral therapy, or to educational-behavioral therapy alone (educational groups). The same therapist provided therapy. Outcome measures were assessed at baseline (T0), end of treatment (T1) and at 7-month follow-up (T2). Rheumatologic outcomes were Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index and Bath Ankylosing Spondylitis Disease Activity Index. Balance parameters (anterior-posterior oscillation, latero-lateral oscillation, sway area, sway density and sway path) were evaluated by stabilometry in a condition of open and closed eyes. Forty-six subjects (36 M, 10 F) were enrolled. Demographic data and clinical status at baseline were comparable between the two groups (22 rehabilitation group, 20 educational group). Primary outcome was sway density that improved both at T1 (SDy: open eyes p = 0.003, closed eyes p = 0.004) and at T2 (SDx: open eyes p = 0.0015, closed eyes p = 0.032). A trend toward improvement in the rehabilitation group rather than in the educational group emerged for balance parameters, especially those measured with closed eyes (0.004 ankylosing spondylitis. Eyes-closed trials show a more marked trend toward improvement, and this may suggest a positive effect of rehabilitation on proprioception.

  1. Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sawacha Zimi

    2012-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a major chronic rheumatic disease that predominantly affects axial joints, determining a rigid spine from the occiput to the sacrum. The dorsal hyperkyphosis may induce the patients to stand in a stooped position with consequent restriction in patients’ daily living activities. The aim of this study was to develop a method for quantitatively and objectively assessing both balance and posture and their mutual relationship in ankylosing spondylitis subjects. Methods The data of 12 healthy and 12 ankylosing spondylitis subjects (treated with anti-TNF-α stabilized, with a mean age of 51.42 and 49.42 years; mean BMI of 23.08 and 25.44 kg/m2 were collected. Subjects underwent a morphological examination of the spinal mobility by means of a pocket compass needle goniometer, together with an evaluation of both spinal and hip mobility (Bath Ankylosing Spondylitis Metrology Index, and disease activity (Bath Ankylosing Spondylitis Disease Activity Index. Quantitative evaluation of kinematics and balance were performed through a six cameras stereophotogrammetric system and a force plate. Kinematic models together with a test for evaluating balance in different eye level conditions were developed. Head protrusion, trunk flexion-extension, pelvic tilt, hip-knee-ankle flexion-extension were evaluated during Romberg Test, together with centre of pressure parameters. Results Each subject was able to accomplish the required task. Subjects’ were comparable for demographic parameters. A significant increment was observed in ankylosing spondylitis subjects for knee joint angle with the target placed at each eye level on both sides (p  Conclusions Our findings confirm the need to investigate both balance and posture in ankylosing spondylitis subjects. This methodology could help clinicians to plan rehabilitation treatments.

  2. Evolution of radiographic damage in ankylosing spondylitis: a 12 year prospective follow-up of the OASIS study

    NARCIS (Netherlands)

    Ramiro, Sofia; Stolwijk, Carmen; van Tubergen, Astrid; van der Heijde, Désirée; Dougados, Maxime; van den Bosch, Filip; Landewé, Robert

    2015-01-01

    To describe the evolution of radiographic abnormalities of the spine in patients with ankylosing spondylitis (AS). Patients with AS were followed prospectively with 2 yearly radiographs for 12 years. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was scored by two readers (R1 and

  3. [Muscular disorders associated with ankylosing spondylitis and their correction with the help of whole body cryotherapy].

    Science.gov (United States)

    Kulikov, A G; Tabiev, V I; Rassulova, M A

    2015-01-01

    The objective of the present study was to evaluate the possibilities for the correction of muscular disorders associated with ankylosing spondylitis and their correction with the help of whole body cryotherapy. The study included 55 patients randomly allocated to two groups. Group 1 was comprised of the patients treated with the use of the common mineral baths, physiotherapy, therapeutic physical exercises, spinal massage, and whole body air-cryotherapy. Group 2 contained the patients who were treated in a similar way with the exception of whole body cryotherapy; they served as controls. Muscular disorders were diagnosed by means of functional muscular testing. The study has demonstrated the high prevalence of muscular disorders in the patients suffering from ankylosing spondylitis. Moreover, it revealed the profile of such disorders associated with ankylosing spondylitis and showed significant correlation between the results of functional muscular testing, BASMI and BASFI indices as well as characteristics of chest excursions (pcryotherapy in comparison with the alternative therapeutic modalities employed in the present study. This therapeutic modality ensured the statistically more pronounced improvement of functional muscular testing parameters (pcryotherapy accounting for its corrective influence on the muscular disorders in the patients presenting with ankylosing spondylitis. It is concluded that the proposed approach can be recommended for the introduction in the combined therapeutic and rehabilitative treatment of muscular disorders associated with ankylosing spondylitis.

  4. Evaluation of paravertebral muscle atrophy and fatty degeneration in ankylosing spondylitis.

    Science.gov (United States)

    Resorlu, Hatice; Savas, Yılmaz; Aylanc, Nilufer; Gokmen, Ferhat

    2017-07-01

    The purpose of this study was to assess morphological changes in the paravertebral muscles in patients with ankylosing spondylitis. Fifty-one patients diagnosed with ankylosing spondylitis and a 50 member control group were included in the study. The surface area of the multifidus and erector spinae muscles was measured at four levels between L1 and L5, and fatty degeneration in these muscles was scored. Lumbosacral and lumbar lordotic angles were determined for the patient and control groups. Loss of muscle cross-sectional area compatible with atrophy was present at all four levels in the paraspinal muscles in patients with ankylosing spondylitis. A negative correlation was observed between paravertebral muscle area and duration of disease at three levels, but not at L1-2. Although muscle area decreased with the duration of disease at the L1-2 level, this was not statistically significant (r= -0.195, p = 0.171). Comparison of intramuscular fatty degeneration between the groups revealed increased intramuscular fat at all levels in patients with ankylosing spondylitis, with the exception of L3-4, and a positive correlation between fatty degeneration and duration of disease was determined at all levels. Chronic inflammation, cytokine-mediated fibrosis, immobilization, and postural changes in ankylosing spondylitis contribute to fatty degeneration and atrophy in the paravertebral muscles.

  5. High-dose thalidomide increases the risk of peripheral neuropathy in the treatment of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Hong-xia Xue

    2015-01-01

    Full Text Available Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among ankylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treatments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the < 6 months medication and ≥ 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclusion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.

  6. Opioid Analgesic Use in Patients with Ankylosing Spondylitis: An Analysis of the Prospective Study of Outcomes in an Ankylosing Spondylitis Cohort.

    Science.gov (United States)

    Dau, Jonathan D; Lee, MinJae; Ward, Michael M; Gensler, Lianne S; Brown, Matthew A; Learch, Thomas J; Diekman, Laura A; Tahanan, Amirali; Rahbar, Mohammad H; Weisman, Michael H; Reveille, John D

    2018-02-01

    Opioid analgesics may be prescribed to ankylosing spondylitis (AS) patients with pain that is unresponsive to antirheumatic treatment. Our study assessed factors associated with opioid usage in AS. A prospective cohort of 706 patients with AS meeting modified New York criteria followed at least 2 years underwent comprehensive clinical evaluation of disease activity and functional impairment. These were assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). Radiographic severity was assessed by the Bath Ankylosing Spondylitis Radiology Index and modified Stokes Ankylosing Spondylitis Scoring System. Medications taken concurrently with opioids, as well as C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR), were determined at each study visit, performed every 6 months. Analyses were carried out at baseline, and longitudinal multivariable models were developed to identify factors independently associated with chronic and intermittent opioid usage over time. Factors significantly associated with opioid usage, especially chronic opioid use, included longer disease duration, smoking, lack of exercise, higher disease activity (BASDAI) and functional impairment (BASFI), depression, radiographic severity, and cardiovascular disease. Patients taking opioids were more likely to be using anxiolytic, hypnotic, antidepressant, and muscle relaxant medications. Multivariable analysis underscored the association with smoking, older age, antitumor necrosis factor agent use, and psychoactive drugs, as well as with subjective but not objective determinants of disease activity. Opioid usage was more likely to be associated with subjective measures (depression, BASDAI, BASFI) than objective measures (CRP, ESR), suggesting that pain in AS may derive from sources other than spinal inflammation alone.

  7. Enterobacterial involvement in the pathogenesis of secondary ankylosing spondylitis.

    Science.gov (United States)

    van Bohemen, C G; Weterings, E; Goei The, H S; Grumet, F C; Zanen, H C

    1988-01-01

    Ankylosing spondylitis (AS) is closely associated with the histocompatibility antigen HLA-B27. Pathogenesis of AS is thought to involve interactions between B27 and certain enterobacterial antigens. However, this is uncertain and contested by some. The present paper argues that the presence of statistically raised specific serum IgA to a common enterobacterial heat modifiable major outer membrane protein (h-momp; Mr 35,000) in active AS (N = 25; IgA = 1485 +/- 20) in comparison to controls, most notably hospital patients without known arthropathies or gastrointestinal disease (N = 12; IgA = 548 +/- 59), supports an inductive contribution of enterobacterial antigens to the pathogenesis of secondary AS. Serum IgG and IgM did not statistically differ. Raised specific serum IgA to h-momp might indicate enterobacterial antigenic stimulation from the gastrointestinal tract. It does not necessarily imply direct involvement in the pathogenesis of primary AS. H-momp appears to be a convenient tool for serological studies of AS and at present is likely to be more suitable than other bacterial antigens, notably those with B27-like epitopes. Namely, the confirmed presence in AS of enterobacteria with freely accessible B27-like antigenic epitopes on their cell surface might induce unusual tolerance to these organisms in B27 positive hosts, thus causing chronic inflammation, initially sacroiliitis (and spondylitis) due to the proximity of presacral and para-aortic colon draining lymph nodes, later becoming more generalized (for reasons unclear) to include other lesions (e.g. peripheral arthritis, uveitis, enthesopathies). Thus, antibodies to B27-like antigenic epitopes need not be detectable or may be absent. Also, cellular immune responsiveness to these antigens might be involved.

  8. Is there a common pathogenesis in aggressive periodontitis & ankylosing spondylitis in HLA-B27 patient?

    Science.gov (United States)

    Agrawal, Neeraj; Agarwal, Kavita; Varshney, Atul; Agrawal, Navneet; Dubey, Ashutosh

    2016-05-01

    HLA-B27 is having strong association to ankylosing spondylitis (AS) and other inflammatory diseases collectively known as seronegative spondyloarthropathy. In literature, although the evidence for association between AS and periodontitis as well as AS and HLA-B27 are there but the association of aggressive periodontitis in HLA-B27 positive patient with AS are not there. We hypothesize that there may be a common pathogenesis in aggressive periodontitis and ankylosing spondylitis in HLA-B27 patient. A 27-years-old female presented with the features of generalized aggressive periodontitis and difficulty in walking. On complete medical examination, ankylosing spondylitis was diagnosed with further positive HLA-B27 phenotype and negative rheumatic factor. This report may open up a new link to explore in the pathogenesis of aggressive periodontitis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity

    DEFF Research Database (Denmark)

    Molnar, Christoph; Scherer, Almut; Baraliakos, Xenofon

    2018-01-01

    OBJECTIVES: To analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS). METHODS: Patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years...... were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial...... generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis. RESULTS: A total...

  10. Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis

    Science.gov (United States)

    Senabre-Gallego, José Miguel; Santos-Ramírez, Carlos; Santos-Soler, Gregorio; Salas-Heredia, Esteban; Sánchez-Barrioluengo, Mabel; Barber, Xavier; Rosas, José

    2013-01-01

    To date, anti-tumor necrosis factor alfa (anti-TNF-α) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept

  11. Spinal Fracture in Patients With Ankylosing Spondylitis: Cohort Definition, Distribution of Injuries, and Hospital Outcomes.

    Science.gov (United States)

    Lukasiewicz, Adam M; Bohl, Daniel D; Varthi, Arya G; Basques, Bryce A; Webb, Matthew L; Samuel, Andre M; Grauer, Jonathan N

    2016-02-01

    A retrospective cohort. The aim of this study was to characterize spinal fractures in patients with ankylosing spondylitis. Patients with ankylosing spondylitis are susceptible to fractures of the spinal column, even from minor trauma. However, the literature describing patients with ankylosing spondylitis and spinal fractures consists largely of case reports and small case series. The purpose of this study is to better characterize fractures of the ankylosed spine, including the patient population, locations of fracture, and outcomes in a large, nationally representative sample. All patients with diagnoses of both fracture of the spinal column and ankylosing spondylitis admitted between 2005 and 2011 were identified in the National Inpatient Sample (NIS). Patient demographics, fracture regions, and complications were characterized with descriptive statistics. The associations between injury characteristics and outcomes were assessed using Poisson regression. A total of 939 patients with ankylosing spondylitis admitted with a spinal fracture were identified in NIS. The average age was 68.4 ± 14.7 years, and 85% of patients were male. Cervical fractures were the most common (53.0%), followed by thoracic (41.9%), lumbar (18.2%), and sacral (1.5%). Spinal cord injury was present in 27.5% of cervical fractures, 16.0% of thoracic fractures, and 21.1% of cases overall. Fractures involving more than 1 region of the spine occurred in 13.1% of patients. Patients were treated with fusion in 49.9% of cases. In-hospital adverse events occurred in 29.4% of patients, and 6.6% of patients died during their admission. More than 10% of patients had fractures in more than 1 region of the spine. There is a high risk of adverse events in this population, and 6.6% of patients died during their inpatient stay. These results provide clinicians with a better understanding of the distribution and the high morbidity and mortality of fractures in the ankylosed spine. 3.

  12. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis....... Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided...... Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists Udgivelsesdato: 2008/12/1...

  13. Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Tschoeke Sven K

    2008-06-01

    Full Text Available Abstract Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries.

  14. MMP mediated type V collagen degradation (C5M) is elevated in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Veidal, S S; Larsen, D V; Chen, Xijuan

    2012-01-01

    Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS).......Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS)....

  15. Critical appraisal of the guidelines for the management of ankylosing spondylitis: disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Soriano, Enrique R; Clegg, Daniel O; Lisse, Jeffrey R

    2012-05-01

    Surprisingly, little data are available for the use of disease-modifying antirheumatic drugs in ankylosing spondylitis. Sulfasalazine has been the best studied. Efficacy data for individual agents (including pamidronate) and combinations of agents are detailed in this review. Intriguingly, these agents continue to be used with some frequency, even in the absence of efficacy data. To answer these questions, additional systematic studies of these agents in ankylosing spondylitis are needed and will likely need to be done by interested collaborative groups such as SPARTAN.

  16. A case of severe ankylosing spondylitis posted for hip replacement surgery

    Directory of Open Access Journals (Sweden)

    Nalini Kotekar

    2007-01-01

    Full Text Available A 50-year-old male patient with history of ankylosing spondylitis (AS for 30 years presented for hip replacement surgery. Airway management in ankylosing spondylitis patients presents the most serious array of intubation and airway hazards imagin-able, which is secondary to decrease in cervical spine mobility and possible temporo-mandibular joint disease. Literatures support definitive airway management and many authors consider regional anaesthesia to be contraindicated. The reasons cited include inability to gain neuraxial access and the need for urgent airway control in case of complication of regional anaesthesia.

  17. The abilities of golimumab in the therapy of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2014-09-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  18. The abilities of golimumab in the therapy of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2014-01-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  19. The epidemiology of extra-articular manifestations in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Stolwijk, Carmen; Essers, Ivette; van Tubergen, Astrid

    2015-01-01

    OBJECTIVE: To assess the incidence and risks of common extra-articular manifestations (EAMs), that is, acute anterior uveitis (AAU), psoriasis and inflammatory bowel disease (IBD), in patients with ankylosing spondylitis (AS) compared with population-based controls. METHODS: All incident patients......-dependent adjustments for age, sex, comorbidity and medication use. RESULTS: At diagnosis of AS, the proportion of patients with an EAM was 11.4% for AAU, 4.4% for psoriasis and 3.7% for IBD. Incidence rates of EAMs were 8.9/1000 person-years for AAU, 3.4/1000 person-years for psoriasis and 2.4 /1000 person......-years for IBD in AS. The 20-year cumulative incidence was 24.5%, 10.1% and 7.5%, respectively. Risks of EAMs were 1.5-fold to 16-fold increased versus controls, with an adj HR of 15.5 (95% CI 11.6 to 20.7) for AAU, adj HR of 1.5 (95% CI 1.1 to 1.9) for psoriasis and adj HR of 3.3 (95% CI 2.3 to 4.8) for IBD...

  20. Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, M.P.; Kiuru, M.J.; Koskinen, S.K. [Helsinki Univ. Central Hospital, Toeoeloe Trauma Center (Finland). Dept. of Radiology

    2004-11-01

    Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice.

  1. Serum Prolidase Activity in Ankylosing Spondylitis and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Demet Uçar

    2013-01-01

    Full Text Available The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA in ankylosing spondylitis (AS and rheumatoid arthritis (RA. 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups ( P < 0.001/ P = 0.002. No statistically significant difference was found between the RA and the control groups ( P = 0.891. In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

  2. Physical Activity and Exercise: Perspectives of Adults With Ankylosing Spondylitis.

    Science.gov (United States)

    O'Dwyer, Tom; McGowan, Emer; O'Shea, Finbar; Wilson, Fiona

    2016-05-01

    Exercise is a key component of the management of ankylosing spondylitis (AS). Despite numerous benefits, compliance with exercise programs is low. Little attention has been accorded to the experiences of individuals with AS toward physical activity (PA). This study aimed to explore the attitudes toward PA and exercise of adults with AS. A qualitative descriptive design using thematic analysis was used. Seventeen adults with AS participated in individual, semistructured interviews. Interviews were recorded, transcribed, coded and analyzed for themes and subthemes. Four themes emerged from the analysis: (1) benefits, (2) barriers, (3) motivation, and (4) strategies and enablers. Benefits included amelioration of symptoms, improvements in general health, and enhancement of quality of life. Subthemes of barriers to PA included lack of resources, negative attitudes to exercise, misinformation, and condition-related factors. Motivation to exercise was influenced by intrinsic and extrinsic factors. Participants proposed strategies to enhance PA participation and exercise engagement. Awareness of the benefits of PA appears insufficient to motivate individuals with AS to exercise; a number of factors influence individual motivation to exercise. Many perceived barriers to PA may be considered modifiable. Individually-tailored interventions, collaboratively developed by the individual and the healthcare professionals, were proposed as strategies for effective PA and exercise prescription.

  3. Emerging drugs for axial spondyloarthritis including ankylosing spondylitis.

    Science.gov (United States)

    Busquets-Perez, Noemi; Marzo-Ortega, Helena; Emery, Paul

    2013-03-01

    Only non-steroidal anti-inflammatories (NSAIDs) and TNF inhibitors (TNFi) are effective in ankylosing spondylitis (AS). However, not all patients successfully respond to these drugs and a subset may have contraindications to their use. In the last decade, an earlier diagnosis of AS has been achieved due to the increasing availability of MRI. This has led to prompt treatment initiation with improved outcomes. NSAIDs and TNFi are the current treatments for AS which lead to sustained clinical responses in the long term. Recent studies have shown other potential biomarkers in AS, such as the IL-17/IL-23 axis. This has translated into the development of new drugs which interfere with these pathways, such as apremilast and secukinumab, which have shown efficacy in early clinical trials. AS carries considerable short- and long-term disabilities. Anti-TNF-α therapies reduce pain, improve function and decrease inflammation as seen by MRI. New treatment options are being developed which may prove efficacious on those patients not responding to anti-TNF. The ultimate research goal should focus on treatments to prevent and stop new bone formation.

  4. Meta-analysis of differentially expressed genes in ankylosing spondylitis.

    Science.gov (United States)

    Lee, Y H; Song, G G

    2015-05-18

    The purpose of this study was to identify differentially expressed (DE) genes and biological processes associated with changes in gene expression in ankylosing spondylitis (AS). We performed a meta-analysis using the integrative meta-analysis of expression data program on publicly available microarray AS Gene Expression Omnibus (GEO) datasets. We performed Gene Ontology (GO) enrichment analyses and pathway analysis using the Kyoto Encyclopedia of Genes and Genomes. Four GEO datasets, including 31 patients with AS and 39 controls, were available for the meta-analysis. We identified 65 genes across the studies that were consistently DE in patients with AS vs controls (23 upregulated and 42 downregulated). The upregulated gene with the largest effect size (ES; -1.2628, P = 0.020951) was integral membrane protein 2A (ITM2A), which is expressed by CD4+ T cells and plays a role in activation of T cells. The downregulated gene with the largest ES (1.2299, P = 0.040075) was mitochondrial ribosomal protein S11 (MRPS11). The most significant GO enrichment was in the respiratory electron transport chain category (P = 1.67 x 10-9). Therefore, our meta-analysis identified genes that were consistently DE as well as biological pathways associated with gene expression changes in AS.

  5. The role of bone morphogenetic proteins in ankylosing spondylitis.

    Science.gov (United States)

    Carter, Shea; Braem, Kirsten; Lories, Rik J

    2012-08-01

    Ankylosing spondylitis (AS), the best-known form of spondyloarthritis (SpA), is a remodelling arthritis characterized by chronic inflammation and bone formation. Ankylosis of the axial skeleton and sacroiliac joints leads to an impairment of spinal mobility, progressive spinal fusion and an increased risk of spinal fractures. The nature of the relationship between inflammation and new bone formation in AS has been controversial and questions remain as to whether there is a direct relationship between inflammation and new bone formation. Like others, we have hypothesized that the molecular pathways underlying ankylosis recapitulate the process of endochondral bone formation and that bone morphogenetic proteins (BMPs) play a key role in this process in AS. Furthermore, we discuss the entheseal stress hypothesis, which proposes that inflammation and ankylosis are linked but largely independent processes, and consider observations from mouse models and other human diseases which also imply that biomechanical factors contribute to the pathogenesis of AS. As current therapeutics, such as tumour necrosis factor inhibitors do not impede disease progression and ankylosis in AS, it is the pathways discussed in this review that are the now the focus for the identification of future drug targets.

  6. Genetics of ankylosing spondylitis--insights into pathogenesis.

    Science.gov (United States)

    Brown, Matthew A; Kenna, Tony; Wordsworth, B Paul

    2016-02-01

    Ankylosing spondylitis (AS), an immune-mediated arthritis, is the prototypic member of a group of conditions known as spondyloarthropathies that also includes reactive arthritis, psoriatic arthritis and enteropathic arthritis. Patients with these conditions share a clinical predisposition for spinal and pelvic joint dysfunction, as well as genetic associations, notably with HLA-B(*)27. Spondyloarthropathies are characterized by histopathological inflammation in entheses (regions of high mechanical stress where tendons and ligaments insert into bone) and in the subchondral bone marrow, and by abnormal osteoproliferation at involved sites. The association of AS with HLA-B(*)27, first described >40 years ago, led to hope that the cause of the disease would be rapidly established. However, even though many theories have been advanced to explain how HLA-B(*)27 is involved in AS, no consensus about the answers to this question has been reached, and no successful treatments have yet been developed that target HLA-B27 or its functional pathways. Over the past decade, rapid progress has been made in discovering further genetic associations with AS that have shed new light on the aetiopathogenesis of the disease. Some of these discoveries have driven translational ideas, such as the repurposing of therapeutics targeting the cytokines IL-12 and IL-23 and other factors downstream of this pathway. AS provides an excellent example of how hypothesis-free research can lead to major advances in understanding pathogenesis and to the development of innovative therapeutic strategies.

  7. Involvement of Notch1/Hes signaling pathway in ankylosing spondylitis.

    Science.gov (United States)

    Xu, Wei; Liang, Chao-Ge; Li, Yi-Fan; Ji, Yun-Han; Qiu, Wen-Jun; Tang, Xian-Zhong

    2015-01-01

    We aimed to investigate the role of Notch1/Hes signaling pathway in the pathogenesis of abnormal ossification of hip ligament in patients with ankylosing spondylitis (AS). 22 AS patients scheduled for artificial hip arthroplasty were randomly chosen as AS group. As controls, we used 4 patients diagnosed with transcervical fracture who underwent hip replacement surgery. Notch1 and Hes mRNA expressions were detected by real-time fluorescent quantitative polymerase chain reaction (RFQ-PCR). Immunohistochemistry (IHC) was used to detect Notch1 and Hes protein expression. Correlation analyses of Notch-l and Hes with AS-related clinical factors were conducted with spearman's correlation analysis and partial correlation analysis. RFQ-PCR results showed significant differences in Notch1 and Hes mRNA expressions between AS group and the control group (all Ppathways. Semi-quantitative IHC showed a higher Notch1 and Hes expression levels in AS group compared to the control group (all Ppathways mediated by Notch1-Hes may contribute to ligament ossification of hip joints in AS patients.

  8. Ankylosing spondylitis: beyond genome-wide association studies.

    Science.gov (United States)

    O'Rielly, Darren D; Uddin, Mohammed; Rahman, Proton

    2016-07-01

    This article discusses genomic investigations in ankylosing spondylitis (AS) beyond genome-wide association (GWA) studies, but prior to this, genetic variants achieving genome-wide significance will be summarized highlighting key pathways contributing to disease pathogenesis. Evidence suggests that disease pathogenesis is attributed to a complex interplay of genetic, environmental and immunological factors. GWA studies have greatly enhanced our understanding of AS pathogenesis by illuminating distinct immunomodulatory pathways affecting innate and acquired immunity, most notably the interleukin-23/interleukin-17 pathway. However, despite the wealth of new information gleaned from such studies, a fraction of the heritability (24.4%) has been explained. This review will focus on investigations beyond GWA studies including copy number variants, gene expression profiling, including microRNA (miRNA), epigenetics, rare variants and gene-gene interactions. To address the 'missing heritability' and advance beyond GWA studies, a concerted effort involving rethinking of study design and implementation of newer technologies will be required. The coming of age of next-generation sequencing and advancements in epigenetic and miRNA technologies, combined with familial-focused investigations using well-characterized cohorts, is likely to reveal some of the hidden genomic mysteries associated with AS.

  9. Pain in ankylosing spondylitis: a neuro-immune collaboration.

    Science.gov (United States)

    Bidad, Katayoon; Gracey, Eric; Hemington, Kasey S; Mapplebeck, Josiane C S; Davis, Karen D; Inman, Robert D

    2017-07-01

    Clinicians have commonly differentiated chronic back pain into two broad subsets: namely, non-inflammatory (or mechanical) back pain and inflammatory back pain. As the terminology suggests, the latter category, in which ankylosing spondylitis (AS) is prominent, presupposes a close link between pain and inflammation. Advances in research into the genetics and immunology of AS have improved our understanding of the inflammatory processes involved in this disease, and have led to the development of potent anti-inflammatory biologic therapeutic agents. However, evidence from clinical trials and from biomarker and imaging studies in patients with AS indicate that pain and inflammation are not always correlated. Thus, the assumption that pain in AS is a reliable surrogate marker for inflammation might be an over-simplification. This Review provides an overview of current concepts relating to neuro-immune interactions in AS and summarizes research that reveals an increasingly complex interplay between the activation of the immune system and pain pathways in the nervous system. The different types of pain experienced by patients with AS, insights from brain imaging studies, neurological mechanisms of pain, sex bias in pain and how the immune system can modify pain in patients with AS are also discussed.

  10. BONE METABOLISM AND ITS REGULATION IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    O. V. Bugrova

    2016-01-01

    Full Text Available Osteoporosis in ankylosing spondylitis (AS may exacerbate pain and functional disorders and increases the risk of fractures. The mechanisms  of its development in AS have not been adequately studied.Objective: to study bone mineral density (BMD  and its regulation in patients with AS.Subjects and methods. 70 patients (mean age, 43.2±9.2 years with a documented diagnosis of AS (mean disease duration, 17.1±7.8 years and a control group of 30 healthy individuals were examined. All the patients underwent estimation of BMD and the serum concentrations of osteocalcin,  CrossLaps, and key regulators of osteoclastogenesis, such as osteoprotegerin (OPG  and a receptor activator of nuclear factor kappa-B ligand (RANKL by an enzyme immunoassay. Results and discussion. In patients with AS, bone metabolism was characterized  by a decrease in bone formation and by some increase in bone tissue degradation especially in high AS activity. These patients showed the elevated levels of the major blocker of osteoclastogenesis OPG and the OPG/RANKL ratio, which can cause the process of ossification characteristic  of AS.

  11. Ankylosing spondylitis and psoriatic arthritis: clinical and economic consequences of the use of etanercept

    OpenAIRE

    Viola Sacchi; Orietta Zaniolo; Ignazio Olivieri

    2010-01-01

    Spondyloarthritis (SpA) is the name for a family of inflammatory rheumatic disease that can affect the spine and joints, ligaments and tendons. Spondyloarthritis disease include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, the spondylitis associated with the inflammatory bowel diseases and the undifferentiated spondyloarthritis. The most common treatments prescribed for spondyloarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs) given in combination with disease-mo...

  12. Baseline predictors of response to TNF-α blocking therapy in ankylosing spondylitis

    NARCIS (Netherlands)

    Arends, Suzanne; van der Veer, Eveline; Kallenberg, Cees G. M.; Brouwer, Elisabeth; Spoorenberg, Anneke

    PURPOSE OF REVIEW: Identifying the characteristics of patients with ankylosing spondylitis (AS) before start of treatment which are able to predict a beneficial response to tumor necrosis factor-alpha (TNF-α) blocking therapy is relevant, especially in view of the high costs and potential

  13. Spinal pseudo arthrosis in the ankylosing spondylitis: complications with infectious discytis simulation

    International Nuclear Information System (INIS)

    Galant, J.; Marti-Bonmarti, L.; Poyatos, C.; Martinez-Rodrigo, J.; Ferrer, M.D.

    1995-01-01

    A case is presented of radiological signs typical of spinal pseudo arthrosis in a patient with ankylosing spondylitis. The radiological signs (plain radiology, computerized tomography and magnetic resonance) are described, and the recognition of this disorder and its differentiation with respect to infectious spondilodiscitis is discussed. (Author) 11 refs

  14. Why golimumab in the treatment of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis?

    Directory of Open Access Journals (Sweden)

    M. Rossini

    2015-03-01

    Full Text Available Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

  15. Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial

    NARCIS (Netherlands)

    van Tubergen, A.; Landewé, R.; van der Heijde, D.; Hidding, A.; Wolter, N.; Asscher, M.; Falkenbach, A.; Genth, E.; Thè, H. G.; van der Linden, S.

    2001-01-01

    To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean

  16. Bamboo spine – X-ray findings of ankylosing spondylitis revisited ...

    African Journals Online (AJOL)

    Ankylosing spondylitis is a debilitating disease that is one of the seronegative spondylarthropathies, affecting more males than females in the proportion of about 6:1 in the age group 15 - 35 years of age. Early radiographic findings include bilateral sacro-iliitis and early axial (lower lumbar spine) ankylosis. Typical X-ray ...

  17. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-a (TNF-a) agents is more likely to develop into a de novo...... syndesmophyte visible on a radiograph as compared to a vertebral corner with no CIL....

  18. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-α (TNF-α) agents is more likely to develop into a de novo...... syndesmophyte visible on a radiograph as compared to a vertebral corner with no CIL....

  19. Direct costs of ankylosing spondylitis and its determinants: an analysis among three European countries

    NARCIS (Netherlands)

    Boonen, A.; van der Heijde, D.; Landewé, R.; Guillemin, F.; Rutten-van Mölken, M.; Dougados, M.; Mielants, H.; de Vlam, K.; van der Tempel, H.; Boesen, S.; Spoorenberg, A.; Schouten, H.; van der Linden, Sj

    2003-01-01

    To assess direct costs associated with ankylosing spondylitis (AS). To determine which variables, including country, predict costs. 216 patients with AS from the Netherlands, France, and Belgium participated in a two year observational study and filled in bimonthly economic questionnaires. Disease

  20. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-a (TNF-a) agents is more likely to develop into a de novo...

  1. Ankylosing spondylitis in a 50-year-old man: a case report | Kawu ...

    African Journals Online (AJOL)

    Ankylosing spondylitis (AS) is a distinct disease entity characterized by inflammation of multiple articular and paraarticular structures especially of the spine, sacroiliac joints and large peripheral joints such as the hips, shoulders and rarely the knees frequently resulting in bony ankylosis. This is a case report of a 50 year old ...

  2. The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial.

    Science.gov (United States)

    Karahan, Ali Yavuz; Tok, Fatih; Yildirim, Pelin; Ordahan, Banu; Turkoglu, Gozde; Sahin, Nilay

    2016-01-01

    Exergames are a well-known type of game based on a virtual avatar's body movements. This hightech approach promotes an active lifestyle. The aim of this randomized controlled trial was to evaluate the effects of exergames on pain, disease activity, functional capacity and quality of life in patients with ankylosing spondylitis (AS). The study involved 60 patients, who were randomized into either the exergame group (EG) or the control group (CG). The EG patients engaged in exergaming, and CG patients did not engage in any exercises. The exergaming sessions were performed five times a week for eight weeks (40 sessions in total). The patients were assessed before and after the eight-week program on a visual analog scale (VAS), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. A statistically significant improvement was observed in VAS, BASFI, BASDAI and ASQoL scores in the EG group after completion of the exercise program (p < 0.05). This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle. The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could, therefore, be feasible and safe.

  3. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Sørensen, Jan; Hetland, Merete Lund

    2014-01-01

    ) and ankylosing spondylitis (AS) changed from year 2000 to 2011. METHODS: Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13 721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset...

  4. Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Lie, Elisabeth; Lindström, Ulf; Zverkova-Sandström, Tatiana

    2017-01-01

    OBJECTIVES: Tumour necrosis factor-α inhibitor (TNFi) treatment has been shown to reduce the rates of anterior uveitis (AU) in patients with ankylosing spondylitis (AS). Our objective was to compare the effect of adalimumab (ADA), etanercept (ETN) and infliximab (IFX) on AU occurrence in AS, using...

  5. Surgical interventions for nephrolithiasis in ankylosing spondylitis and the general population

    DEFF Research Database (Denmark)

    Jakobsen, Ane Krag; Jacobsson, Lennart T H; Patschan, Oliver

    2015-01-01

    OBJECTIVE: The aim of this study was to estimate rates and type of definitive surgical interventions for nephrolithiasis in Swedish patients with ankylosing spondylitis (AS) compared to the general population. MATERIALS AND METHODS: This national prospective cohort study linked data from Swedish...

  6. The impact of ankylosing spondylitis on audiovestibular functions.

    Science.gov (United States)

    Kapusuz Gencer, Zeliha; Özkırış, Mahmut; Günaydın, Ilhan; Saydam, Levent

    2014-09-01

    In this study, we aimed to evaluate the audiovestibular functions in the patients with ankylosing spondylitis (AS). This prospective study was performed in collaboration by the Otolaryngology and Rheumatology Departments of Bozok University School of Medicine between May 1, 2012, and January 1, 2013. We studied 80 subjects consisting of 40 AS patients (37 men and 3 women) in whom the diagnosis confirmed by the criteria of New York and 40 healthy controls (35 men and 5 women). All participants were evaluated by routine audiologic (including tympanometric evaluation, pure-tone audiograms, speech tests) and vestibular studies (including spontaneous nystagmus, gaze, optokinetic, saccadic movements, smooth pursuit, caloric test and Dix-Hallpike tests). The tympanometric values did not show a statistically significant difference between the AS group and the healthy subjects (p > 0.05). At low frequencies (250, 500, 1,000, and 2,000 Hz) pure-tone audiologic evaluations also proved statistically non-significant results at mean air conduction thresholds (ACT) and bone conduction thresholds (BCT) between the AS and control groups (p > 0.05). At high frequencies (4,000, 6,000, and 8,000 Hz), the ACTs and BCTs in AS group were lower than control group which was statistically significant (p 0.05). The comparison of smooth pursuit and Dix-Hallpike tests reached statistical significance (p VNG) revealed central abnormalities in 7 patients (17.5 %), peripheral abnormalities in 16 patients (40 %), and mixed abnormalities in 3 patients (7.5 %). Our findings suggest a possible association between AS and audiovestibular system dysfunction. We assume that the hearing and vestibular disturbances in AS are more prevalent than previously recognized.

  7. Detection of novel diagnostic antibodies in ankylosing spondylitis: An overview.

    Science.gov (United States)

    Quaden, Dana H F; De Winter, Liesbeth M; Somers, Veerle

    2016-08-01

    Ankylosing spondylitis (AS) is a debilitating, chronic, rheumatic disease characterized by inflammation and new bone formation resulting in fusion of the spine and sacroiliac joints. Since early treatment is impeded by a delayed diagnosis, it is highly important to find new biomarkers that improve early diagnosis and may also contribute to a better assessment of disease activity, prognosis and therapy response in AS. Because of the absence of rheumatoid factor, AS was long assumed to have a seronegative character and antibodies are thus not considered a hallmark of the disease. However, emerging evidence suggests plasma cells and autoantibodies to be involved in the disease course. In this review, the role of B cells and antibodies in AS is discussed. Furthermore, an overview is provided of antibodies identified in AS up till now, and their diagnostic potential. Many of these antibody responses were based on small study populations and further validation is lacking. Moreover, most were identified by a hypothesis-driven approach and thus limited to antibodies against targets that are already known to be involved in AS pathogenesis. Hence, we propose an unbiased approach to identify novel diagnostic antibodies. The already successfully applied techniques cDNA phage display and serological antigen selection will be used to identify antibodies against both known and new antigen targets in AS plasma. These newly identified antibodies will enhance early diagnosis of AS and provide more insight into the underlying disease pathology, resulting in a more effective treatment strategy and eventually an improved disease outcome. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Risk of premature cerebrovascular disease in patients with ankylosing spondylitis.

    Science.gov (United States)

    Zhang, Xingwen; Liu, Ruozhuo; Wang, Jing; Zhang, Yuqi; Liu, Yufei; Yu, Zhe; Yu, Shengyuan

    2016-01-01

    Patients with ankylosing spondylitis (AS) are at an elevated risk for the development of coronary artery disease, but the risk cerebrovascular disease among these patients remains incompletely understood. We investigated the cerebrovascular risk profiles of patients with a cerebrovascular disease and AS and compared these profiles to those of cerebrovascular disease patients without AS. We retrospectively analyzed 34 patients with ischemic cerebrovascular disease also diagnosed with AS and 597 controls without AS with respect to patient age, gender, cerebrovascular risk factors, and laboratory test results. AS patients were significantly younger than control patients in this study (56.2±13.5 years vs. 63.0±13.4 years, respectively; p=0.004). Logistic regression analysis did not indicate significant relationships between gender, cerebrovascular risk factors, and biochemical risk factors in AS patients, nor were any significant relationships found between erythrocyte sedimentation rate or C-reactive protein and biochemical risk factors. A low frequency of large-artery atherosclerosis and high frequency of small-vessel occlusion according to TOAST classification were found in AS patients with stroke. Among the patients included in this study, patients with AS sought treatment for cerebrovascular disease were at a younger age compared to control patients without AS. Thus, our results indicate that AS patients have an increased risk for the premature onset of cerebrovascular disease. And the premature atherosclerosis may associate with the patients with AS. Furthermore, the high frequency of the small-vessel stroke subtype in AS patients indicates that small-vessel inflammation may be involved in the pathogenesis of vascular diseases in AS patients. Further prospective study with more samples will be needed to confirm this point of view.

  9. Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Senabre-Gallego JM

    2013-09-01

    Full Text Available José Miguel Senabre-Gallego,1 Carlos Santos-Ramirez,2 Gregorio Santos-Soler,1 Esteban Salas-Heredia,1 Mabel Sánchez-Barrioluengo,3 Xavier Barber,4 José Rosas1 On behalf of the AIRE-MB group 1Rheumatology, Hospital Marina Baixa, Villajoyosa, 2Rheumatology, Hospital Marina Salud, Denia, 3INGENIO (Instituto de Gestión de la Inovación y del Conocimiento (CSIC [Consejo Superior de Investigaciones Científicas]-UPV [Universidad Politécnica de Valencia], Universitat Politècnica de València, Valencia, 4CIO (Centro de Investigación Operativa-UMH (Universidad Miguel Hernández, Universidad Miguel Henández, Elche, Spain Abstract: To date, anti-tumor necrosis factor alfa (anti-TNF-α therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of

  10. Responsiveness and discriminative capacity of the assessments in ankylosing spondylitis disease-controlling antirheumatic therapy core set and other outcome measures in a trial of etanercept in ankylosing spondylitis

    NARCIS (Netherlands)

    Wanders, Astrid J. B.; Gorman, Jennifer D.; Davis, John C.; Landewe, Robert B. M.; van der Heijde, Désirée M. F. M.

    2004-01-01

    To investigate the responsiveness and discriminative capacity, and the relationship between both, of instruments selected for the disease-controlling antirheumatic therapy (DC-ART) core set by the Assessments in Ankylosing Spondylitis Working Group (ASAS). Responsiveness and discriminative capacity

  11. Disease flare of ankylosing spondylitis presenting as reactive arthritis with seropositivity: a case report

    Directory of Open Access Journals (Sweden)

    Manoj EM

    2012-02-01

    Full Text Available Abstract Introduction Concurrent rheumatoid factor seropositivity is occasionally detected in ankylosing spondylitis and often causes confusion in clinical routine. Overlap between various seronegative arthritides is a known but uncommon association. Differentiation of spondyloarthropathy from rheumatoid arthritis is important, since the natural history, complications, treatments and prognosis of the two diseases differ significantly. Case presentation Here, we report the case of a 47-year-old Sri Lankan man who had a long history of intermittent joint pains worsening following a recent episode of self-resolving non-bloody diarrhea. Subsequently, he developed a skin rash suggestive of keratoderma blenorrhagica and circinate balanitis. He had classical radiological evidence of ankylosing spondylosis (previously undiagnosed associated with human leukocyte antigen B27 antigen, but was positive for rheumatoid factor. Conclusions A disease flare of ankylosing spondylitis prompted by a minor diarrheal illness showing well documented features of reactive arthritis is remarkable. The prognostic implications of seropositivity in spondyloarthritis are discussed.

  12. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system.

    Science.gov (United States)

    Azevedo, Valderilio Feijó; Rossetto, Chayanne N; Lorencetti, Pedro G; Tramontin, Mariana Y; Fornazari, Bruna; Araújo, Denizar V

    2016-01-01

    Patients with ankylosing spondylitis require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. 70 patients (75.28%) were male and 23 (24.72%) female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32); 63.44% were using anti-tumour necrotic factor drugs. Comparing male and female patients the mean Bath Ankylosing Spondylitis Disease Activity Index was 4.64 and 5.49 while the mean Bath Ankylosing Spondylitis Functional Index was 5.03 and 6.35 respectively. The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-tumour necrotic factor therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

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

    Science.gov (United States)

    Akbal, Ayla; Reşorlu, Hatice; Gökmen, Ferhat; Savaş, Yılmaz; Zateri, Çoşkun; Sargin, Betül; Bozkurt, Emre; Sılan, Fatma; Özdemir, Öztürk

    2016-01-01

    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. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  14. Efficiency of adalimumab, etanercept and infliximab in ankylosing spondylitis in clinical practice.

    Science.gov (United States)

    Escudero-Vilaplana, Vicente; Ramírez-Herráiz, Esther; Alañón-Plaza, Estefanía; Trovato-López, Nicolás; García-Vicuña, Rosario; Carreño-Pérez, Luis; Morell-Baladrón, Alberto; Sanjurjo-Sáez, María

    2015-10-01

    Information on the use of ankylosing spondylitis (AS) therapies in clinical practice is a key factor in decision making, as more efficient treatments may involve substantial savings while maintaining the clinical benefits for the patient. To assess the mean annual doses and associated costs of the three main anti-tumour necrosis factor agents used in Spanish daily clinical practice in ankylosing spondylitis patients and to correlate these costs with disease activity. This retrospective, observational study included adult ankylosing spondylitis patients over a 4-year period that had been treated for at least 6 months with adalimumab, etanercept or infliximab at two University Hospitals in Spain. Disease activity was estimated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores at the start of anti-tumour necrosis factor (anti-TNF) therapy and in the last visit or whenever the drug was switched. Mean costs were estimated for a 52-week horizon from the delivered doses registered by pharmacy records. Outcomes were the doses and costs of anti TNFs administered to each patient, and the BASDAI score. A total of 119 patients (137 cases) were included (28 cases treated with adalimumab, 48 cases with etanercept and 61 with infliximab). Mean doses of adalimumab and etanercept were 92.8 and 88.8% of the initially prescribed doses, respectively, while the mean dose of infliximab administered was 102%. There were no statistical differences among treatments in terms of clinical effectiveness. Associated mean patient-year costs were significantly higher in the infliximab group (€14,235), compared to the other treatments [adalimumab €11,934; etanercept €10,516; (P ankylosing spondylitis patients, doses and associated costs of biological therapies can be reduced while controlling disease activity. Mean doses used in our clinical practice vary from the recommended doses and are significantly lower for adalimumab and etanercept than for infliximab. These

  15. Association of cytokine and matrix metalloproteinase profiles with disease activity and function in ankylosing spondylitis

    Science.gov (United States)

    2012-01-01

    Introduction The pathology of ankylosing spondylitis (AS) suggests that certain cytokines and matrix metalloproteinases (MMPs) might provide useful markers of disease activity. Serum levels of some cytokines and MMPs have been found to be elevated in active disease, but there is a general lack of information about biomarker profiles in AS and how these are related to disease activity and function. The purpose of this study was to investigate whether clinical measures of disease activity and function in AS are associated with particular profiles of circulating cytokines and MMPs. Methods Measurement of 30 cytokines, five MMPs and four tissue inhibitors of metalloproteinases was carried out using Luminex® technology on a well-characterised population of AS patients (n = 157). The relationship between biomarker levels and measures of disease activity (Bath ankylosing spondylitis disease activity index (BASDAI)), function (Bath ankylosing spondylitis functional index) and global health (Bath ankylosing spondylitis global health) was investigated. Principal component analysis was used to reduce the large number of biomarkers to a smaller set of independent components, which were investigated for their association with clinical measures. Further analyses were carried out using hierarchical clustering, multiple regression or multivariate logistic regression. Results Principal component analysis identified eight clusters consisting of various combinations of cytokines and MMPs. The strongest association with the BASDAI was found with a component consisting of MMP-8, MMP-9, hepatocyte growth factor and CXCL8, and was independent of C-reactive protein levels. This component was also associated with current smoking. Hierarchical clustering revealed two distinct patient clusters that could be separated on the basis of MMP levels. The high MMP cluster was associated with increased C-reactive protein, the BASDAI and the Bath ankylosing spondylitis functional index. Conclusions

  16. The Impact of Body Mass Index on Disease Progression in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Zepa Jūlija

    2018-02-01

    Full Text Available Obesity can be a factor that affects the course of chronic systemic inflammatory arthritis. The objective of this study was to characterise patients with ankylosing spondylitis (AS according to an evaluation of their body mass index (BMI and by exploring the link between the overweightness and obesity with routinely measured disease-specific variables, including disease activity (Bath Ankylosing Spondylitis Disease Activity Index BASDAI; Ankylosing Spondylitis Disease Activity Score, using CRP, ASDAScrp, spinal mobility (Bath Ankylosing Spondylitis Metrology Index, BASMI, functional capacity (BASFI, extraspinal manifestations like fatigue, uveitis, and peripheral arthritis present during the course of the disease. A total of 107 patients were included in the cross-sectional study fulfilling the modified New York criteria for AS. Patients were divided into three groups: with the evaluation of BMI ≤ 24.9, 25.0–29.9 (overweight and ≥ 30.0 (obesity. The mean BMI was 25.13 (SD 4.07. 33% of patients were overweight and 15% were obese. The mean values of age, duration of AS, ASDAScrp, BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI, BASMI, pain in spine, and fatigue in the group with BMI ≤ 24.9 were lower than in the other groups (p < 0.05. There was no difference between groups in age of AS onset, uveitis and peripheral arthritis. AS patients who were overweight or obese had a higher level of the disease activity, pain, fatigue, functional disability and spinal mobility impairment with worse values in the case of obesity.

  17. Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices

    Directory of Open Access Journals (Sweden)

    F.M. Perrotta

    2013-07-01

    Full Text Available The aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range 43.5/28-69 years; disease duration (median/range 9.7/1-36 years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy. Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR, ASDAS-C-reactive protein (CRP, bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03. FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05. We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04. No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls.

  18. Identification of multiple risk variants for ankylosing spondylitis through high-density genotyping of immune-related loci

    Science.gov (United States)

    Cortes, Adrian; Hadler, Johanna; Pointon, Jenny P; Robinson, Philip C; Karaderi, Tugce; Leo, Paul; Cremin, Katie; Pryce, Karena; Harris, Jessica; lee, Seunghun; Joo, Kyung Bin; Shim, Seung-Cheol; Weisman, Michael; Ward, Michael; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Jiang, Lei; Liu, Yu; Wu, Xin; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Kenna, Tony J; Haroon, Nigil; Ferreira, Manuel A; Yang, Jian; Mulero, Juan; Fernandez-Sueiro, Jose Luis; Gonzalez-Gay, Miguel A; lopez-Larrea, Carlos; Deloukas, Panos; Donnelly, Peter; Bowness, Paul; Gafney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Xu, Huji; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Chou, Chung-Tei; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Videm, Vibeke; Martin, Javier; Breban, Maxime; Reveille, John D; Evans, David M; Kim, Tae-Hwan; Wordsworth, Bryan Paul; Brown, Matthew A

    2013-01-01

    Ankylosing spondylitis is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. In addition to HLA-B*27 alleles, 12 loci have previously been identified that are associated with ankylosing spondylitis in populations of European ancestry, and 2 associated loci have been identified in Asians. In this study, we used the Illumina Immunochip microarray to perform a case-control association study involving 10,619 individuals with ankylosing spondylitis (cases) and 15,145 controls. We identified 13 new risk loci and 12 additional ankylosing spondylitis–associated haplotypes at 11 loci. Two ankylosing spondylitis–associated regions have now been identified encoding four aminopeptidases that are involved in peptide processing before major histocompatibility complex (MHC) class I presentation. Protective variants at two of these loci are associated both with reduced aminopeptidase function and with MHC class I cell surface expression. PMID:23749187

  19. Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting.

    Science.gov (United States)

    Curtis, Jeffrey R; Harrold, Leslie R; Asgari, Maryam M; Deodhar, Atul; Salman, Craig; Gelfand, Joel M; Wu, Jashin J; Herrinton, Lisa J

    2016-01-01

    Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings. We used computerized diagnoses to estimate the prevalence of axSpA and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). We identified persons aged 18 years or older with 1 or more International Classification of Diseases, Ninth Revision (ICD-9) diagnosis Code 720.X (ankylosing spondylitis and other inflammatory spondylopathies) in clinical encounter data from 1996 through 2009 to estimate the prevalence of axSpA and ankylosing spondylitis. We reviewed medical records to confirm the diagnosis in a random sample and estimated the positive predictive value of computerized data to identify confirmed cases using various case definitions. In the computerized data, 5568 adults had diagnostic codes indicating axSpA. On the basis of our case-finding approach using a single physician diagnosis code for ICD-9 720.X, the point prevalence of these conditions, standardized to the 2000 US Census, was 2.26 per 1000 persons for axSpA and 1.07 per 1000 for ankylosing spondylitis. Less than half of suspected cases saw a rheumatologist. The most specific algorithm for confirmed ankylosing spondylitis required 2 or more computerized diagnoses assigned by a rheumatologist, with 67% sensitivity (95% confidence interval, 64%-69%) and 81% positive predictive value (95% confidence interval, 79%-83%). Observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests there is substantial underrecognition of these conditions in routine clinical practice. However, use of computerized data is able to identify true cases of ankylosing spondylitis, facilitating population-based research.

  20. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    OpenAIRE

    Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analys...

  1. Case study of physiotherapy treatment of a patient with the diagnosis of ankylosing spondylitis and status after total replacement of hip joint

    OpenAIRE

    Chlebečková, Helena

    2013-01-01

    Title: Case study of physiotherapy treatment of a patient with the diagnosis of ankylosing spondylitis and status after total replacement of hip joint Summary: This bachelor thesis deals with the problem of rheumatic disease ankylosing spondylitis and the effects of this disease. General part focuses on describing the theoretical knowledge of ankylosing spondylitis and possible methods for its treatment, and the implantation of hip replacement and subsequent rehabilitation. The special part p...

  2. Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility

    Science.gov (United States)

    Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

    2013-01-01

    Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBRTNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P ankylosing spondylitis risk in HLA-B27–positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

  3. [Ankylosis of the temporomandibular joint: a rare manifestation of ankylosing spondylitis].

    Science.gov (United States)

    Benazzou, S; Maagoul, R; Boulaadas, M; El Kohen, A; El Quessar, A; Essakelli, L; Alaoui Rachidi, F; Benchekroun, L; Jazouli, N; Kzadri, M

    2005-11-01

    The ankylosing spondylitis is a chronic inflammatory rheumatoid disease with predilection in the axial structures. The temporomandibular joint (TMJ) is involved in 10 to 24% of cases. Ankylosis of the TMJ is exceptional, only 11 cases being reported to date. A 48-year-old patient had been followed since 1987 for severe ankylosing spondylitis. The patient, known to be positive for tissue antigen HLA B27, was admitted for limitation of mouth opening. At physical examination, mouth opening was reduced to 1cm with no mandibular movements and a stiffness of the cervical spine in flexion. Computed tomography of the TMJs highlighted a bilateral lesion with ankylosis of the left joint and of C1-C2. Surgical treatment consisted in block resection of the two TMJs using a cartilaginous rib. With a follow up of 9 months, results have been satisfactory. Complementary explorations should be undertaken in ankylosing spondylitis patients with clinical symptoms suggestive of TMJ lesions in order to establish the diagnosis and initiate treatment and avoid the development of ankylosic forms.

  4. Ankylosing spondylitis and psoriatic arthritis: clinical and economic consequences of the use of etanercept

    Directory of Open Access Journals (Sweden)

    Viola Sacchi

    2010-06-01

    Full Text Available Spondyloarthritis (SpA is the name for a family of inflammatory rheumatic disease that can affect the spine and joints, ligaments and tendons. Spondyloarthritis disease include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, the spondylitis associated with the inflammatory bowel diseases and the undifferentiated spondyloarthritis. The most common treatments prescribed for spondyloarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs given in combination with disease-modifying antirheumatic drugs (DMARDs. Due to a recently suggested role of the tumour necrosis factor (TNFa in the pathogenesis of SpA, new therapies specifically blocking TNFa have been investigated. Anti-TNF medications currently available on the Italian market are etanercept, infliximab and adalimumab. The aim of the present work was to furnish a clinical and pharmaco-economical profile of etanercept in treatment of psoriatic arthritis and ankylosing spondylitis based on a review of the published literature. Economical evaluations performed in several countries indicate that total treatment costs are lower with etanercept and adalimumab as compared to infliximab, mainly because of differences in the route of administration. Etanercept appears to be cost effective for the treatment of psoriatic arthritis and ankylosing spondylitis especially considering improved health related quality of life and lower medical costs due to superior efficacy of treatment.

  5. MR imaging features of foot involvement in ankylosing spondylitis

    International Nuclear Information System (INIS)

    Erdem, C. Zuhal; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  6. MR imaging features of foot involvement in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  7. Serum procalcitonin levels in patients with ankylosing spondylitis.

    Science.gov (United States)

    Ozmen, Mustafa; Oktay, Esin; Tarhan, Emine F; Aslan, Ozgur; Oflazoglu, Utku; Koseoglu, Mehmet H

    2016-05-01

    Procalcitonin is a marker of bacterial and fungal infection and sepsis. The present study evaluated the relationship between serum procalcitonin levels and disease activity in patients with ankylosing spondylitis (AS). A total of 61 patients who met the 1984 New York criteria for AS were studied. Twenty-four age- and sex-matched healthy volunteers were recruited to this study as a control group. Disease activity was assessed by the Bath AS Disease Activity Index (BASDAI). The functional status of patients was evaluated by the Bath AS Functional Index (BASFI). Spinal mobility was measured by the Bath AS Metrology Index (BASMI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum procalcitonin levels were measured. Thirty patients were on anti-tumor necrosis factor-alpha treatment and 31 patients were on conventional treatment. Seventeen (28%) of the AS patients were active (BASDAI > 4) and 44 (72%) of the AS patients were in remission. The median ESR was 14 (34-6) mm/h and 4 (7-2) mm/h (P < 0.001) for the patient and control groups, respectively. The median CRP level was 0.91 (2.72-0.37) mg/dL and 0.15 (0.25-0.07) mg/dL in the patient and control groups, respectively (P < 0.001). Median BASDAI, BASFI and BASMI scores for all AS patients were 3.6 (5.25-2.29), 2.5 (4.22-0.91) and 3 (5-1), respectively. Serum procalcitonin levels were normal (< 0.05 ng/mL) for all patients and controls. Serum procalcitonin levels were not high in AS patients and controls, and the levels were independent of disease activity and medications. If bacterial or fungal infection is suspected in an AS patient, serum procalcitonin level may be useful for diagnosis. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  8. Plasma homocysteine status in patients with ankylosing spondylitis.

    Science.gov (United States)

    Wei, James Cheng-Chung; Jan, Ming-Shiou; Yu, Chen-Tung; Huang, Yi-Chia; Yang, Chi-Chiang; Tsou, Hsi-Kai; Lee, Hong-Shan; Chou, Chang-Tei; Tsay, Gregory; Chou, Ming-Chih

    2007-05-01

    Homocysteine (Hcy), a sulfur-containing amino acid, is eliminated through B vitamins-dependent pathways. Hyperhomocysteinemia has been found to be an independent risk factor for atherosclerotic cardiovascular, cerebrovascular, and peripheral vascular diseases. Recently, psoriasis, lupus, and rheumatoid arthritis were reported to be associated with hyperhomocysteinemia. This study was aimed to evaluate the changes of plasma Hcy level before and after sulfasalazine and MTX therapy in patients with ankylosing spondylitis (AS). One hundred and two patients with AS and ten normal controls were enrolled in the cross-sectional case-control study. Fasting plasma Hcy levels were determined by ELISA kits (IMX, Abbott). Hcy levels were compared to their Bath AS disease activity index (BASDAI) and the usage of sulfasalazine and/or MTX. Active disease was defined by BASDAI as more than 3 in a 10-cm scale with ESR >20 mm/h. For those patients with plasma Hcy >or=15 micromol/l, a perspective trial of daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg for 2 weeks were also tested for the efficacy. Plasma Hcy level increased significantly in AS patients under sulfasalazine (10.4+/-3.8 micromol/l, p<0.05), MTX (11.9+/-4.7, p<0.05) and sulfasalazine/MTX combination treatment (11.2+/-2.6, p<0.05) compared with normal controls (8.6+/-1.2 micromol/l) and AS patients without DMARD(9.4+/- 2.6 micromol/l). No correlation between disease activity and plasma Hcy level was found. Daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg can lower Hcy level in 2 weeks (32.3+/-24.0 vs 15.6+/-11.1 micromol/l, p=0.007). Plasma homocysteine level did significantly increase in AS patients under sulfasalazine or MTX treatment. B-vitamins should be considered as a routine supplementation for patients who underwent sulfasalazine and/or MTX treatment. Further longitudinal studies are required to confirm the conclusions.

  9. Magnetic resonance imaging for ankylosing spondylitis; Magnetresonanztomographie bei ankylosierender Spondylitis (Morbus Struempell-Marie-Bechterew)

    Energy Technology Data Exchange (ETDEWEB)

    Bollow, M. [Augusta-Kranken-Anstalt, Inst. fuer Radiologie, Bochum (Germany)

    2002-12-01

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [German

  10. Insights into cardiac involvement in ankylosing spondylitis from cardiovascular magnetic resonance.

    Science.gov (United States)

    Biesbroek, P Stefan; Heslinga, Sjoerd C; Konings, Thelma C; van der Horst-Bruinsma, Irene E; Hofman, Mark B M; van de Ven, Peter M; Kamp, Otto; van Halm, Vokko P; Peters, Mike J L; Smulders, Yvo M; van Rossum, Albert C; Nurmohamed, Mike T; Nijveldt, Robin

    2017-05-01

    To evaluate cardiac involvement in patients with ankylosing spondylitis using cardiac magnetic resonance (CMR). Patients with ankylosing spondylitis without cardiovascular symptoms or known cardiovascular disease were screened by transthoracic echocardiography (TTE) for participation in this exploratory CMR study. We prospectively enrolled 15 ankylosing spondylitis patients with an abnormal TTE for further tissue characterisation using late gadolinium enhancement (LGE) and T1 mapping. T1 mapping was used to calculate myocardial extracellular volume (ECV). Disease activity was assessed by C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measurements. In the total of 15 included patients, 14 had a complete CMR exam (mean age 62 years, 93% male and mean disease duration 21 years). Left ventricular (LV) diastolic dysfunction was the most common finding on TTE (79%), followed by aortic root dilatation (14%), right ventricular (RV) dilatation (7%) and RV dysfunction (7%). CMR revealed focal hyperenhancement in three patients (21%), all with a particular pattern of enhancement. LV dysfunction, as defined by a LV ejection fraction below 55%, was observed in five patients (36%). Myocardial ECV was correlated with the CRP concentration (R=0.78, pankylosing spondylitis, CMR with cine imaging and LGE identified global LV dysfunction and focal areas of hyperenhancement. Myocardial ECV, quantified by CMR T1 mapping, was associated with the degree of disease activity. These results may suggest the presence of cardiac involvement in ankylosing spondylitis and may show the potential of ECV as a marker for disease monitoring. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Reproducibility of the Bath Ankylosing Spondylitis Indices of disease activity (BASDAI), functional status (BASFI) and overall well-being (BAS-G) in anti-tumour necrosis factor-treated spondyloarthropathy patients

    DEFF Research Database (Denmark)

    Madsen, Ole R; Rytter, Anne; Hansen, Lonnie B

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment...

  12. Discriminant validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis: a cohort study.

    Science.gov (United States)

    Kilic, Erkan; Kilic, Gamze; Akgul, Ozgur; Ozgocmen, Salih

    2015-06-01

    The aim of this study was to assess discriminant validity of Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) and to compare with The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) as clinical tools for the measurement of disease activity in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). Also, the cut-off values for ASDAS-CRP in nr-axSpA and AS is revisited. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and were assessed for disease activity, quality of life and functional measures. The discriminatory ability of ASDAS-CRP and ASDAS-ESR was assessed using standardized mean differences and receiver operating characteristic (ROC) curves analysis. Optimal cut-off values for disease activity scores were calculated. Two hundred and eighty-seven patients with axSpA (nr-axSpA:132, AS:155) were included in this study. Two ASDAS versions and BASDAI had good correlations with patient's and physician's global assessment in both groups. Discriminatory ability of ASDAS-CRP, ASDAS-ESR and BASDAI were similar in patients with nr-axSpA and AS when the patients were assigned into low and high disease activity according to the ASAS partial remission, patient's and physician's global assessment scores (based on the comparison of ROC curves). ASDAS cut-off values are quite similar between groups indicating that ASDAS-CRP works similarly well in nr-axSpA and AS. The performance of ASDAS to discriminate low and high disease activity and cut-off values are quite similar in patients with AS and non-radiographic axial SpA.

  13. Safety of Etoricoxib, Celecoxib, and Nonselective Nonsteroidal Antiinflammatory Drugs in Ankylosing Spondylitis and Other Spondyloarthritis Patients

    DEFF Research Database (Denmark)

    Kristensen, L E; Jakobsen, A K; Askling, J

    2015-01-01

    OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular, and cardio......OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular...... exposure was assessed time dependently based on the prescription drug register from 2006-2009, adjusting for sociodemographics and comorbidities derived from national population-based registers. RESULTS: Exposure to etoricoxib, celecoxib, and nonselective NSAIDs was 7.6%, 3.9%, and 71.2%, respectively...

  14. The painful heel. Comparative study in rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthrosis.

    Science.gov (United States)

    Gerster, J C; Vischer, T L; Bennani, A; Fallet, G H

    1977-01-01

    This study presents the frequency of severe and mild talalgias in unselected, consecutive patients with rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthosis. Achilles tendinitis and plantar fasciitis caused a severe talalgia and they were observed mainly in males with Reiter's syndrome or ankylosing spondylitis. On the other hand, sub-Achilles bursitis more frequently affected women with rheumatoid arthritis and rarely gave rise to severe talalgias. The simple calcaneal spur was associated with generalized osteoarthrosis and its frequency increased with age. This condition was not related to talalgias. Finally, clinical and radiological involvement of the subtalar and midtarsal joints were observed mainly in rheumatoid arthritis and occasionally caused apes valgoplanus. Images PMID:901031

  15. Danger of injudicious use of tui-na therapy in ankylosing spondylitis.

    Science.gov (United States)

    Zou, Gen; Wang, Guyi; Li, Jinxiu; Wu, Guobao; Huang, Jia; Huang, Siyang

    2017-05-01

    Tui-na is a very important component of Chinese medicine. It is a well-respected treatment modality known to be helpful and safe for a wide range of conditions. It can be considered as a certain kind of massage which is performed at acupoints, meridians, and collaterals by pushing, finger twisting, grasping thumb waving pressing, patting, palm twisting, and other manipulation techniques. At present, it is extensively used for relieving pain and stiffness associated with ankylosing spondylitis in China, even though there is a lack of evidence to support its validation and feasibility. The patient in this case was treated by tui-na massage at acute flare-up of ankylosing spondylitis and ended up with catastrophic results.

  16. Carbohydrate metabolism disorders in patients with rheumatoid arthritis and ankylosing spondylitis – impact of treatment

    Directory of Open Access Journals (Sweden)

    Piotr Dąbrowski

    2014-06-01

    Full Text Available Chronic inflammation – the crucial pathogenic mechanism of rheumatoid arthritis and ankylosing spondylitis – is the main cause of accelerated atherosclerosis, insulin resistance and well-known consequences related to it. The conservative treatment of rheumatoid arthritis and ankylosing spondylitis may provide a significant influence on glucose metabolism. The paper is a literature overview concerning insulin resistance and impaired glucose metabolism during treatment with disease-modifying drugs including biologic DMARDs (disease-modifying antirheumatic drugs, corticosteroids and commonly used non-steroidal anti-inflammatory drugs (NSAID. It has been found that the risk of carbohydrate disorders among those patients is much lower after therapy with hydroxychloroquine, methotrexate and TNF blockers – particularly with infliximab. The NSAID may play an important protective role in reducing risk of diabetes. The recent data show, contrary to general opinion, the advantageous outcome for glucose metabolism after treatment with corticosteroids, especially in the early active stage of rheumatoid arthritis.

  17. Anxiety and depression correlate with disease and quality-of-life parameters in Chinese patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Xu X

    2016-05-01

    Full Text Available Xujuan Xu,1,* Biyu Shen,2,3,* Aixian Zhang,4 Jingwei Liu,3 Zhanyun Da,4 Hong Liu,4 Zhifeng Gu4 1Department of Nursing, Affiliated Hospital of Nantong University, 2School of Nursing, Nantong University, 3Department of Nursing, The Second Affiliated Hospital of Nantong University, 4Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, People’s Republic of China *These authors contributed equally to this work Aim: To evaluate the relationship between mental and physical health in Chinese patients with ankylosing spondylitis (AS and to identify the predictors of psychological status.Methods: Patients with AS (n=103 and healthy controls (n=121 were surveyed between 2010 and 2011 (cross-sectional study. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, pain visual analog scale, Health Assessment Questionnaire, revised Self-Rating Anxiety Scale, revised Self-Rating Depression Scale, and Short-Form 36 questionnaire were administered.Results: The frequency of anxiety and depression in patients with AS was higher than that in healthy controls (P<0.001. Severe disease status and reduced quality of life (QoL were associated with anxiety and depression. Disease activity and somatic pain were more severe in the anxious and depressed subgroups. Impaired physical functioning (assessed by Bath Ankylosing Spondylitis Functional Index was higher in the anxious and depressed subgroups, while measures of spinal mobility (assessed by Bath Ankylosing Spondylitis Metrology Index were not associated with depression. Lower QoL was observed in the depressed subgroup.Conclusion: Low socioeconomic status, lack of health insurance, and fatigue contributed to depression in Chinese patients with AS. These patients may require a psychological care approach that is different from those of other countries. Keywords: ankylosing spondylitis, disease activity

  18. Tramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.

    Science.gov (United States)

    Chang, Jhi-Kai; Yu, Chen-Tung; Lee, Ming-Yung; Yeo, Kj; Chang, I-Chang; Tsou, Hsi-Kai; Wei, James Cheng-Chung

    2013-03-01

    This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. Active disease was defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for more than 3 at randomization. Subjects were randomized equally into two groups: the treatment group received aceclofenac plus Ultracet® one tablet twice a day, and the control group received aceclofenac plus placebo for 12 weeks. The primary endpoint was a difference of Assessment in Ankylosing Spondylitis (ASAS20) response criteria between two groups at week 12. At week 12, ASAS20 was achieved by 53.3 % of the aceclofenac plus Ultracet group and 31 % of the aceclofenac alone group (p = 0.047). For the pain visual analogue scale at week 12, there was a reduction of 45.6 % in aceclofenac plus Ultracet group and 25.7 % in the aceclofenac alone group (p = 0.087). There was no statistically significant difference between two groups in BASDAI, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Global Index, Physician Global Assessment, spinal mobility, ESR, hs-CRP, and Ankylosing Spondylitis Quality of Life Questionnaire. A slight increase in total adverse events was noted with dizziness (7.5 vs 1.5 %), vertigo (4.5 vs 1.5 %), and nausea/vomiting (6 vs 0 %) in the Ultracet arm compared to placebo. The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted.

  19. Exercise and ankylosing spondylitis with New York modified criteria: a systematic review of controlled trials with meta-analysis.

    Science.gov (United States)

    Martins, N A; Furtado, Guilherme Eustáquio; Campos, Maria João; Leitão, José Carlos; Filaire, Edith; Ferreira, José Pedro

    2014-01-01

    Ankylosing spondylitis is a systemic rheumatic disease that affects the axial skeleton, causing inflammatory back pain, structural and functional changes which decrease quality of life. Several treatments for ankylosing spondylitis have been proposed and among them the use of exercise. The present study aims to synthesize information from the literature and identify the results of controlled clinical trials on exercise in patients with ankylosing spondylitis with the New York modified diagnostic criteria and to assess whether exercise is more effective than physical activity to reduce functional impairment. The sources of studies used were: LILACS, Pubmed, EBSCOhost, B-on, personal communication, manual research and lists of references. The criteria used for the studies selection was controlled clinical trials, participants with New York modified diagnostic criteria for ankylosing spondylitis, and with interventions through exercise. The variables studied were related to primary outcomes such as BASFI (Bath Ankylosing Spondylitis Functional Index) as a functional index, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) as an index of intensity of disease activity and BASMI (Bath Ankylosing Spondylitis Metrology Index) as a metrological index assessing patient's limitation on movement. From the 603 studies identified after screening only 37 articles were selected for eligibility, from which 18 studies were included. The methodological quality was assessed to select those with an high methodological expressiveness using the PEDro scale. A cumulative meta-analysis was subsequently performed to compare exercise versus usual level of physical activity. Exercise shows significant statistical outcomes for the BASFI, BASDAI and BASMI, higher than those found for usual level of physical activity.

  20. The relationship between inflammation and new bone formation in patients with ankylosing spondylitis.

    Science.gov (United States)

    Baraliakos, Xenofon; Listing, Joachim; Rudwaleit, Martin; Sieper, Joachim; Braun, Juergen

    2008-01-01

    Spinal inflammation as detected by magnetic resonance imaging and new bone formation as identified by conventional radiographs are characteristic of ankylosing spondylitis. Whether and how spondylitis and syndesmophyte formation are linked are unclear. Our objective was to investigate whether and how spinal inflammation are associated with new bone formation in ankylosing spondylitis. Spinal magnetic resonance images and conventional radiographs from 39 ankylosing spondylitis patients treated with anti-tumour necrosis factor (anti-TNF) agents at baseline and after 2 years were analysed for syndesmophyte formation at vertebral edges with or without inflammatory lesions at baseline. Overall, 922 vertebral edges at the cervical and lumbar spine were analysed. At baseline, the proportion of vertebral edges with and without inflammation (magnetic resonance imaging) that showed structural changes (conventional radiographs) was similar (in total, 16.6% of all vertebral edges in 71.4% of patients). From the perspective of syndesmophyte formation (n = 26, 2.9%) after 2 years, there were more vertebral edges without (62%) than with (38%) inflammation at baseline (P = 0.03). From the perspective of spinal inflammation at baseline (n = 153 vertebral edges), more syndesmophytes developed at vertebral edges with (6.5%) than without (2.1%) inflammation (P = 0.002, odds ratio 3.3, 95% confidence interval 1.5 to 7.4). Inflammation persisted in 31% of the initially inflamed vertebral edges (n = 132), and new lesions developed in 8% of the vertebral edges without inflammation at baseline (n = 410). From the perspective of spinal inflammation after 2 years (n = 72 vertebral edges), 5.6% of the vertebral edges showed syndesmophyte development in contrast to 1.9% of the vertebral edges with new syndesmophytes without inflammation (P = 0.06). These findings obtained in patients treated with anti-TNF agents suggest linkage and some dissociation of inflammation and new bone formation in

  1. Cerebral magnetic resonance imaging in a patient with ankylosing spondylitis and multiple sclerosis-like syndrome

    International Nuclear Information System (INIS)

    Cellerini, M.; Gabbrielli, S.; Bongi, S.M.

    2001-01-01

    Clinical and cerebral magnetic resonance imaging (MRI) findings in a patient with ankylosing spondylitis (AS) and multiple sclerosis-like (MS-like) syndrome are reported. Cerebral MRI demonstrated multiple, MS-like, scattered foci of signal abnormality, one of which showed contrast enhancement. Lesion dissemination in ''space and time'' is a hallmark for diagnosis of MS, and its demonstration by enhanced cerebral MRI prompted suspicion of coexistence of MS and AS in our patient. (orig.)

  2. Prospects for the use of celecoxib in patients with ankylosing spondylitis: impact on retarding disease progression

    Directory of Open Access Journals (Sweden)

    Yulia Leonidovna Korsakova

    2012-01-01

    Full Text Available Ankylosing spondylitis (AS is one of the major inflammatory diseases that affect the vertebral column and joints. The first-line drugs for the treatment of this disease are now nonsteroidal anti-inflammatory drugs (NSAIDs that not only reduce painful sensations and rigidity, but also retard the radiological progression of AS. Celecoxib is one of the effective and safe NDAIDs that are promising for the treatment of AS.

  3. Ankylosing Spondylitis patients with Type D personality have worse clinical status.

    Science.gov (United States)

    Erkol İnal, Esra; Demirci, Kadir; Doğru, Atalay; Şahin, Mehmet

    2016-01-01

    Type D personality was identified as an important factor that can explain the differences in clinical outcomes in various diseases. The aim of this study is to clarify the relationships between Type D personality and clinical status of patients with Ankylosing Spondylitis (AS). The scores of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), the Bath Ankylosing Spondylitis Functional Index (BASFI), the 36-Item Short-Form Health Survey (SF-36), and 14-item Type D Scale (DS-14) were noted. We found significantly higher levels of the BASDAI, the BASFI, and the SF-36 mental subscale scores in patients with Type D personalities compared to those who were Non-Type D (p < 0.05). The total DS-14 scores were found to be correlated with the scores of physical and mental subscales of SF-36, the BASDAI, the BASFI, ASDAS-CRP, and ESR (p < 0.05). In logistic regression analysis, the occurrence of Type D personality was found to be an independent predictor for disease activity of AS due to BASDAI and ASDAS-ESR (p = 0.016, OR, 95% CI = 2.98,1.23-7.22; p = 0.022, OR, 95% CI = 2.78,1.16-6.63 respectively). Patients may over-rate self-reported measurements such as the BASDAI, BASFI, and SF-36 related to their interpersonal characteristics. Therefore, including the Type D personality, which is a stable construct in evaluating AS patients with brief and valid DS-14, may be noteworthy.

  4. Assessment of serum asymmetric dimethylarginine levels and left ventricular diastolic function in patients with ankylosing spondylitis.

    Science.gov (United States)

    Inci, Umit; Yildiz, Abdulkadir; Batmaz, Ibrahim; Tekbas, Ebru

    2017-02-01

    To assess left ventricular diastolic functions and serum dimethylarginine (ADMA) concentrations, as well as the effect of different treatment strategies on ADMA concentrations and diastolic function parameters, in patients with ankylosing spondylitis (AS). Sixty AS patients and 40 control subjects without classical cardiovascular (CV) risk factors were included in the study. Baseline clinical and echocardiographic variables were obtained. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ADMA levels were measured. Spinal mobility, disease activity and functional status were assessed using Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index. CRP, ESR and ADMA levels were significantly higher in the AS group as compared to the control group. Two (5%) control subjects and six (10%) AS patients met the criteria for left ventricular diastolic dysfunction (DD) on conventional Doppler echocardiography, but the difference was not statistically significant (P = 0.36). However, using tissue Doppler imaging, 12 (20%) patients in the AS group and three (8%) subjects in the control group were diagnosed with left ventricular DD (P = 0.08). The anti-tumor necrosis factor (TNF)-α group, conventional therapy group and control group were compared in terms of ADMA, CRP, ESR levels and echocardiographic parameters. ADMA levels were significantly lower in anti-TNF-α group as compared to the conventional therapy group (P < 0.001). In the control group, ADMA levels were significantly lower than both treatment groups (P < 0.001). Increased ADMA levels reveal impaired nitric oxide metabolism in a relatively young group of patients with AS, who have no classical CV risk factors. Anti-TNF-α may have beneficial effect on endothelial function in AS patients by reducing ADMA levels. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  5. Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation?

    Science.gov (United States)

    Klingberg, Eva; Sveälv, Bente Grüner; Täng, Margareta Scharin; Bech-Hanssen, Odd; Forsblad-d'Elia, Helena; Bergfeldt, Lennart

    2015-11-01

    The aim of this study was to assess the prevalence of aortic regurgitation and any relation to disease activity and specific human leukocyte antigen (HLA)-B27 subtypes in patients with ankylosing spondylitis. Transthoracic echocardiography was performed in 187 patients (105 men), mean age (SD) 50 (13) years, and mean disease duration 24 (13) years, and was related to demographic, clinical, radiographic, electrocardiographic, and laboratory data. Aortic regurgitation was found in 34 patients (18%; 95% confidence interval [CI], 12%-24%): mild in 24, moderate in 9, and severe in one. The prevalence was significantly higher than expected from population data. Conduction system abnormalities were documented in 25 patients (13%; 95% CI, 8%-18%), and significantly more likely in the presence of aortic regurgitation (P = .005), which was related to increasing age and longstanding disease, and increased from ~20% in the 50s to 55% in the 70s. It was also independently associated with disease duration, with higher modified Stoke Ankylosing Spondylitis Spine Score, and with a history of anterior uveitis. HLA-B27 was present in similar proportions in the presence vs absence of aortic regurgitation. For comparison, clinically significant coronary artery disease was present in 9 patients (5%; 95% CI, 2%-8%). Patients with ankylosing spondylitis frequently have cardiac abnormalities, but they more often consist of disease-related aortic regurgitation or conduction system abnormalities than manifestations of atherosclerotic heart disease. Because aortic regurgitation or conduction abnormalities might cause insidious symptoms not easily interpreted as of cardiac origin, we suggest that both electrocardiography and echocardiography evaluation should be part of the routine management of patients with ankylosing spondylitis. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Functional limitation and associated factors in outpatients with ankylosing spondylitis in Southwest China.

    Science.gov (United States)

    Song, Yuqing; Wang, Chen; Chen, Hong

    2017-04-01

    Functional limitation is often complained by patients with ankylosing spondylitis (AS). With a rising number of patients suffering from AS, there are a limited number of reports focusing on functional limitation of AS in Chinese patients. This study was conducted to investigate the level of functional limitation and explore its associations with demographic, disease-related factors. A total of 303 AS outpatients were recruited in this cross-sectional study from a tertiary general hospital in Southwest China. Functional limitation was measured by the Bath Ankylosing Spondylitis Functional Index (BASFI). Other data were collected by the following questionnaires: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Finally, 295 outpatients with AS completed this survey. The median BASFI was 0.80. Worse function limitation was found in outpatients with extra-spinal manifestation, older age, lower household income, more back pain, higher disease activity and morning stiffness, poorer sleep, and worse patient's well-being (all P < 0.05). Multivariate regression analysis indicated that patient's well-being (P < 0.001), disease activity (P < 0.001), and disease duration (P < 0.05) were the positive predictors of functional limitation. AS outpatients in Southwest China had a mild level of functional limitation. The factors associated with functional limitation included disease duration, disease activity, and patients' well-being, which should be taken into consideration when assessing functional limitation of AS outpatients. Besides, more comprehensive and targeted interventions should be conducted for AS patients as early as possible, which will be effective to improve functional outcome.

  7. Absence of radiographic progression of hip arthritis during infliximab treatment for ankylosing spondylitis.

    Science.gov (United States)

    Konsta, M; Sfikakis, P P; Bournia, V K; Karras, D; Iliopoulos, A

    2013-08-01

    This study aims to examine the impact of long-term treatment with the anti-TNF antibody infliximab on radiographic progression of hip arthritis in ankylosing spondylitis. Anteroposterior X-rays of the pelvis obtained at baseline from consecutive patients with ankylosing spondylitis and bilateral hip arthritis were compared with X-rays obtained after 6 ± 2.5 years (mean ± SD) of continuous infliximab treatment. Analysis was performed by the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-h) scoring system (min 0, max 4). Hip joint space width was also assessed by the average of measurements at three distinct sites between the acetabulum and femoral head. In 23 patients with active disease (21 men, mean age and disease duration of 45 and 16 years, respectively), the BASRI-h score at baseline was 1 in 7, 2 in 16, 3 in 16, and 4 in 7 hips (including two arthroplasties). Individual BASRI-h scores at baseline (2.50 ± 0.86, mean ± SD) remained unchanged in all patients at end of follow-up. At baseline, the average width of the whole joint space (3.56 ± 0.70 mm, n = 44) was not associated with disease activity measurements but negatively correlated with BAS functional index (Spearman r = -0.5, P = 0.007). After 2-10 years of infliximab treatment, the average width of the whole joint space in these patients (3.59 ± 0.79 mm) was not reduced. These results suggest that radiographic progression of hip arthritis in ankylosing spondylitis may be arrested during infliximab treatment.

  8. Whole Genome Expression Profiling and Signal Pathway Screening of MSCs in Ankylosing Spondylitis

    OpenAIRE

    Li, Yuxi; Wang, Peng; Xie, Zhongyu; Huang, Lin; Yang, Rui; Gao, Liangbin; Tang, Yong; Zhang, Xin; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

    2014-01-01

    The pathogenesis of dysfunctional immunoregulation of mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) is thought to be a complex process that involves multiple genetic alterations. In this study, MSCs derived from both healthy donors and AS patients were cultured in normal media or media mimicking an inflammatory environment. Whole genome expression profiling analysis of 33,351 genes was performed and differentially expressed genes related to AS were analyzed by GO term analysis ...

  9. Predicting pathway cross-talks in ankylosing spondylitis through investigating the interactions among pathways

    OpenAIRE

    Gu, Xiang; Liu, Cong-Jian; Wei, Jian-Jie

    2017-01-01

    Given that the pathogenesis of ankylosing spondylitis (AS) remains unclear, the aim of this study was to detect the potentially functional pathway cross-talk in AS to further reveal the pathogenesis of this disease. Using microarray profile of AS and biological pathways as study objects, Monte Carlo cross-validation method was used to identify the significant pathway cross-talks. In the process of Monte Carlo cross-validation, all steps were iterated 50 times. For each run, detection of diffe...

  10. Immunogenetic Study in Chinese Population with Ankylosing Spondylitis: Are There Specific Genes Recently Disclosed?

    OpenAIRE

    Zhai, Jiayu; Rong, Ju; Li, Qiuxia; Gu, Jieruo

    2013-01-01

    Purpose. Ankylosing spondylitis (AS) is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. Recent Findings. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing ...

  11. A Sub-Pathway Based Method to Identify Candidate Agents for Ankylosing Spondylitis

    OpenAIRE

    Chen, Kai; Zhao, Yingchuan; Chen, Yu; Wang, Chuanfeng; Chen, Ziqiang; Bai, Yushu; Zhu, Xiaodong; Li, Ming

    2012-01-01

    The need for new therapeutics for Ankylosing Spondylitis (AS) is highlighted by the general lack of efficacy for most agents currently available for this disease. Many recent studies have detailed molecular pathways in AS, and several molecule-targeting agents are undergoing evaluation. We aimed to explore the mechanism of AS and identify biologically active small molecules capable of targeting the sub-pathways which were disregulated in the development of AS. By using the GSE25101 microarray...

  12. Coexistence of RS3PE Syndrome and Ankylosing Spondylitis in a Young Male

    Directory of Open Access Journals (Sweden)

    Erdem İlgün

    2016-12-01

    Full Text Available The RS3PE syndrome is the inflammatory rheumatisms of old age, being related to rheumatoid arthritis. Etiology and pathogenesis of this disease is not fully understood and usually seen over 50 years of age and characterized by recurrent symmetrical pitting type edema. We present a case whose clinical symptoms and laboratory findings are compatible with the RS3PE in young male with ankylosing spondylitis. J Clin Exp Invest 2016; 7(4: 290-293

  13. Andersson lesions of whole spine magnetic resonance imaging compared with plain radiography in ankylosing spondylitis.

    Science.gov (United States)

    Kim, Seong-Kyu; Shin, Kichul; Song, Yoonah; Lee, Seunghun; Kim, Tae-Hwan

    2016-12-01

    The objective of this study was to identify the characteristics of Andersson lesions using whole spine magnetic resonance imaging (MRI) compared with plain radiography in ankylosing spondylitis (AS). A total of 62 patients with AS who had undergone whole spine MRI and plain radiography were retrospectively enrolled in this study. We compared the number of discovertebral units (DVUs) with Andersson lesions with clinical and radiographic indices such as erythrocyte sediment rate (ESR), C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Fifty-three patients (85.5 %) by whole spine MRI and 23 patients (37.1 %) by plain radiography had at least one Andersson lesion. We found 129 DVUs with Andersson lesions (11.1 %) by MRI and 35 DVUs by plain radiography over all the spine levels. Andersson lesions by MRI were most commonly detected at the lower thoracic spine (from T7-8 to T12-L1). Among the 151 total Andersson lesions by whole spine MRI, 41 were identified as central disc type, 26 as anterior peripheral disc type, 44 as posterior peripheral disc type, and 40 as diffuse disc type. However, the number of Andersson lesions did not correlate with ESR, CRP, BASDAI, BASFI, or mSASSS (p > 0.05 for all). Our study indicates that the presence of Andersson lesions in patients with AS is clearly underestimated. MRI is a superior technique for detecting early Andersson lesions compared with plain radiography.

  14. Expansion of the lumbosacral spinal canal in neurofibromatosis and ankylosing spondylitis

    International Nuclear Information System (INIS)

    Peeters, F.L.M.; Verbeeten, B. Jr.

    1987-01-01

    Bony erosions of the lumbosacral spinal canal can be caused by tumors, meningoceles, meningeal or arachnoidal cysts and perineural cysts. The bony abnormalities may be visible on plain roentgenograms of the spine and on computed tomograms. Computerized tomography, particularly in conjunction with iohexol myelography, provides the most definitive anatomical study. Meningeal cysts are common in neurofibromatosis and are an uncommon accompaniment of ankylosing spondylitis. Both conditions can be differentiated by computerized tomography. 10 refs.; 4 figs

  15. MUSCLE RELAXANTS: ARE THEY NEEDED IN ANKYLOSING SPONDYLITIS?

    Directory of Open Access Journals (Sweden)

    T. V. Dubinina

    2016-01-01

    Full Text Available Guidelines for the treatment of ankylosing spondylitis (AS lack muscle relaxants. At the same time, the latter are used for combined therapy using nonsteroidal  anti-inflammatory drugs (NSAIDs  in 53.1% of patients in an outpatient  setting. No clear recommendations make the administration of these agents uncontrolled, on the one hand, and substantially restrict therapeutic  possibilities, on the other.Objective: to investigate the short-term effect and safety of using tolperisone hydrochloride  (THC,  Mydocalm®  in patients with AS during group therapeutic  exercise (TE.Subjects and methods. The investigation included 40 patients aged over 18 years with a valid diagnosis of AS who had been treated at the Clinic of the V.A. Nasonova Research Institute of Rheumatology and agreed to participate  in the study. All the patients were randomized  in a 1:1 ratio into two groups: 1 20 patients used NSAIDs in combination with TE; 2 20 patients received NSAIDs,  TE, and THC 450 mg/day. The groups were matched for age, gender, disease duration,  and functional impairments. Before and after completion  of the investigation, the investigators estimated BASDAI, BASFI, patient-rated numerical pain rating scale (NPRS, patient-rated TE performance  scores (NPRS, where 0 (very effective, 10 (ineffective, THC tolerance monitoring  (consideration of adverse events. Spinal motility was evaluated using BASMI and chest excursion measurement.Results and discussion. During TE, both groups showed a significant increase in the volume of movements (p < 0.03, when measuring chest excursion and carrying out modified Schober's test, a decrease in BASDAI (p < 0.01 and BASFI (p < 0.009, as well as a reduction  in patient-rated overall disease activity assessment (p < 0.02 as compared to the baseline values. At the same time the modified Schober test revealed that the increase in motility was significantly higher in Group 2 than in Group 1 (p < 0.05. During the

  16. Progression rate of ankylosing spondylitis in patients with undifferentiated spondyloarthritis

    Science.gov (United States)

    Xia, Qing; Fan, Dazhi; Yang, Xiao; Li, Xiaona; Zhang, Xu; Wang, Mengmeng; Xu, Shengqian; Pan, Faming

    2017-01-01

    Abstract Background: The idea that undifferentiated spondyloarthritis (uSpA) represents the early undifferentiated stage of ankylosing spondylitis (AS) and other well-defined SpA subtypes is well known. The gist of this study is to assess the rate estimate of patients with uSpA evolved to AS during long-term follow-up. Methods: A systematic search was implemented to identify pertinent articles. The primary outcome was the rate estimate that patients with uSpA fulfilling the diagnosis of AS according to the modified New York criteria during follow-up. The rate estimate and corresponding 95% confidence interval (95%CI) were pooled by the random-effects model in STATA 11.0 software. Meta-regression analyses were adopted to explore the sources of heterogeneity. The quality assessment was conducted by the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Begg test and the Egger test were applied to assess publication bias. Results: Sixteen papers were finally included in this study after screening 1299 citations. The pooled rate of patients with uSpA progression to AS synthesized from the 16 papers was 0.323 (95%CI 0.257–0.389). Subgroup analysis based on the length of follow-up showed that the rate at the time-point of 5, 8, and 10 years follow-up was 0.220 (95%CI 0.110–0.330), 0.291 (95%CI 0.257–0.325), and 0.399 (95%CI 0.190–0.608), respectively; while the rate in Asia, Europe, and Latin America was 0.367 (95%CI 0.282–0.452), 0.228 (95%CI 0.066–0.390), and 0.269 (95%CI 0.209–0.329), respectively. Meta-regression analysis indicated that the length of follow-up alone accounts for 45.23% of the total heterogeneity. Nearly half of the papers scored fair quality and none publication bias was identified based on the Begg test and the Egger test. Further, line chart describes an obviously increased trend for the patients with uSpA fulfilling the diagnosis of AS over time. Conclusion: The

  17. Use of static lung mechanics to identify early pulmonary involvement in patients with ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Aggarwal A

    2001-04-01

    Full Text Available AIM: To assess if a detailed analysis of lung mechanics could help in early recognition of pulmonary abnormalities in patients with ankylosing spondylitis. METHODS: Static pulmonary mechanics were studied in 17 patients (16 men and one woman of ankylosing spondylitis with no obvious clinical or radiological evidence of pulmonary involvement. Lung pressure-volume relationship was generated using a whole body plethysmograph, and a monoexponential equation fitted to this data. RESULTS: Total lung capacity (TLC was reduced in one (5.9% and static lung compliance (Cst in nine (52.9% patients. Four (23.5% patients had normal TLC, yet Cst and shape constant (K were reduced. Five (29.4% patients had reduced TLC and Cst; four of them had low K. One (5.9% patient had normal TLC but elevated Cst and K. CONCLUSIONS: Pulmonary involvement in patients with ankylosing spondylitis is probably diffuse and begins much earlier than generally presumed. Evaluation of static lung mechanics can identify pulmonary involvement early in the course of disease in several of these patients.

  18. [Effects of balneotherapy on the reactants of acute inflammation phase in ankylosing spondylitis].

    Science.gov (United States)

    2009-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects sacroiliac joints, spinal column and peripheral joints. Beside medication therapy, physical and balneotherapy play an important role in its complex treatment. The aim of the research was to establish serum concentrations of C-reactive protein (CRP), alpha 1-acid glycoprotein (alpha 1-AGP), ceruloplasmine (CP) and erythrocyte sedimentation rate (SE) before and after the balneotherapy in ankylosing spondylitis. The research included 50 AS patients according to the revised New York criteria, of mean age 43 years, who were treated for 14 days on the average at the Clinic for Rheumatology of the Institute "Niska Banja". All the patients received medications and balneotherapy (radioactive oligomineral baths, peloid, massage, kinesitherapy); the serum concentrations of CRP, al-AGP, CP and SE were measured before and after balneotherapy. Serum proteins were determined using original Nor Partigen plates Boehringer. Erythrocyte sedimentation rate was measured by Westergreen method. Balneotherapy was applied individually, intensively or mildly, depending on the AS stage and activity phase. After dosed balneotherapy, a significant decrease in the concentrations of CP (p acute phase reactants is important in the evaluation of dosed balneotherapy efficiency in the treatment of ankylosing spondylitis.

  19. Relationship of environmental exposures and ankylosing spondylitis and spinal mobility: US NHAENS, 2009-2010.

    Science.gov (United States)

    Shiue, Ivy

    2015-01-01

    It was aimed to study the relationships of different sets of urinary environmental chemical concentrations and ankylosing spondylitis in a national and population-based setting. Data were extracted from United States National Health and Nutrition Examination Surveys, 2009-2010. Information on demographics was obtained by household interview and ankylosing spondylitis clinical measures and urines were taken at examination. People with abnormal occiput-to-wall distance were found to have higher urinary cadmium (OR 2.17, 95 % CI 1.34-3.52, p = 0.004), antimony (OR 1.74, 95 % CI 1.15-2.62, p = 0.012), tungsten (OR 1.91, 95 % CI 1.39-2.64, p = 0.001), uranium (OR 1.49, 95 % CI 1.03-2.15, p = 0.036), and trimethylarsine oxide (OR 5.01, 95 % CI 2.34-10.71, p ankylosing spondylitis clinical measures, compared to those who resided in households that were built in 1990 or after. The odds were 1.74 for households built in 1978-1989 and 1.81 for those built in 1940 or earlier.

  20. Efficacy of golimumab on recurrent uveitis in HLA-B27-positive ankylosing spondylitis.

    Science.gov (United States)

    Yazgan, Serpil; Celik, Ugur; Işık, Metin; Yeşil, Nesibe Karahan; Baki, Ali Erdem; Şahin, Hatice; Gencer, Ercan; Doğan, İsmail

    2017-02-01

    To evaluate the efficacy of golimumab on severe and frequent recurrent anterior uveitis in patients with HLA-B27-positive ankylosing spondylitis. In this study, 15 eyes of 12 HLA-B27-positive AS patients with resistant anterior uveitis who received 50 mg of subcutaneous golimumab (Gol) per month due to frequent uveitis recurrences were analyzed retrospectively between May 2013 and October 2015. Assessment criteria were uveitis activity, the number of recurrence of uveitis, visual acuity, systemic corticosteroid, or other drug requirement for maintenance of remission of AU. Twelve patients (15 eyes) with HLA-B27-positive ankylosing spondylitis and anterior uveitis have been treated with golimumab 50 mg/month. Remission of uveitis was observed in 12 eyes out of 15. Malign hypertension developed in one subject after the second dose of golimumab therefore the treatment was stopped and this subject was excluded from the study. Median follow-up time was 11 months (interquartile range: 8-18). No uveitic reaction was seen except in the patient who stopped treatment. No topical or systemic steroid necessity was needed except in two cases with oral 4 mg systemic maintenance. Visual acuity was significantly increased (p = 0.002). Golimumab may be a new and effective choice for maintaining remission and the prevention of recurrences of severe, resistant anterior uveitis in patients with HLA-B27-positive ankylosing spondylitis.

  1. Celecoxib versus diclofenac for the treatment of ankylosing spondylitis: 12-week randomized study in Norwegian patients.

    Science.gov (United States)

    Walker, Chris; Essex, Margaret N; Li, Chunming; Park, Peter W

    2016-06-01

    To compare the efficacy and safety of two different doses of celecoxib and diclofenac in the treatment of Norwegian patients with ankylosing spondylitis. In this 12-week, double-blind, non-inferiority trial patients were randomized to 200 mg once daily (qd) celecoxib, 400 mg qd celecoxib, or 50 mg three times daily (tid) diclofenac. The primary objective compared patients' assessments of Global Pain Intensity, measured on a visual analogue scale. A total of 330 patients were randomized (200 mg celecoxib, n = 107; 400 mg celecoxib, n = 108; diclofenac, n = 115). Least squares mean changes in Global Pain Intensity at 12 weeks were -25.8 mm, -30.6 mm and -28.2 mm, respectively. Both celecoxib treatment groups were non-inferior to diclofenac. More patients in the 400 mg celecoxib group met the Assessments in Ankylosing Spondylitis 20 responder criteria at Week 12 (60.2%) than in the celecoxib 200 mg (51.4%) and the diclofenac 50 mg (57.4%) groups. Adverse events were mild-to-moderate in severity, with dyspepsia and diarrhoea the most commonly reported. Celecoxib and diclofenac both provided pain reduction, in addition to improvements in disease activity and functional capacity, in patients with ankylosing spondylitis. © The Author(s) 2016.

  2. The role of land and aquatic exercise in ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Zão, Ana; Cantista, Pedro

    2017-12-01

    Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era. Systematic review of the literature published until November 2016 in Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Thirty-five studies were included for further analysis (30 concerning land exercise and 5 concerning water exercise; combined or not with biological drugs), comprising a total of 2515 patients. Most studies showed a positive effect of exercise on Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, pain, mobility, function and quality of life. The benefit was statistically significant in randomized controlled trials. Results support a multimodal approach, including educational sessions and maintaining home-based program. This study highlights the important role of exercise in management of AS, therefore it should be encouraged and individually prescribed. More studies with good methodological quality are needed to strengthen the results and to define the specific characteristics of exercise programs that determine better results.

  3. Influence of methotrexate on infliximab pharmacokinetics and pharmacodynamics in ankylosing spondylitis

    Science.gov (United States)

    Ternant, David; Mulleman, Denis; Lauféron, Francine; Vignault, Céline; Ducourau, Emilie; Wendling, Daniel; Goupille, Philippe; Paintaud, Gilles

    2012-01-01

    AIMS Infliximab, an anti-tumour necrosis factor α monoclonal antibody, has profoundly modified the treatment of several inflammatory diseases. The objective was to assess the influence of methotrexate on the variability of infliximab pharmacokinetics and concentration–effect relationship in axial ankylosing spondylitis (AAS) patients. METHODS Twenty-six patients with AAS were included in a prospective study. They were treated by infliximab 5 mg kg−1 infusions at weeks 0, 2, 6, 12 and 18. Infliximab concentrations were measured before, and 2 and 4 h after each infusion, and at each intermediate visit (weeks 1, 3, 4, 5, 8, 10 and 14). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was measured at each visit. Infliximab pharmacokinetics was described using a two-compartment model with first-order distribution and elimination constants. A population approach was used. Infliximab pharmacodynamics was described using the area under the BASDAI curve. RESULTS A total of 507 blood samples and 329 BASDAI measurements were collected. The following pharmacokinetic parameters were obtained (interindividual coefficient of variation): volumes of distribution for the central compartment = 2.4 l (9.6%) and peripheral compartment = 1.8 l (26%), systemic clearance = 0.23 l day−1 (22%) and intercompartment clearance = 2.3 l day−1. Methotrexate influenced neither pharmacokinetic nor BASDAI variability. CONCLUSIONS Using the present dosage, the clinical efficacy of infliximab is only weakly influenced by its serum concentrations. The results do not support the combination of methotrexate with infliximab in ankylosing spondylitis. PMID:21692827

  4. Proposal of a linear definition of the Bath Ankylosing Spondylitis Metrology Index (BASMI) and comparison with the 2-step and 10-step definitions

    NARCIS (Netherlands)

    van der Heijde, D.; Landewé, R.; Feldtkeller, E.

    2008-01-01

    The Bath Ankylosing Spondylitis Metrology Index (BASMI) characterises the spinal mobility of patients with ankylosing spondylitis. Two versions have been published using categorical scores with either scores 0-2 for each of the five assessments, or scores 0-10. For metric purposes, we recently

  5. Evaluating the reliability of Persian version of ankylosing spondylitis quality of life (ASQoL) questionnaire and related clinical and demographic parameters in patients with ankylosing spondylitis.

    Science.gov (United States)

    Fallahi, Sasan; Jamshidi, Ahmad Reza; Bidad, Katayoon; Qorbani, Mostafa; Mahmoudi, Mahdi

    2014-06-01

    Ankylosing spondylitis quality of life (ASQoL) is an instrument for assessing quality of life (QoL). The aims of this study were to assess the reliability of Persian version of ASQoL questionnaire and evaluation of QoL status and related factors in ankylosing spondylitis (AS). One hundred and sixty-three Iranian patients with AS who fulfilled modified New York criteria were enrolled. Patients were evaluated using questionnaires including demographic and clinical variables, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), fatigue, Bath AS Metrology Index, pain and ASQoL. Reliability and validity of Persian version of ASQoL were evaluated by test-re-test agreement, internal consistency and correlation with specific scales. Relationship of parameters with ASQoL was analyzed by multiple regression. Age, disease duration and ASQoL score (mean ± SD) were 37.74 ± 9.88, 14.49 ± 8.47 and 8.02 ± 5.28 years, respectively. Test-re-test reproducibility for ASQoL was good as assessed by intra-class correlation coefficient (ICC: 0.97, P educational level, r = -0.37). Persian version of ASQoL is a valid and reliable scale to assess QoL in AS. Function, fatigue, mood, hip mobility and education are the factors which should be noted to achieve the best QoL.

  6. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    Science.gov (United States)

    Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total) were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP) was GNG11 (combined RP = 299.64). The downregulated gene with the smallest combined RP was S100P (combined RP = 335.94). In the gene ontology (GO) analysis, the most significantly enriched GO term was “immune system process” (P = 3.46 × 10−26). The most significant pathway identified in the pathway analysis was antigen processing and presentation (P = 8.40 × 10−5). The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis. PMID:25688367

  7. Treatment efficacy of etanercept and MTX combination therapy for ankylosing spondylitis hip joint lesion in Chinese population.

    Science.gov (United States)

    Lian, Fan; Yang, Xiuyan; Liang, Liuqin; Xu, Hanshi; Zhan, Zhongping; Qiu, Qian; Ye, Yujin

    2012-06-01

    To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25 mg for the first six months, followed by 25 mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI > or = 4. Combined MTX was administered intravenously once a week at the dosage of 15 mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing.

  8. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    Directory of Open Access Journals (Sweden)

    Fang Fang

    2015-01-01

    Full Text Available The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data program, we performed the meta-analysis to identify consistently differentially expressed (DE genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP was GNG11 (combined RP=299.64. The downregulated gene with the smallest combined RP was S100P (combined RP=335.94. In the gene ontology (GO analysis, the most significantly enriched GO term was “immune system process” (P=3.46×10-26. The most significant pathway identified in the pathway analysis was antigen processing and presentation (P=8.40×10-5. The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis.

  9. Identification of potential transcriptomic markers in developing ankylosing spondylitis: a meta-analysis of gene expression profiles.

    Science.gov (United States)

    Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total) were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP) was GNG11 (combined RP=299.64). The downregulated gene with the smallest combined RP was S100P (combined RP=335.94). In the gene ontology (GO) analysis, the most significantly enriched GO term was "immune system process" (P=3.46×10(-26)). The most significant pathway identified in the pathway analysis was antigen processing and presentation (P=8.40×10(-5)). The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis.

  10. Biomarkers of bone metabolism in ankylosing spondylitis in relation to osteoproliferation and osteoporosis.

    Science.gov (United States)

    Klingberg, Eva; Nurkkala, Merja; Carlsten, Hans; Forsblad-d'Elia, Helena

    2014-07-01

    To identify biomarkers for bone metabolism in patients with ankylosing spondylitis (AS) and to determine the relationship between these biomarkers and disease activity, back mobility, osteoproliferation, and bone mineral density (BMD). Serum levels of Wingless protein (Wnt-3a), Dickkopf-1 (DKK-1), sclerostin, soluble receptor activator of nuclear factor-κB ligand (sRANKL), and osteoprotegerin were assessed using ELISA. Ankylosing Spondylitis Disease Activity Score-C reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis patient global score, and C-reactive protein (CRP) were used as disease activity measures, and Bath Ankylosing Spondylitis Metrology Index (BASMI) as a measure of spinal mobility. Lateral spine radiographs were scored for chronic AS-related changes (mSASSS). BMD was measured with dual-energy x-ray absorptiometry. Two hundred four patients with AS (NY criteria; 57% men), with a mean age of 50 ± 13 years and disease duration 15 ± 11 years, and 80 age and sex-matched controls were included. The patients with AS had significantly higher serum levels of Wnt-3a (p < 0.001) and lower levels of sclerostin (p = 0.014) and sRANKL (p = 0.047) compared with the controls. High CRP was associated with low sclerostin (r(S) = -0.21, p = 0.003) and DKK-1 (r(S) = -0.14, p = 0.045). In multiple linear regression analyses, increasing BASMI and mSASSS were independently associated with older age, male sex, high CRP, and elevated serum levels of Wnt-3a. In addition, mSASSS remained associated with a high number of smoking pack-years after adjusting for age. Low BMD of femoral neck was associated with high mSASSS after adjusting for age. Serum levels of Wnt-3a are elevated in AS and associated with increased BASMI and mSASSS, independent of age, indicating that Wnt-3a could be a biomarker for the osteoproliferative process.

  11. Validation of the Italian versions of the Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI in patients with ankylosing spondylitis

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    W. Grassi

    2011-09-01

    Full Text Available Objectives: The Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI are the most commonly used instruments to measure functioning in ankylosing spondylitis (AS. The aim of this study was to translate, adapt and validate these instruments into the Italian language. Methods: The BASFI and DFI questionnaires were translated into Italian by two independent bilingual physicians who were familiar with the medical aspects of AS and by one professional translator. Two rheumatologists familiar with instrument validation, and who were aware of the purpose of the study, examined semantic, idiomatic and conceptual issues and produced by consensus unified versions of each instrument. English back-translations from the Italian were done by a professional translator unaware of the original version. Both English versions were compared, and where needed, modifications to the Italian versions were made. Results: A total of 95 patients were included: 77 males, age (mean±SD 47.9±9.3years, and disease duration 12.4±6.6 years, and 18 females, age 45.9±8.7 years, and disease duration 11.3±8.2 years. Reliability, measured in 23 patients participating a physiotherapy program, showed an acceptable one-week test-retest intraclass correlation coefficient (ICC - BASFI ICC: 0.91, 95% CI: 0,87-0.94 and DFI ICC: 0.86, 95% CI: 0.83-0.90. The internal consistency was 0.90 (Cronbach’s alpha for the BASFI and 0.87 for the DFI. For validity the functional indices were correlated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Metrology Index (BASMI, Bath Ankylosing Spondylitis Patient Global Score (BAS-G, modified Health Assesment Questionnaire (HAQ-S, SF-36 physical component summary (SF-36 PCS, stiffness, pain, physician’s assessment of disease activity, Bath AS Radiology Index-total (BASRI-t, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP. The functional indices

  12. [Ankylosing spondylitis associated with Still's disease: should it be considered a pathophysiologic link or a simple association?

    Science.gov (United States)

    Aradoini, Nassira; Talbi, Sofia; Azzouzi, Hamida; Abourazzak, Fatima Zahra; Khibri, Hajar; Berrady, Rhizlane; Bono, Wafaa; Harzy, Taoufik

    2017-01-01

    Ankylosing spondylitis is a chronic inflammatory rheumatism; it is part of the group of spondyloarthrites. General signs such as fever and weight loss are of little importance. Adult Still's disease is a rare systemic condition, a diagnosis of exclusion commonly characterized by high hectic fever, rash, arthritis and various systemic manifestations. Few cases of ankylosing spondylitis associated with adult Still's disease have been described in the literature. We here report the case of a 31-year old patient followed up for ankylosing spondylitis presenting with fever which had lasted for a long time and clinico-biological signs compatible with adult Still's disease. A possible pathophysiologic link between the two diseases may be suggested, even if their simultaneous occurrence has been rarely reported in the literature.

  13. Stability of fatigue, pain, patient global assessment and the Bath Ankylosing Spondylitis Functional Index (BASFI) in spondyloarthropathy patients with stable disease according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek

    2018-01-01

    The study objective was to examine natural variation of the patient-reported outcome measures fatigue, pain, patient global assessment (PaGl) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with stable axial spondyloarthropathy (ax-SpA) defined on the basis of the Bath...... Spondylitis Ankylosing Disease Activity Index (BASDAI). 107 TNF-inhibitor treated stable ax-SpA patients were identified in the Danish rheumatology registry (DANBIO). According to the Assessment of SpondyloArthritis international Society (ASAS) response criteria, stable disease was defined as a change...

  14. Airway management in a patient of ankylosing spondylitis with traumatic cervical spine injury

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    Nilesh Kumar

    2015-01-01

    Full Text Available Traumatic cervical lesions compressing the spinal cord pose a significant risk of exacerbating the existing neurological condition during tracheal intubation and subsequent positioning. Preexisting ankylosing spondylitis with spinal column involvement renders the spinal column more rigid and introduces difficulty in airway management of the patient with traumatic cervical spinal cord. To improve ease and success, and reduce cervical spine movement, awake fibreoptic intubation (FOI is considered the gold standard technique for airway management in such cases. Attaining appropriate position for intubation was challenge in this case due to rigid curvature of the ankylosed spinal column. To prevent neurological injury to the spinal cord and preserve spinal cord function, minimizing movement during intubation and attaining appropriate position was of prime concern. Optimal sedation with self-positioning by the patient in a comfortable posture is quite imperative and assures both airway as well as neurological protection in such expected difficult situations. We report the use of dexmedetomidine for self-positioning and awake FOI in a patient with ankylosing spondylitis having traumatic cervical spine who was otherwise neither able to co-operative nor able to give appropriate position for FOI.

  15. Association between HLA-A, HLA-C and HLA-B Genes and Ankylosing Spondylitis in Macedonian Population

    OpenAIRE

    Kirijas, Meri; Mishevska-Perchinkova, Snezhana; Karadzova-Stojanoska, Anzelika; Efinska-Mladenovska, Olivija; Petlichkovski, Aleksandar; Trajkov, Dejan; Spiroski, Mirko

    2014-01-01

    Aim: The aim of this study was to determine the association of HLA-A, -C and -B genes with ankylosing spondylitis in patients from the Republic of Macedonia.Material and Methods: This study included 307 subjects (250 healthy individuals and 57 patients with ankylosing spondylitis who were diagnosed at the University Clinic of Rheumatology in Skopje). The HLA typing of class 1 (HLA-A, HLA-C and HLA-B) genes was performed using the method of Reverse Line Strip, after isolation of DNK from the b...

  16. Airtraq® optical laryngoscope for tracheal intubation in patients with severe ankylosing spondylitis: A report of two cases

    Directory of Open Access Journals (Sweden)

    Qazi Ehsan Ali

    2012-01-01

    Full Text Available Airway management in patients of ankylosing spondylitis remains a challenge for anaesthesiologists. Many new airway devices have been used for securing airway in these patients. The Airtraq® optical laryngoscope is one of the new rigid laryngoscopes with a proximal view finder that reflects an image transferred from the distal tip of the blade through a series of lenses, prisms and mirrors. We report two cases of ankylosing spondylitis who were scheduled for total hip replacement and subtotal thyroidectomy and were successfully intubated using the Airtraq® laryngoscope.

  17. Coexistence of multiple sclerosis and ankylosing spondylitis: Report of four cases from Russia and review of the literature.

    Science.gov (United States)

    Fominykh, Vera; Shevtsova, Tatyana; Arzumanian, Narine; Brylev, Lev

    2017-10-01

    Multiple sclerosis is a chronic demyelinating disorder of the central nervous system. There are many cases of multiple sclerosis - like syndrome and demyelinating disorders in systemic lupus erythematosus, Sjogren disease, Behcet disease and other autoimmune conditions. Coexistence of ankylosing spondylitis and multiple sclerosis usually is rare but in this article we report 4 Russian patients with concomitant multiple sclerosis and ankylosing spondylitis diseases. None of these patients received anti-tumor necrosis factor alpha therapy prior to diagnosis of multiple sclerosis. Pathogenesis, diagnostic and treatment challenges are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Effectiveness of ultrasound treatment applied with exercise therapy on patients with ankylosing spondylitis: a double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Şilte Karamanlioğlu, Duygu; Aktas, Ilknur; Ozkan, Feyza Unlu; Kaysin, Meryem; Girgin, Nuray

    2016-05-01

    The aim of our study was to evaluate effectiveness of ultrasound treatment applied with exercise therapy in patients with ankylosing spondylitis. Fifty-two patients, who were diagnosed according to modified New York criteria, were aged 25-60, and have spine pain, were randomly assigned to two groups. Ultrasound (US) and exercise therapy were applied to treatment group (27); placebo US treatment and exercise therapy were applied to control group (25). Patients were evaluated before treatment, at the end of treatment, and 4 weeks after the treatment. Daily and night pain, morning stiffness, patient global assessment (PGA), doctor global assessment (DGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR), and ASDAS C-reactive protein (CRP) were used as clinical parameters. In US group, all parameters showed significant improvements at 2 and 6 weeks, in comparison with the baseline. In placebo US group, significant improvement was obtained for all parameters (except tragus-to-wall distance and modified Schober test at 2 weeks and lumbar side flexion and modified Schober test at 6 weeks). Comparison of the groups showed significantly superior results of US group for parameters of BASMI (p treatment increases the effect of exercise in patients with ankylosing spondylitis.

  19. Evaluation of the effects of Global Postural Reeducation in patients with ankylosing spondylitis.

    Science.gov (United States)

    Silva, Eliane Maria; Andrade, Sandra C; Vilar, Maria J

    2012-07-01

    The objective of this study is to assess the effects of Global Postural Reeducation (GPR) in patients with ankylosing spondylitis and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated for more than 4 months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire-Spondyloarthropathies-HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index-BASDAI). Statistical analysis was used with a significance level of P < 0.05. There was a statistically significant improvement for all the parameters analyzed between pre-and post-treatment in both groups. In the intergroup comparison, the GPR group showed a significantly greater improvement in morning stiffness (P = 0.013), spine mobility parameters, except finger-floor distance (P = 0.118), in chest expansion (P = 0.028), and in the physical aspect component of the SF-36 (P = 0.001). The results of this study showed that individual treatment with GPR (overall stretching) seems to have better clinical outcomes than group treatment with conventional segmental self-stretching and breathing exercises for patients with ankylosing spondylitis.

  20. Development of a prognostic score for work disability in Romanian patients with ankylosing spondylitis.

    Science.gov (United States)

    Oancea, Corina; Mihai, Carina; Gherman, Despina; Milicescu, Mihaela; Ancuta, Ioan; Martin, Andrei; Bojinca, Mihai; Stoica, Victor; Ciuvica, Maria Magdalena

    2015-01-01

    To develop a prognostic score for predicting work disability (WD) in patients with ankylosing spondylitis (AS) as strong indicator for poor vocational rehabilitation. A cross-sectional study was performed in a group of 170 patients with AS, 120 work disabled and 50 still employed. The variables strongly associated with WD were quantified (scored 0-30) - abnormalities of: anterior-posterior radiograph of pelvis, lateral cervical spine radiograph and lung function tests, certain work factors (occupation, physical strain and microclimate), Bath Ankylosing Spondylitis Mobility Index and Bath Ankylosing Spondylitis Functional Index tests. The eight-item score identifies WD with sensitivity of 91.7% and specificity of 85.7%. The scaling properties were fulfilled: internal consistency - Chronbach's alpha 0.73; reliability - intraclass correlation coefficient 0.73; redundancy weak-moderate, with coefficients ranging from 0.032 to 0.797; the discriminative capacity by the significant variations of the score according to the statute (employed or work disabled) and the degree of WD. The score is a reliable method for assessing the WD risk in patients with AS. It allows a complex evaluation by performing minimal investigations and it is easy to perform. Work disability is an important outcome in AS, determined by numerous variables but highly dependent on the national characteristics of economy, social security and healthcare system. The prognostic score for work disability in AS not only contains medical but also socio-demographic and work-related factors and is expected to be a useful tool for specialists to guide the tertiary prevention-oriented rehabilitation measures. Our study suggests the prognostic score to be comprehensive, useful and a reliable method to assess the risk of work disability in AS.

  1. Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis.

    Science.gov (United States)

    Gökmen, Ferhat; Akbal, Ayla; Reşorlu, Hatice; Gökmen, Esra; Güven, Mustafa; Aras, Adem Bozkurt; Erbağ, Gökhan; Kömürcü, Erkam; Akbal, Erdem; Coşar, Murat

    2015-07-01

    In recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS). We enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index. In the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 ± 12.9 and 46.5 ± 11.2 years, respectively. Mean disease duration of AS patients was 6.9 ± 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 ± 1.23 and 1.73 ± 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor α therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 ± 0.62 and 2.41 ± 1.33, respectively, P = 0.02). NLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF-α therapy. © 2014 Wiley Periodicals, Inc.

  2. M2 polarization of monocytes in ankylosing spondylitis and relationship with inflammation and structural damage.

    Science.gov (United States)

    Zhao, Jinzhu; Yuan, Wei; Tao, Chunsheng; Sun, Peifeng; Yang, Zaixing; Xu, Weidong

    2017-12-01

    The aim of this study was to evaluate the polarization of peripheral blood monocytes in the patients with ankylosing spondylitis (AS) and to determine the correlations between monocyte polarization and inflammation and structural damage. A total of 120 AS patients, 50 rheumatoid arthritis (RA) patients and 100 healthy controls were enrolled in the study. M1 (CD68+CD192+) and M2 (CX3CR1+CD163+) monocytes were characterized by flow cytometry. Demographic, clinical, radiographic and laboratory data were collected and analyzed. A large increase in M2 (CX3CR1+CD163+) monocytes was observed in AS, and M2/M1 ratio was 7.18 ± 6.12, 2.54 ± 3.14 and 35.61 ± 20.04 in control, RA and AS, respectively. The M2/M1 ratio correlated with modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) (r = 0.565; p Ankylosing Spondylitis Disease Activity Index (BASDAI) (r = -0.201; p = 0.028). Anti-TNF-α therapy induced a significant reduction in the percentage of M1 monocyte, ESR, CRP and BASDAI in AS patients. The present results demonstrated that M2 type polarized monocytes are predominant in the peripheral blood in AS and the M2/M1 ratio is correlated with structural damage (mSASSS), inflammatory biomarkers (ESR and CRP) and BASDAI. © 2017 APMIS. Published by John Wiley & Sons Ltd.

  3. Association study of ankylosing spondylitis and polymorphisms in ERAP1 gene in Zhejiang Han Chinese population.

    Science.gov (United States)

    Liu, Yangbo; Li, Liangda; Shi, Shanfen; Chen, Xin; Gao, Jianqing; Zhu, Minyu; Yuan, Jiandong

    2016-02-01

    The susceptibility loci of ERAP1 polymorphisms have been found to be strongly associated with ankylosing spondylitis (AS). The researches in multiple ethnic cohorts suggested that the population attributable risk in ERAP1 polymorphisms is at a high significance level. This study was undertaken to estimate the prevalence and incidence of subsets of AS and investigate the specific variants of ERAP1 polymorphisms in AS susceptibility, in the Han ethnic Chinese population in Zhejiang Province. AS patients were selected, diagnosed, and confirmed by a qualified rheumatologist. The basal clinical and demographic characteristics were compared with all subjects. Genotypes for eight selected single nucleotide polymorphisms (SNPs) in ERAP1 gene (rs27038, rs27037, rs27434, rs27980, rs7711564, rs30187, rs10050860, and rs17482078) were determined by using the Sequenom MassARRAY iPLEX platform in Zhejiang Han Chinese population. Association analyses were performed on the whole genotyped data set in 707 unrelated ankylosing spondylitis cases and 837 ethnically matched controls. We observed the strongest association between AS and HLA-B27, which confers over 90 % of ankylosing spondylitis cases. Moreover, we found three loci of ERAP1 polymorphisms were at a high significance level (rs27037 P = 0.00451; rs27434 P = 0.00012; rs27980 P = 0.00682) with AS in Zhejiang population. We also confirmed polymorphism locus of ERAP1 previously reported association with AS (rs27434; P = 5.3 × 10(-12)). Our results indicated a difference in the mechanism of susceptibility loci in subsets of Zhejiang Han Chinese population and provided further evidence that rs27434 is the key polymorphism associated with AS in ERAP1 gene.

  4. Results of Corrective Osteotomy and Treatment Strategy for Ankylosing Spondylitis with Kyphotic Deformity.

    Science.gov (United States)

    Kim, Ki-Tack; Park, Dae-Hyun; Lee, Sang-Hun; Lee, Jung-Hee

    2015-09-01

    To report the radiological and clinical results after corrective osteotomy in ankylosing spondylitis patients. Furthermore, this study intended to classify the types of deformity and to suggest appropriate surgical treatment options. We retrospectively analyzed ankylosing spondylitis patients who underwent corrective osteotomy between 1996 and 2009. The radiographic assessments included the sagittal vertical axis (SVA), spinopelvic alignment parameters, correction angle, correction loss, type of deformity related to the location of the apex, and the craniocervical range of motion (CCROM). The clinical outcomes were assessed by the Oswestry Disability Index (ODI) scores. A total of 292 corrective osteotomies were performed in 248 patients with a mean follow-up of 40.1 months (range, 24 to 78 months). There were 183 cases of single pedicle subtraction osteotomy (PSO), 19 cases of multiple Smith-Petersen osteotomy (SPO), 17 cases of PSO + SPO, 14 cases of single SPO, six cases of posterior vertebral column resection (PVCR), five cases of PSO + partial pedicle subtraction osteotomy (PPSO), and four cases of PPSO. The mean correction angles were 31.9° ± 11.7° with PSO, 14.3° ± 8.4° with SPO, 38.3° ± 12.7° with PVCR, and 19.3° ± 7.1° with PPSO. The thoracolumbar type was the most common. The outcome analysis showed a significant improvement in the ODI score (p ankylosing spondylitis, resulting in satisfactory outcomes with acceptable complications. The CCROM and postoperative SVA were important factors in determining the outcome.

  5. Regulatory T cells in ankylosing spondylitis and the response after adalimumab treatment.

    Science.gov (United States)

    Liao, Hsien-Tzung; Lin, Yuh-Feng; Tsai, Chang-Youh; Chou, Chung-Tei

    2015-12-01

    The aim of this study was to investigate the role of regulatory T cells (Tregs) in ankylosing spondylitis (AS). We included 69 AS patients (15 of them received anti-tumor necrosis factor-apha agent-adalimumab) in the study and used a questionnaire to record the demographic data, disease activity index, functional index, human leukocyte antigen-B27, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Thirty healthy subjects were used as controls. The peripheral blood mononuclear cells (PMBCs) were stained with anti-CD4, anti-CD25 and anti-Forkhead/winged helix transcription factor P3 (anti-FoxP3) antibodies and flow-cytometry was used to determine cell populations. The percentages of Tregs in PMBCs were significantly higher in AS patients than in healthy controls. In AS patients who had poor disease functional index with higher levels of ESR and CRP were positively and significantly correlated with Tregs percentages in PMBCs. After adalimumab treatment in 15 patients, the percentages of Tregs, the ESR/CRP levels and the Bath Ankylosing Spondylitis Disease Activity Index/Bath Ankylosing Spondylitis Functional Index were significantly and gradually decreased over time. The high expression of FoxP3 and CD25 on CD4(+) T cells in PBMCs in AS patients was noted, and could be reversed by adalimumab therapy. These findings suggest that Tregs may play a role in modulating the inflammatory process in AS. Whether Tregs can be taken as a predictor for disease activity or treatment outcome is unclear and requires further study. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  6. [Efficacy and Safety Evaluation of Bushen Shuji Granule in Treating Ankylosing Spondylitis Patients: a Clinical Study].

    Science.gov (United States)

    Kong, Wei-ping; Tao, Qing-wen; Zhang, Ying-ze; Yang, Shu; Xu, Yuan; Zhu, Xiao-xia; Jin, Yue; Yang, Wen-xue; Yan, Xiao-ping

    2015-06-01

    To evaluate the short-term efficacy and safety of Bushen Shuji Granule (BSG) in treating ankylosing spondylitis (AS) patients. A prospective randomized controlled clinical trial was carried out in 62 active stage AS patients with Shen deficiency Du-channel cold syndrome (SDDCS), who were randomly assigned to the BSG group (treated with BSG) and the control group (treated with Celecoxib Capsule). Twelve weeks consisted of one therapeutic course. Therapeutic effects were evaluated by ASAS20 and ASAS40 (set by Assessments in Ankylosing Spondylitis working group) , BASDA150, Chinese medical (CM) syndrome efficacy evaluation standards. BASDAI, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), scores for spine pain, scores for pain at night, patient global assessment (PGA) , erythrocyte sedimentation rate (ESR) , and C reactive protein (CRP) were observed before and after treatment. After three-month treatment by BSG, ASAS20 standard rate was 63. 33% (19/30 cases) in the BSG group and 66.67% (20/30 cases) in the control group with no significant difference between the two groups (χ2 = 0.073, P > 0.05). The efficacy for CM syndromes was 70.00% (21/30 cases) in the BSG group, higher than that in the control group [40.00% (12/30 cases), χ2 = 5.455, P BSG group (P BSG group was lower than that of the control group. BSG based on Shen supplementing, Du-channel strengthening, blood activating, and channels dredging method had good short-term clinical efficacy and safety in treating AS.

  7. Efficacy of golimumab in treating uveitis in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    T. V. Dubinina

    2016-01-01

    Full Text Available The paper presents the results of recent studies of the efficacy of golimumab (GLM in the treatment of uveitis in patients with ankylosing spondylitis (AS. The data obtained in these studies suggest that GLM is highly effective in relieving and preventing uveitis attacks. However, all the given studies have a number of disadvantages; primarily they have included a limited number of patients. Further prospective randomized clinical trials with large sample sizes are required to evaluate the efficacy and safety of GLM for the treatment of uveitis in patients with spondyloarthritis.

  8. Bone formation rather than inflammation reflects Ankylosing Spondylitis activity on PET-CT: a pilot study

    OpenAIRE

    Bruijnen, Stefan TG; van der Weijden, Mignon AC; Klein, Joannes P; Hoekstra, Otto S; Boellaard, Ronald; van Denderen, J Christiaan; Dijkmans, Ben AC; Voskuyl, Alexandre E; van der Horst-Bruinsma, Irene E; van der Laken, Conny J

    2012-01-01

    Introduction Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in ima...

  9. HLA class I associations of ankylosing spondylitis in the white population in the United Kingdom.

    OpenAIRE

    Brown, M A; Pile, K D; Kennedy, L G; Calin, A; Darke, C; Bell, J; Wordsworth, B P; Cornélis, F

    1996-01-01

    OBJECTIVE: To investigate the HLA class I associations of ankylosing spondylitis (AS) in the white population, with particular reference to HLA-B27 subtypes. METHODS: HLA-B27 and -B60 typing was performed in 284 white patients with AS. Allele frequencies of HLA-B27 and HLA-B60 from 5926 white bone marrow donors were used for comparison. HLA-B27 subtyping was performed by single strand conformation polymorphism (SSCP) in all HLA-B27 positive AS patients, and 154 HLA-B27 positive ethnically mat...

  10. Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis.

    Science.gov (United States)

    Feng, Dong-Xu; Zhang, Kun; Zhang, Yu-Min; Nian, Yue-Wen; Zhang, Jun; Kang, Xiao-Min; Wu, Shu-Fang; Zhu, Yang-Jun

    2016-08-01

    Total hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non-cemented components. From June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis. The study patients included 13 men and 4 women with a mean age of 24.2 years. The mean duration of disease was 8.3 years and the average duration of hip involvement was 7.6 years. All patients had severe hip pain and dysfunction with bilateral bony ankylosis and no range of motion preoperatively and all underwent bilateral cementless total hip arthroplasty performed by a single surgeon. Joint pain, range of motion (ROM), and Harris hip scores were assessed to evaluate the postoperative results. At a mean follow-up of 31.7 months, all patients had experienced significant clinical improvement in function, ROM, posture and ambulation. At the final follow-up, the mean postoperative flexion ROM was 134.4° compared with 0° preoperatively. Similar improvements were seen in hip abduction, adduction, internal rotation and external rotation. Postoperatively, 23 hips were completely pain-free, six had only occasional discomfort, three mild to moderate pain and two severe pain. The average Harris Hip Score improved from 23.7 preoperatively to 65.8 postoperatively. No stems had loosened at the final follow-up in any patient, nor had any revision surgery been required. Bilateral severe hip ankylosis in patients with ankylosing spondylitis can be treated with cementless bilateral synchronous total hip arthroplasty, which can greatly improve hip joint function and

  11. Posterior wedge osteotomy and debridement for Andersson lesion with severe kyphosis in ankylosing spondylitis.

    Science.gov (United States)

    Liang, Yan; Tang, Xiangyu; Zhao, Yongfei; Wang, Zheng

    2017-03-31

    Andersson lesion is a well-known complication in ankylosing spondylitis. Recently, owing to the worry about the healing of fracture, some scholars advocated additional anterior surgery or other procedures were necessary, which increase the risk of the nerve injury. The purpose of this study is to introduce our experience and to explore the efficacy and feasibility of posterior wedge osteotomy and debridement through Andersson Lesion for surgical treatment of severe kyphosis in ankylosing spondylitis. From January 2012 to January 2014, a retrospective study of 14 Andersson lesion patients with severe kyphosis in ankylosing spondylitis treated with surgery was completed with an at least 2-year follow-up. The debridement procedure, before posterior wedge osteotomy in posterior approach, must scrape all sclerosis bone until healthy cancellous bone appears. Radiographic and clinical results and complications were assessed with an average follow-up of 24 months. The CT scan was obtained preoperatively and at the final follow-up to assess the displacement of the fracture preoperatively, the safety of screw insertion, the healing of the fracture at the final follow-up. The Bridwell interbody fusion grading system was used to assess the healing of the fracture. Local kyphosis was substantially corrected from 51.7 ± 15.6 to 7.1 ± 19.5, with a mean correction of 44°. The global kyphosis (GK) changed from 60.6 ± 28.3 to 20.3 ± 10.3 (P = 0.000). The mean VAS back pain scores decreased from 6.7 ± 0.8 preoperatively to 0.75 ± 0.6 after a 2-year follow-up (P = 0.000). The ODI score improved from 60.56 ± 15.1% preoperatively to 23.46 ± 8.2% after a 2-year follow-up (P = 0.000). The CT scan showed solid fusion at the level of the AL, and no internal fixation loose. All patients achieved grade 1 fusion. No major complication occurred. The posterior wedge osteotomy and debridement through AL can be used to correct the severe

  12. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis.

    Science.gov (United States)

    Klingberg, Eva; Strid, Hans; Ståhl, Arne; Deminger, Anna; Carlsten, Hans; Öhman, Lena; Forsblad-d'Elia, Helena

    2017-02-02

    Patients with ankylosing spondylitis (AS) are at increased risk of developing inflammatory bowel disease (IBD). We aimed to determine the variation in fecal calprotectin in AS over 5 years in relation to disease activity and medication and also to study the incidence of and predictors for development of IBD. Fecal calprotectin was assessed at baseline (n = 204) and at 5-year follow-up (n = 164). The patients answered questionnaires and underwent clinical evaluations. At baseline and at 5-year follow-up, ileocolonoscopy was performed in patients with fecal calprotectin ≥500 mg/kg and ≥200 mg/kg, respectively. The medical records were checked for diagnoses of IBD during the follow-up period. Fecal calprotectin >50 mg/kg was found in two-thirds of the patients at both study visits. In 80% of the patients, fecal calprotectin changed by Ankylosing Spondylitis Disease Activity Score based on C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, C-reactive protein, erythrocyte sedimentation rate, and fecal calprotectin at 5-year follow-up. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with higher fecal calprotectin, and 3-week cessation of NSAIDs resulted in a drop of a median 116 mg/kg in fecal calprotectin. The use of tumor necrosis factor (TNF) blockers was associated with lower fecal calprotectin at both visits, but the users of TNF receptor fusion proteins had significantly higher fecal calprotectin than users of anti-TNF antibodies at 5-year follow-up. The 5-year incidence of Crohn's disease (CD) was 1.5% and was predicted by high fecal calprotectin. Fecal calprotectin was elevated in a majority of the patients and was associated with disease activity and medication at both visits. CD developed in 1.5% of the patients with AS, and a high fecal calprotectin was the main predictor thereof. The results support a link between inflammation in the gut and the

  13. Determining the relationship of kinesiophobia with respiratory functions and functional capacity in ankylosing spondylitis.

    Science.gov (United States)

    Er, Göktuğ; AngIn, Ender

    2017-07-01

    Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causes inflammatory lower back pain, and structural and functional disorders, which affect quality of life negatively.The purpose of this study is to investigate the effects of kinesiophobia in AS on pulmonary function tests (PFTs) and functional performance.Thirty-one individuals with AS (n = 19 male, n = 12 female) who were suitable on the basis of the Modified New York (MNY) criteria were included in the study. The participants were given the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), in addition to the Tampa Scale for Kinesiophobia (TKS), PFTs, respiratory muscle strength, pain evaluation, and 6-minute walking test (6MWT).The mean values were found as the following: TKS, 41.65 ± 7.59; pain visual analog scale (VAS) score, 6.23 ± 2.86; forced vital capacity (%) (FVC), 75.35% ± 17.92%; forced expiratory volume in first second (%) (FEV1), 73.45% ± 17.20%; FEV1/FVC (%), 75.58% ± 15.99%; peak expiratory flow (%) (PEF), 54,90% ± 20.21%; forced expiratory flow at 25% to 75% (FEF25-75), 77.71% ± 27.05%; maximal inspiratory pressure (MIP), 62.06 ± 31.68; maximal expiratory pressure (MEP), 95.94 ± 36.60; 6MWT, 445.88 ± 99.48. The scores obtained in TKS were found related to the values of FVC (%), FEV1 (%), chest expansion, BASFI, modified Schober test, lumbar lateral flexion, cervical rotation, and total BASMI score (r = -0.43, -0.36, -0.41, 0.42, -0.49, -0.56, -0.52, 0.56, respectively; P < .05).Kinesiophobia is a condition that may arise in individuals with AS, which has negative effects. Physiotherapists have a responsibility to eliminate kinesiophobia beliefs and prefer therapy method in line with this responsibility.

  14. Temporomandibular joint ankylosis in ankylosing spondylitis: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Nishtha Gupta

    2016-01-01

    Full Text Available Ankylosing spondylitis (AS is a chronic systemic inflammatory disorder. It primarily affects the axial skeleton through involvement of the peripheral joint scan occurs. Temporomandibular joint (TMJ involvement in AS varies from 4% to 35%. Here, we present a case of a 35-year-old male, follow-up of AS from last 8 years on nonsteroidal anti-inflammatory drugs, presented with fresh complaints of painfully restricted movements of jaw during swallowing. Computer tomography of patient demonstrates articular cartilage changes with disc and joint abnormalities.

  15. Determining the relationship of kinesiophobia with respiratory functions and functional capacity in ankylosing spondylitis

    Science.gov (United States)

    Er, Göktuğ; AngIn, Ender

    2017-01-01

    Abstract Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causes inflammatory lower back pain, and structural and functional disorders, which affect quality of life negatively. The purpose of this study is to investigate the effects of kinesiophobia in AS on pulmonary function tests (PFTs) and functional performance. Thirty-one individuals with AS (n = 19 male, n = 12 female) who were suitable on the basis of the Modified New York (MNY) criteria were included in the study. The participants were given the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), in addition to the Tampa Scale for Kinesiophobia (TKS), PFTs, respiratory muscle strength, pain evaluation, and 6-minute walking test (6MWT). The mean values were found as the following: TKS, 41.65 ± 7.59; pain visual analog scale (VAS) score, 6.23 ± 2.86; forced vital capacity (%) (FVC), 75.35% ± 17.92%; forced expiratory volume in first second (%) (FEV1), 73.45% ± 17.20%; FEV1/FVC (%), 75.58% ± 15.99%; peak expiratory flow (%) (PEF), 54,90% ± 20.21%; forced expiratory flow at 25% to 75% (FEF25–75), 77.71% ± 27.05%; maximal inspiratory pressure (MIP), 62.06 ± 31.68; maximal expiratory pressure (MEP), 95.94 ± 36.60; 6MWT, 445.88 ± 99.48. The scores obtained in TKS were found related to the values of FVC (%), FEV1 (%), chest expansion, BASFI, modified Schober test, lumbar lateral flexion, cervical rotation, and total BASMI score (r = −0.43, −0.36, −0.41, 0.42, −0.49, −0.56, −0.52, 0.56, respectively; P < .05). Kinesiophobia is a condition that may arise in individuals with AS, which has negative effects. Physiotherapists have a responsibility to eliminate kinesiophobia beliefs and prefer therapy method in line with this responsibility. PMID:28723759

  16. Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Konstantinos A. Kontoangelos

    2013-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300 mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued without any withdrawal symptoms reported. Conclusions. Pregabalin is potentially useful in the management of pain in patients with AS while effectively managing the discontinuation of opioid treatment.

  17. If three of my brothers have ankylosing spondylitis, why does the doctor say it is not necessarily hereditary? The meaning of risk in multiplex case families with ankylosing spondylitis.

    Science.gov (United States)

    Peláez-Ballestas, Ingris; Romero-Mendoza, Martha; Burgos-Vargas, Rubén

    2016-03-01

    To investigate how patients with ankylosing spondylitis and their relatives in multiplex case families understand concepts of familial aggregation, heredity and risk perceptions, and its impact on decision-making. This is a multimethod clinical investigation using field research style in 34 individuals from 10 families with ≥2 members with ankylosing spondylitis covering a wide spectrum of disease severity, educational level, and economical status. The narratives of patients and their relatives were obtained using clinical information, unstructured observation, and personal interviews, which were then transcribed verbatim, coded, and analyzed by three investigators. The interpretation of the textual data was based on two analysis styles, immersion/crystallization and interpretative grounded theory. We identified four broad interrelated interpretive units in patient and relatives narratives: (1) familial interpretation of the disease, (2) genetic risk, (3) decision-making based on risk, and (4) patient-family/physician discourse contradiction on the meaning of heredity. Patient's and their relatives interpretation of familial aggregation, HLAB27, heredity, and risk perception in relation with ankylosing spondylitis involves four broad interpretive units spanning from clinical symptoms to heredity and decisions made accordingly. Their thoughts and consequent decisions are often in contradiction with the medical knowledge on the role of genetic factors in ankylosing spondylitis. © The Author(s) 2015.

  18. MRI inflammation at the vertebral unit only marginally predicts new syndesmophyte formation: a multilevel analysis in patients with ankylosing spondylitis

    NARCIS (Netherlands)

    van der Heijde, Désirée; Machado, Pedro; Braun, Jürgen; Hermann, Kay-Geert A.; Baraliakos, Xenofon; Hsu, Benjamin; Baker, Daniel; Landewé, Robert

    2012-01-01

    Objective To investigate the relationship between MRI inflammation at the vertebral unit and the formation and growth of syndesmophytes at the same vertebral unit. Methods An 80% random sample of the ASSERT database was analysed. MRI were scored using the ankylosing spondylitis (AS) spinal MRI

  19. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis?

    DEFF Research Database (Denmark)

    van der Heijde, Désirée; Landewé, Robert; Hermann, Kay-Geert

    2007-01-01

    This report summarizes the discussion during a module update at OMERACT 8 on scoring methods for activity in the spine on magnetic resonance imaging. The conclusion was that the 3 available scoring methods are all very good with respect to discrimination and feasibility: the Ankylosing Spondylitis...

  20. Correlation of serum MMP3 and other biomarkers with clinical outcomes in patients with ankylosing spondylitis: A pilot study

    Science.gov (United States)

    The studies aimed to assess a set of biomarkers for their correlations with disease activity/severity of patients with ankylosing spondylitis (AS). A total of 24 AS patients were treated with etanercept and prospectively followed for 12 weeks. Serum levels of TNF-alpha, IFN-gamma, TGF-beta, IL6, IL1...

  1. Non-steroidal anti-inflammatory drugs (NSAIDs) for axial spondyloarthritis (ankylosing spondylitis and non-radiographic axial spondyloarthritis)

    NARCIS (Netherlands)

    Kroon, Feline P. B.; van der Burg, Lennart R. A.; Ramiro, Sofia; Landewé, Robert B. M.; Buchbinder, Rachelle; Falzon, Louise; van der Heijde, Désirée

    2015-01-01

    Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (radiographic axSpA) and non-radiographic (nr-)axSpA and is associated with psoriasis, uveitis and inflammatory bowel disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line drug treatment. To determine

  2. The effect of bisphosphonates on bone mineral density in patients with ankylosing spondylitis in daily clinical practice

    NARCIS (Netherlands)

    Arends, S.; Veneberg, J.G.; Wink, F.R.; Bos, R.; Brouwer, E.; Van Der Veer, E.; Bootsma, H.; Van Roon, E.N.; Maas, F.; Spoorenberg, A.

    2016-01-01

    Background: Ankylosing spondylitis (AS) is not only characterized by excessive bone formation, but also by excessive bone loss which may lead to low bone mineral density (BMD). So far, little is known about the effect of treatment with bisphosphonates on BMD in patients with AS. Objectives: To

  3. Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial

    Directory of Open Access Journals (Sweden)

    Tom O’Dwyer

    2017-01-01

    Full Text Available Questions: Does a 3-month behaviour change intervention targeting physical activity (PA increase habitual physical activity in adults with ankylosing spondylitis (AS? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up

  4. Elevated Serum Levels of Soluble CD30 in Ankylosing Spondylitis Patients and Its Association with Disease Severity-Related Parameters

    Directory of Open Access Journals (Sweden)

    Rongfen Gao

    2015-01-01

    Full Text Available Soluble CD30 (sCD30, a transmembrane glycoprotein that belongs to the tumor necrosis factor receptor (TNFR superfamily, has been shown to be associated with various pathological conditions. This study was designed to measure the levels of serum sCD30 in patients with ankylosing spondylitis (AS and to evaluate the relationships between serum sCD30 levels and other disease severity-related indexes, including bath ankylosing spondylitis disease activity index (BASDAI, ankylosing spondylitis disease activity score (ASDAS, and bath ankylosing spondylitis functional index (BASFI. Our results demonstrated significantly elevated sCD30 levels in AS patients compared to healthy controls (HCs with mean values of 32.0±12.2 and 24.9±8.0 ng/mL, respectively (P**=0.007, suggesting a potential role of sCD30 in the pathogenesis of AS. However, no significant correlations of sCD30 with BASDAI, ASDAS, or BASFI were detected in our study (P>0.05. Therefore, sCD30 cannot be used as a reliable marker for reflecting disease activity and functional ability of AS patients.

  5. Pain is a major component of quality of life in patients with ankylosing spondylitis and the possibilities of its relief

    Directory of Open Access Journals (Sweden)

    Oksana Anatolyevna Pirogova

    2013-01-01

    Full Text Available The paper gives the results of an investigation of quality of life (QL in patients with ankylosing spondylitis. It shows the implication of chronic pain syndrome in lowering QL and considers the issues of combination therapy with nimesulide (nise and tizanidine (sirdalud for pain syndrome.

  6. The use of low-dose etanercept as an alternative therapy for treatment of ankylosing spondylitis: a case series.

    Science.gov (United States)

    Moghimi, Jamileh; Sheikhvatan, Mehrdad; Semnani, Vahid

    2012-08-01

    During recent decades, biological medications play a crucial role for treating rheumatologic disorders and thus are strongly recommended for initial treatment of ankylosing spondylitis. However, because of high cost of biological drugs, the use of these drugs has been limited. In current series, we tried to assess safety of low-dose etanercept as a common usable biological drug in patients with ankylosing spondylitis. In a case-series study, 4 men with ankylosing spondylitis were treated with low-dose etanercept (25 mg/2 weeks) plus methotrexate (10 mg/week). Safety was assessed by measuring rate of differences in severity of clinical manifestations and level of C-reactive protein (CRP). After the completion of treatment with low-dose etanercept, inflammatory low back pain and morning stiffness was reduced lower than 30 min in all patients. Only one patient had baseline high serum ESR and positive CRP that was changed to negative following treatment protocol. At one-year follow-up, all participants continued their regular treatment regimen with the etanercept survival rate 100%. Neither side effects related to drug nor clinical complications were observed within the follow-up period. Our findings suggest that low-dose etanercept (25 mg/2 weeks) has an acceptable safety and effectiveness profile in individuals with ankylosing spondylitis and can be good alternative instead of conventional therapy with etanercept (25 mg two times per week).

  7. Inflammation in ankylosing spondylitis: a systematic description of the extent and frequency of acute spinal changes using magnetic resonance imaging

    NARCIS (Netherlands)

    Baraliakos, X.; Landewé, R.; Hermann, K.-G.; Listing, J.; Golder, W.; Brandt, J.; Rudwaleit, M.; Bollow, M.; Sieper, J.; van der Heijde, D.; Braun, J.

    2005-01-01

    Magnetic resonance imaging (MRI) is increasingly used to detect inflammation in the spine of patients with ankylosing spondylitis (AS). To detect differentially the presence and extent of inflammation in the three spinal segments of patients with AS by MRI. In 38 patients with active AS, acute

  8. Translation, cultural adaptation, and validation of the Bath questionnaires and HAQ-S in Hindi for Indian patients with ankylosing spondylitis.

    Science.gov (United States)

    Dhir, Varun; Kulkarni, Sujay; Adgaonkar, Ashish; Dhobe, Poornima; Aggarwal, Amita

    2012-10-01

    The disease activity and functional impact of ankylosing spondylitis (AS) is currently measured through various questionnaire instruments, the most popular of which are the Bath indices. However, Hindi versions for use in Indian patients are not available. This study aimed to fill this lacuna. Translation and cross-cultural adaptation of the instruments--Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitits Metrology Index (BASMI), Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and Health Assessment Questionnaire-Spondyloarthropathy (HAQ-S)--were done using standard guidelines. These were then self-administered to patients. The BASMI measurements, occiput-to-wall distance, chest expansion (in centimeters), total enthesis count, ESR, and C reactive protein (CRP) were measured. To assess reliability, the patient was called back on day 14, and the questionnaires were again self-administered, and the intra-class correlation coefficient was calculated to assess reliability. Correlation of questionnaire scores with acute phase reactants, measurements, and enthesitis index were used to assess for construct validity. Some modifications were done in the Bath indices and HAQ-S for cross-cultural adaptation. For validation, 41 patients of ankylosing spondylitis with a mean age of 34 years (±10.2) and disease duration of 5.8 years (±6.2) were included. The Bath Ankylosing Spondylitis Functional Index (BASFI), BASDAI, and HAQ-S showed good correlation among themselves (r = 0.69 to 0.84, p Indian patients with ankylosing spondylitis.

  9. Identification of acute phase reactants and cytokines useful for monitoring infliximab therapy in ankylosing spondylitis.

    Science.gov (United States)

    Romero-Sánchez, Consuelo; Robinson, William H; Tomooka, Beren H; Londoño, John; Valle-Oñate, Rafael; Huang, Feng; Deng, Xiaohu; Zhang, Liyun; Yang, Chunhua; Yu, David Tak Yan

    2008-11-01

    Although most ankylosing spondylitis patients show an apparent clinical response to infliximab therapy, there is considerable individual variation. Because current clinical assessment relies heavily on subjective patient self-evaluation, biomarkers of high sensitivity and specificity are much needed. Here, we assessed potential biomarkers in 47 ankylosing spondylitis patients who received three standard pulses of infliximab. Before each infusion and at week 10, the following were measured: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet count, serum levels of metalloproteinase-3 (MMP-3), and 22 different cytokines. We discovered that, 2 weeks after the first infusion, the combination of ESR, CRP, and platelet count distinguished responders from non-responders with 81.3% sensitivity and 72.7% specificity. The distinguishing power was much less when each acute phase reactant was used alone. Among the 22 cytokines, serum IL-1alpha was able to distinguish responders from non-responders at week 6, with sensitivity of 84.9% and specificity of 53.8%. Serum IL-1alpha was probably generated from the joint compartments, as synovial fluid levels were much higher than corresponding serum levels. Although infliximab infusions led to rapid and significant suppression of serum MMP-3 levels, serum MMP-3 levels did not distinguish responders from non-responders. Besides identifying potential biomarkers, our results also demonstrate the usefulness of using sensitivity and specificity to assess usefulness of potential biomarkers.

  10. Whole Genome Expression Profiling and Signal Pathway Screening of MSCs in Ankylosing Spondylitis.

    Science.gov (United States)

    Li, Yuxi; Wang, Peng; Xie, Zhongyu; Huang, Lin; Yang, Rui; Gao, Liangbin; Tang, Yong; Zhang, Xin; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

    2014-01-01

    The pathogenesis of dysfunctional immunoregulation of mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) is thought to be a complex process that involves multiple genetic alterations. In this study, MSCs derived from both healthy donors and AS patients were cultured in normal media or media mimicking an inflammatory environment. Whole genome expression profiling analysis of 33,351 genes was performed and differentially expressed genes related to AS were analyzed by GO term analysis and KEGG pathway analysis. Our results showed that in normal media 676 genes were differentially expressed in AS, 354 upregulated and 322 downregulated, while in an inflammatory environment 1767 genes were differentially expressed in AS, 1230 upregulated and 537 downregulated. GO analysis showed that these genes were mainly related to cellular processes, physiological processes, biological regulation, regulation of biological processes, and binding. In addition, by KEGG pathway analysis, 14 key genes from the MAPK signaling and 8 key genes from the TLR signaling pathway were identified as differentially regulated. The results of qRT-PCR verified the expression variation of the 9 genes mentioned above. Our study found that in an inflammatory environment ankylosing spondylitis pathogenesis may be related to activation of the MAPK and TLR signaling pathways.

  11. Whole Genome Expression Profiling and Signal Pathway Screening of MSCs in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Yuxi Li

    2014-01-01

    Full Text Available The pathogenesis of dysfunctional immunoregulation of mesenchymal stem cells (MSCs in ankylosing spondylitis (AS is thought to be a complex process that involves multiple genetic alterations. In this study, MSCs derived from both healthy donors and AS patients were cultured in normal media or media mimicking an inflammatory environment. Whole genome expression profiling analysis of 33,351 genes was performed and differentially expressed genes related to AS were analyzed by GO term analysis and KEGG pathway analysis. Our results showed that in normal media 676 genes were differentially expressed in AS, 354 upregulated and 322 downregulated, while in an inflammatory environment 1767 genes were differentially expressed in AS, 1230 upregulated and 537 downregulated. GO analysis showed that these genes were mainly related to cellular processes, physiological processes, biological regulation, regulation of biological processes, and binding. In addition, by KEGG pathway analysis, 14 key genes from the MAPK signaling and 8 key genes from the TLR signaling pathway were identified as differentially regulated. The results of qRT-PCR verified the expression variation of the 9 genes mentioned above. Our study found that in an inflammatory environment ankylosing spondylitis pathogenesis may be related to activation of the MAPK and TLR signaling pathways.

  12. Association of Serum Vitamin D Levels with Disease Activity in Male Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Nilgün Mesci

    2016-12-01

    Full Text Available Objective: To examine the relationship between serum 25-hydroxyvitamin D [25(OHD] level and disease activity in male patients with ankylosing spondylitis (AS. Materials and Methods: The study enrolled 51 male AS patients being followed at our hospital. Patient demographics as well as serum levels of 25(OHD vitamin, C-reactive protein (CRP, calcium, phosphorus, alkaline phosphatase and parathormone, and erythrocyte sedimentation rate (ESR at 1 hour were recorded. Patients were divided into two groups based on their serum 25(OHD vitamin levels; one group consisted of 21 patients with 25(OHD vitamin levels less than 20 ng/mL and the other group comprised 30 patients with 25(OHD levels greater than 20 ng/mL. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI scores were evaluated in order to determine the disease activity. Results: BASDAI scores were statistically significantly higher in the group with serum 25(OHD vitamin levels less than 20 ng/mL compared to the group with 25(OHD levels above 20 ng/mL (p<0.05. There was no statistically significant difference between groups in terms of ESR, serum levels of CRP, parathormone, calcium, phosphorus and alkaline phosphatase. Conclusion: In the present study, an inverse relationship has been found between serum vitamin D levels and disease activity in male AS patients and it was concluded that serum vitamin D levels should also be taken into account while developing a treatment plan.

  13. Relationship of work disability between the disease activity, depression and quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Sağ, Sinem; Nas, Kemal; Sağ, Mustafa Serdar; Tekeoğlu, İbrahim; Kamanlı, Ayhan

    2018-02-02

    In this study, our objective was to determine the work productivity and work disability of the patients with ankylosing spondylitis (AS) and to investigate the relation of these parameters with disease activity, anxiety, depression and quality of life. Fifty patients with the diagnosis of AS and 30 healthy control were included in the study. In patients with AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to evaluate the disease activity; Bath Ankylosing Spondylitis Metrology Index (BASMI) was used to evaluate the spinal mobility and Bath Ankylosing Spondylitis Functional Index (BASFI) was used to determine the functional status. In addition, the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire and The Short Form (SF-36) Health Survey was used to evaluate the health status, Hospital Anxiety and Depression Scale (HADS) was used for the evaluation of depression and anxiety and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem v2.0 (WPAI:SHP) was used to evaluate the work productivity. In AS patients duration of disease at the diagnosis was 7.24 ± 6.23 years. The time lost at work due to the disease, decrease in the work productivity and impairment in the time off daily activities were worse in the patient group compared with the control group (pwork productivity was correlated with BASDAI and depression; difficulty in time-off activities was correlated with BASFI and anxiety and depression was correlated with BASDAI (pwork productivity was correlated with the subparameter vitality in SF-36, difficulty in time off activities was correlated with general health status, social functions, vitality and mental health (pworking conditions and the factors related to the disease had a significant correlation with work productivity. Factors related to the psychology and the disease were also correlated with the working conditions.

  14. Is magnetotherapy applied to bilateral hips effective in ankylosing spondylitis patients? A randomized, double-blind, controlled study.

    Science.gov (United States)

    Turan, Yasemin; Bayraktar, Kevser; Kahvecioglu, Fatih; Tastaban, Engin; Aydin, Elif; Kurt Omurlu, Imran; Berkit, Isil Karatas

    2014-03-01

    This double-blind, randomized controlled study was conducted with the aim to investigate the effect of magnetic field therapy applied to the hip region on clinical and functional status in ankylosing spondylitis (AS) patients. Patients with AS (n = 66) who were diagnosed according to modified New York criteria were enrolled in this study. Patients were randomly divided in two groups. Participants were randomly assigned to receive magnetic field therapy (2 Hz) (n = 35), or placebo magnetic field therapy (n = 31) each hip region for 20 min. Patients in each group were given heat pack and short-wave treatments applied to bilateral hip regions. Both groups had articular range of motion and stretching exercises and strengthening exercises for surrounding muscles for the hip region as well as breathing and postural exercises by the same physical therapist. These treatment protocols were continued for a total of 15 sessions (1 session per day), and patients were examined by the same physician at months 1, 3 and 6. Visual analogue scale (VAS) pain, VAS fatigue, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrologic Index (BASMI), DFI, Harris hip assessment index and Ankylosing Spondylitis Quality of Life scale (ASQOL) were obtained at the beginning of therapy and at month 1, month 3 and month 6 for each patient. There were no significant differences between groups in the VAS pain, VAS fatigue, morning stiffness, BASDAI, BASFI, BASMI, DFI, Harris hip assessment index and ASQoL at baseline, month 1, month 3 or month 6 (p > 0.05). Further randomized, double-blind controlled studies are needed in order to establish the evidence level for the efficacy of modalities with known analgesic and anti-inflammatory action such as magnetotherapy, particularly in rheumatic disorders associated with chronic pain.

  15. Surgical anesthesia with a combination of T12 paravertebral block and lumbar plexus, sacral plexus block for hip replacement in ankylosing spondylitis: CARE-compliant 4 case reports.

    Science.gov (United States)

    Ke, Xijian; Li, Ji; Liu, Yong; Wu, Xi; Mei, Wei

    2017-06-26

    Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints. A combination of T12 paravertebral block, lumbar plexus and sacral plexus block was successfully used for the surgery without any additional intravenous anesthetic or local anesthetics infiltration to the incision, and none of the patients complained of discomfort during the operations. The combination of T12 paravertebral block, lumbar plexus and sacral plexus block, which may block all nerves innervating the articular capsule, surrounding muscles and the skin involved in total hip arthroplasty, might be a promising alternative for total hip arthroplasty in ankylosing spondylitis.

  16. Improvement of Lipid Profile Is Accompanied by Atheroprotective Alterations in High-Density Lipoprotein Composition Upon Tumor Necrosis Factor Blockade A Prospective Cohort Study in Ankylosing Spondylitis

    NARCIS (Netherlands)

    Eijk, van I.C.; Vries, de M.K.; Levels, J.H.M.; Peters, M.J.L.; Huizer, E.E.; Dijkmans, B.A.C.; Horst - Bruinsma, van der I.E.; Hazenberg, B.P.C.; Stadt, van de R.J.; Wolbink, G.; Nurmohamed, M.T.

    2009-01-01

    Objective. Cardiovascular mortality is increased in ankylosing spondylitis (AS), and inflammation plays an important role. Inflammation deteriorates the lipid profile and alters high-density lipoprotein cholesterol (HDL-c) composition, reflected by increased concentrations of serum amyloid A (SAA)

  17. Reproducibility of the Bath Ankylosing Spondylitis Indices of disease activity (BASDAI), functional status (BASFI) and overall well-being (BAS-G) in anti-tumour necrosis factor-treated spondyloarthropathy patients

    DEFF Research Database (Denmark)

    Madsen, Ole R; Rytter, Anne; Hansen, Lonnie B

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment...... and overall well-being in patients with ankylosing spondylitis and other spondyloarthropathies (SpA). In Denmark, BASDAI, BASFI and BAS-G are systematically used to monitor treatment response in patients treated with tumour necrosis factor (TNF) inhibitors. The purpose of the present study was to examine...

  18. Early anti-inflammatory intervention ameliorates axial disease in the proteoglycan-induced spondylitis mouse model of ankylosing spondylitis.

    Science.gov (United States)

    Tseng, Hsu-Wen; Glant, Tibor T; Brown, Matthew A; Kenna, Tony J; Thomas, Gethin P; Pettit, Allison R

    2017-05-30

    Ankylosing spondylitis (AS) is characterised by immune-mediated arthritis and osteoproliferation, ultimately leading to joint ankylosis. Whether inflammation is necessary for osteoproliferation is controversial, fuelled by the unclear efficacy of anti-inflammatory treatments on radiographic progression. In proteoglycan-induced spondylitis (PGISp), a mouse model of AS, inflammation is the prerequisite for osteoproliferation as osteoproliferation was only observed following inflammation-driven intervertebral disc (IVD) destruction. We hypothesised that early intervention with a potent anti-inflammatory therapy would protect IVD integrity and consequently alter disease progression. PGISp mice received vehicle or a combination of etanercept (ETN) plus prednisolone (PRD) therapy for 2 or 6 weeks initiated at an early disease stage. Peripheral arthritis was scored longitudinally. Spinal disease was assessed using a semi-quantitative histological scoring regimen including inflammation, joint destruction and excessive tissue formation. ETN + PRD therapy significantly delayed the onset of peripheral arthritis. IVD integrity was significantly protected when treatment was commenced in early disease. Six-weeks of treatment resulted in trends towards reductions in intervertebral joint damage and excessive tissue formation. IVD score distribution was dichotomized, likely reflecting the extent of axial disease at initiation of therapy. In the sub-group of mice with high IVD destruction scores, ETN + PRD treatment significantly reduced IVD destruction severity, inflammation and bone erosion and reduced cartilage damage and excessive tissue formation. Early intervention with anti-inflammatory treatment not only improved inflammatory symptoms but also ameliorated structural damage of spine in PGISp mice. This preclinical observation suggests that early anti-inflammatory intervention may slow radiographic progression in AS patients.

  19. Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Alonso-Blanco, Cristina; Morales-Cabezas, Matilde; Miangolarra-Page, Juan Carlos

    2005-06-01

    The purpose of this clinical trial was to evaluate the impact of a 4-month comprehensive protocol of strengthening and flexibility exercises developed by our research group versus conventional exercises for patients with Ankylosing Spondylitis (AS) on functional and mobility outcomes. Randomized controlled trial. Forty-five patients diagnosed with AS according to the modified criteria of New York were allocated to control or experimental groups using a random numbers table. The control group was treated with a conventional protocol of physical therapy in AS, whereas the experimental group was treated with the protocol suggested by our research group. The conventional intervention consisted of 20 exercises: motion and flexibility exercises of the cervical, thoracic, and lumbar spine; stretching of the shortened muscles; and chest expansion exercises. The experimental protocol is based on the postural affectation of the AS and the treatment of the shortened muscle chains in these patients according to the Global Posture Reeducation (GPR) method. This intervention employs specific strengthening and flexibility exercises in which the shortened muscle chains are stretched and strengthened. The study lasted 4 mos. During this period, patients received a weekly group session managed by an experienced physiotherapist. Each session lasted an hour, and there were 15 total sessions. Changes in activity, mobility, and functional capacity were evaluated by an assessor blinded to the intervention, using the following previously validated scores from the Bath group: BASMI (tragus to wall distance, modified Schober test, cervical rotation, lumbar side flexion, and intermalleolar distance), BASDAI (The Bath Ankylosing Spondylitis Disease Activity Index), and BASFI (The Bath Ankylosing Spondylitis Functional Index). Both groups showed an improvement (prepost scores) in all the outcome measures, mobility measures of the BASMI index, as well as in BASFI and BASDAI indexes. In the

  20. Differences in clinical presentation of ankylosing spondylitis in men and women

    Directory of Open Access Journals (Sweden)

    Hossain Soleymani Salehabadi

    2016-10-01

    Full Text Available Background: Ankylosing spondylitis (AS is an inflammatory disease that mainly affects axial skeleton of the body and ankylosing spondylitis ligaments around the spine at the junction of the spine are inflamed, because the disease is progressive and can lead to significantly cause of disability and the studies could provide a mechanism for the early detection of the disease or help determine when to start treatment, the difference in clinical presentations of AS in men and women is indicative of potential effect of gender on severity of the disease. This study was conducted with the aim to investigate the effect of gender on severity of AS. Methods: In a cross-sectional study, one hundred and fifteen patients with ankylosing spondylitis who referred to Yazd Rheumatology Clinic between 2001 and 2013 were evaluated. Sampling was performed using non-random convenient method. The most important variables studied included demographic data, clinical presentation, radiographic stage of sacroiliac involvement, and laboratory data extracted from patients’ files and recorded in questionnaires. Results: Both groups according to age at diagnosis, presence of enteritis, peripheral joint involvement and laboratory data such as C-reactive protein (CRP, erythrocyte sedimentation rate (ESR and hemoglobin were matched. Inflammatory neck pain was more prevalent in men than in women (77.2% against 51.8%; P< 0.05. Sacroiliac radiographic study revealed stage 1 involvement in 11.3% of men and 37% of women (P= 0.009, and stage 4 in 27.2% of men and 3.7% of women (P< 0.001, with a significant difference. Conclusion: According to the results of the study, the time between age of onset and age at diagnosis, inflammatory pain in the neck and advanced stage in men than in women was higher. Although these findings suggest that gender may have an impact on the pattern and severity of AS but the time delay in diagnosis as a disease affecting the intensity and pattern should

  1. Construction and analysis of protein-protein interaction network correlated with ankylosing spondylitis.

    Science.gov (United States)

    Kanwal, Attiya; Fazal, Sahar

    2018-01-05

    Ankylosing spondylitis, a systemic illness is a foundation of progressing joint swelling that for the most part influences the spine. However, it frequently causes aggravation in different joints far from the spine, and in addition organs, for example, the eyes, heart, lungs, and kidneys. It's an immune system ailment that may be activated by specific sorts of bacterial or viral diseases that initiate an invulnerable reaction that don't close off after the contamination is recuperated. The particular reason for ankylosing spondylitis is obscure, yet hereditary qualities assume a huge part in this condition. The rising apparatuses of network medicine offer a stage to investigate an unpredictable illness at framework level. In this study, we meant to recognize the key proteins and the biological regulator pathways including in AS and further investigating the molecular connectivity between these pathways by the topological examination of the Protein-protein communication (PPI) system. The extended network including of 93 nodes and have 199 interactions respectively scanned from STRING database and some separated small networks. 24 proteins with high BC at the threshold of 0.01 and 55 proteins with large degree at the threshold of 1 have been identified. CD4 with highest BC and Closeness centrality located in the centre of the network. The backbone network derived from high BC proteins presents a clear and visual overview which shows all important regulatory pathways for AS and the crosstalk between them. The finding of this research suggests that AS variation is orchestrated by an integrated PPI network centered on CD4 out of 93 nodes. Ankylosing spondylitis, a systemic disease is an establishment of advancing joint swelling that generally impacts the spine. Be that as it may, it as often as possible causes disturbance in various joints a long way from the spine, and what's more organs. It's a resistant framework affliction that might be actuated by particular sorts

  2. Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab.

    Science.gov (United States)

    Bosnić, Dubravka; Žarković, Branimir; Barešić, Marko; Zarkovic, Maja; Anić, Branimir

    2016-01-01

    Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient's quality of life and affect everyday activities. We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life.

  3. THE POSSIBILITIES AND RESULTS OF INDIRECT COMPARISON OF BIOLOGICAL AGENTS IN ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2016-01-01

    Full Text Available The paper analyzes two matching-adjusted indirect comparison-based investigations of the efficacy of adalimumab (ADA and secukinumab (SCM in active ankylosing spondylitis, which have been recently reported at the EULAR Congress (London, 2016. One study sponsored by AbbVie was conducted to determine the short-term (16-week comparative clinical and economic efficacy of the test drugs and the other was supported by Novartis to reveal long-term (52-week, only clinical efficacy. Both studies have shown that the short-term efficacy ofADAand SCM is practically similar; however, the latter has a better long-term clinical efficacy. A pharmacoeconomic analysis of both drugs used during the first 12 weeks has demonstrated some advantage ofADA. 

  4. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    ability was assessed using Z-scores (Mann-Whitney test) comparing change in score between patients treated with TNF-blocking drug and placebo. RESULTS: The mean time to score one set of MRI was shortest for the Berlin method. SDC was lowest for the Berlin method and highest for SPARCC. Overall inter...... of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo (n...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered...

  5. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    OBJECTIVE: Magnetic resonance imaging (MRI) of the spine is increasingly important in the assessment of inflammatory activity in clinical trials with patients with ankylosing spondylitis (AS). We investigated feasibility, inter-reader reliability, sensitivity to change, and discriminatory ability...... of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo (n...... systems to be used in assessing spinal activity on MRI in patients with AS in clinical trials. On the basis of these results it is not possible to prioritize one of the 3 methods....

  6. Association between Copy Number Variations HLA-DQA1 and Ankylosing Spondylitis in Chinese Han population

    Science.gov (United States)

    Wang, Jiucun; Yang, Yajun; Guo, Shicheng; Chen, Yulin; Yang, Chengde; Ji, Hengdong; Song, Xinqiang; Zhang, Feng; Jiang, Zhengwen; Ma, Yanyun; Li, Yuan; Du, Aiping; Jin, Li; Reveille, John D.; Zou, Hejian; Zhou, Xiaodong

    2013-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease with complex genetic traits. Multiple sequence variations have been associated with AS, but explained only a proportion of heritability. The studies herein aimed to explore potential associations between genomic copy number variation (CNV) and AS of Han Chinese. Five AS patients were examined with the high-density comparative genomic hybridization (CGH) microarrays in the first screen test for AS associated CNVs. A total of 533 AS patients and 792 unrelated controls were examined in confirmation studies with the AccuCopy assays. A significant association was observed between the CNV of the HLA-DQA1 and AS. Comparing with controls, AS patients showed an aberrant copy number (CN), and significantly increased number of patients had more than 2 copies of the HLA-DQA1. Therefore, CNV of the HLA-DQA1 may play an important role in susceptibility to AS in Han Chinese population. PMID:24048351

  7. Acute fulminant drug induced necrotizing pancreatitis in a patient with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Pablo Miramontes

    2015-03-01

    Full Text Available Drug-induced acute necrotizing pancreatitis is a rare adverse event, although it has been reported in association with different drugs, including non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and analgesic agents commonly used in rheumatology. In different reviews of the pancreotoxicity of drugs, infliximab and etanercept are mentioned among all medications implicated in drug-induced pancreatitis, but clinical cases of acute pancreatitis complicating treatment with these anti-TNF-α agents have been exceptionally reported. We describe a patient with ankylosing spondylitis treated with etanercept, who developed an acute fulminant necrotizing pancreatitis that resulted in death. Doctors should pay close attention to patients taking biologic drugs in which a complaint of abdominal pain lasting for several days with no apparent cause may require a prompt referral for medical consultation.

  8. A Possible Role of Intestinal Microbiota in the Pathogenesis of Ankylosing Spondylitis

    Science.gov (United States)

    Yang, Lianjun; Wang, Liping; Wang, Xin; Xian, Cory J.; Lu, Hai

    2016-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the sacroiliac joints and the spine, for which the pathogenesis is thought to be a result of the combination of host genetic factors and environmental triggers. However, the precise factors that determine one’s susceptibility to AS remain to be unraveled. With 100 trillion bacteria residing in the mammalian gut having established a symbiotic relation with their host influencing many aspects of host metabolism, physiology, and immunity, a growing body of evidence suggests that intestinal microbiota may play an important role in AS. Several mechanisms have been suggested to explain the potential role of the microbiome in the etiology of AS, such as alterations of intestinal permeability, stimulation of immune responses, and molecular mimicry. In this review, the existing evidence for the involvement of the microbiome in AS pathogenesis was discussed and the potential of intestinal microbiome-targeting strategies in the prevention and treatment of AS was evaluated. PMID:27999312

  9. Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review.

    Science.gov (United States)

    Kotsis, Konstantinos; Voulgari, Paraskevi V; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

    2014-12-01

    Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-α) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population.

  10. The interleukin (IL)-23/IL-17 axis in ankylosing spondylitis: new advances and potentials for treatment.

    Science.gov (United States)

    Jethwa, H; Bowness, P

    2016-01-01

    Ankylosing spondylitis (AS), the most common form of spondyloarthropathy, is a chronic, progressive multi-system inflammatory disorder characteristically affecting the sacroiliac joints and axial skeleton. Although the exact mechanisms underlying the pathogenesis of AS remain to be elucidated, the presence of human leucocyte antigen (HLA)-B27 is known to markedly increase its risk of development. Current treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and tumour necrosis factor (TNF) blockers. In recent years, the interleukin (IL)-23/IL-17 pathway has been shown to have significance in the pathogenesis of AS and treatment modalities targeting this pathway have been shown to be beneficial in various other inflammatory conditions. This review provides an overview of the IL-23/IL-17 pathway in the pathogenesis of AS and summarizes new potential treatments for AS and related inflammatory diseases. © 2015 British Society for Immunology.

  11. A Possible Role of Intestinal Microbiota in the Pathogenesis of Ankylosing Spondylitis.

    Science.gov (United States)

    Yang, Lianjun; Wang, Liping; Wang, Xin; Xian, Cory J; Lu, Hai

    2016-12-17

    Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the sacroiliac joints and the spine, for which the pathogenesis is thought to be a result of the combination of host genetic factors and environmental triggers. However, the precise factors that determine one's susceptibility to AS remain to be unraveled. With 100 trillion bacteria residing in the mammalian gut having established a symbiotic relation with their host influencing many aspects of host metabolism, physiology, and immunity, a growing body of evidence suggests that intestinal microbiota may play an important role in AS. Several mechanisms have been suggested to explain the potential role of the microbiome in the etiology of AS, such as alterations of intestinal permeability, stimulation of immune responses, and molecular mimicry. In this review, the existing evidence for the involvement of the microbiome in AS pathogenesis was discussed and the potential of intestinal microbiome-targeting strategies in the prevention and treatment of AS was evaluated.

  12. Integrated genomics identifies convergence of ankylosing spondylitis with global immune mediated disease pathways.

    Science.gov (United States)

    Uddin, Mohammed; Codner, Dianne; Hasan, S M Mahmud; Scherer, Stephen W; O'Rielly, Darren D; Rahman, Proton

    2015-05-18

    Ankylosing spondylitis(AS), a highly heritable complex inflammatory arthritis. Although, a handful of non-HLA risk loci have been identified, capturing the unexplained genetic contribution to AS pathogenesis remains a challenge attributed to additive, pleiotropic and epistatic-interactions at the molecular level. Here, we developed multiple integrated genomic approaches to quantify molecular convergence of non-HLA loci with global immune mediated diseases. We show that non-HLA genes are significantly sensitive to deleterious mutation accumulation in the general population compared with tolerant genes. Human developmental proteomics (prenatal to adult) analysis revealed that proteins encoded by non-HLA AS risk loci are 2-fold more expressed in adult hematopoietic cells.Enrichment analysis revealed AS risk genes overlap with a significant number of immune related pathways (p pathways with other immune mediated diseases. This information will be pivotal to fully explain AS pathogenesis and identify new therapeutic targets.

  13. Progress in spondylarthritis. Progress in studies of the genetics of ankylosing spondylitis.

    Science.gov (United States)

    Brown, Matthew A

    2009-01-01

    The advent of high-throughput SNP genotyping methods has advanced research into the genetics of common complex genetic diseases such as ankylosing spondylitis (AS) rapidly in recent times. The identification of associations with the genes IL23R and ERAP1 have been robustly replicated, and advances have been made in studies of the major histocompatibility complex genetics of AS, and of KIR gene variants and the disease. The findings are already being translated into increased understanding of the immunological pathways involved in AS, and raising novel potential therapies. The current studies in AS remain underpowered, and no full genomewide association study has yet been reported in AS; such studies are likely to add to the significant advances that have already been made.

  14. Recent results of the follow-up of radium-224-treated ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Wick, R.R.; Goessner, W.

    1989-01-01

    In this study 1473 ankylosing spondylitis patients were followed after treatment with 10-12 weekly injections of radium 224 of about 1MBq each injections( skeletal dose 0.56-0.67 Gy for a 70 kg man). 495 in the exposure group and 602 in the controls have died. By June 1988 (mean follow-up time 17 years), 3 cases of skeletal malignancies were observed in the exposure group versus one in the controls. Haematopoietic tissue disease among living and dead included bone marrow failure (10 in the exposed, seven in controls), and leukemias (7 versus 4). In the exposure group 3 of the leukemias were chronic myeloid and one acute lymphoblastic, and in the controls no chronic myeloid cases were found but 3 cases of lymphoblastic leukemia. Incidence of myeloproliferative disease is discussed compared with patients treated with other doses and dose rates. (author)

  15. The natural history of ankylosing spondylitis in the 21st century

    Directory of Open Access Journals (Sweden)

    C. Campana

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton and evolves in stiffnes followed by ankylosis and disability. However, it may be difficult to exactly establish the natural history of the disease and the influence of risk factors of progression, since most patients are treated with various pharmacologic or non-pharmacologic agents, which may potentially influence the natural progression of the disease. In this context, we report here a very interesting case of a 40 year old man, presented to our outpatient clinic, 28 years after the onset of AS. Previously for personal reasons, did not choose not to undergo any treatment. This case allows us to evaluate the natural radiological progression of the disease and the influence of predictive risk factors.

  16. Understanding presenteeism in patients with ankylosing spondylitis: contributing factors and association with sick leave.

    Science.gov (United States)

    Gordeev, Vladimir S; Maksymowych, Walter P; Schachna, Lionel; Boonen, Annelies

    2014-06-01

    To understand the impact of ankylosing spondylitis (AS) on presenteeism and to explore its relationship to sick leave. AS patients completed a questionnaire consisting of sociodemographics, disease characteristics, and work outcomes, including sick leave and presenteeism, assessed by the Work Limitations Questionnaire (WLQ). Associations between a broad range of explanatory variables with the WLQ and AS-related sick leave were assessed by zero-inflated negative binomial and zero-inflated Poisson regressions. Of 311 employed patients (204 men [65.6%]), 18% had sick leave in the past month. Limitations in meeting time management demands (33.7%), physical demands (30.2%), mental-interpersonal demands (20.2%), and output (19.0%) were noted. With the mean ± SD WLQ index score of 6.7 ± 5.9, the average decrease in work productivity attributable to health was 6.3%; an extra 7.1% of work hours would be needed to compensate for lost productivity. Helplessness, female sex, and impaired health-related quality of life (Ankylosing Spondylitis Quality of Life instrument [ASQoL]) were major contributors to the level of presenteeism (P < 0.01). At-work limitations (WLQ) and lower quality of life (ASQoL) were significantly associated with probability of sick leave, while the length of sick leave was strongly associated with lower educational level and helplessness (P < 0.01), and in some models, also with disease duration and country of residence (P < 0.05). AS hinders patients' work, mainly in time management and physical demand domains. The WLQ and ASQoL are able to identify patients who incur sick leave. Helplessness contributes independently to the level of presenteeism and the length of sick leave. Copyright © 2014 by the American College of Rheumatology.

  17. Expression of uncarboxylated matrix Gla protein in ankylosing spondylitis and its significance

    Directory of Open Access Journals (Sweden)

    Han-qing HUANG

    2013-07-01

    Full Text Available Objective To investigate the serum level of uncarboxylated matrix Gla protein (ucMGP in ankylosing spondylitis (AS patients, and to evaluate its diagnostic value and the relation of ucMGP to inflammation and ossification process in AS. Methods Eight-two AS patients and 76 healthy controls were enrolled in this randomized controlled study. The clinical indices (age, gender, course of disease, disease activity, changes in radiographic studies, and indices of bone metabolism or inflammation, including erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, osteocalcin (OC, and bone-specific alkaline phosphatase (BALP were evaluated or measured. The disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and changes in radiographic pictures were evaluated according to the modified Stoke AS Spine Score (mSASSS, and serum level of ucMGP was measured by a competitive ELISA. The relationship between ucMGP and clinical indexes, radiographic scoring, indices in bone metabolism or inflammation was estimated by SPSS software, and the diagnostic value of ucMGP was analyzed by receiver operator characteristic (ROC curve. Results The levels of ESR and CRP in AS patients were higher than those in healthy controls, but the serum ucMGP was lower (2958±654nmol/L compared with healthy controls (4551±1036nmol/L, P0, r=-0.715, P1, r=-0.741, P10, r=-0.776, P<0.01; mSASSS <10, r=-0.297, P=0.028. Conclusion Serum ucMGP may serve as a diagnostic biomarker of AS and progression index of ossification, especially in late stage of AS.

  18. Greek adaptation and validation of the Ankylosing Spondylitis Quality of Life (ASQoL) measure.

    Science.gov (United States)

    Graham, J E; Rouse, M; Twiss, J; McKenna, S P; Vidalis, A A

    2015-01-01

    Ankylosing Spondylitis (AS) is a chronic rheumatic disease that has a significant impact on patient's quality of life (QoL). The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire is a disease-specific patient-reported outcome measure for assessing QoL in AS. While the ASQoL has been adapted for use in 46 countries worldwide, a Greek language version of the measure has not been available and was required for an international clinical trial. The aim was to develop and assess the psychometric properties of a Greek language version of the ASQoL. The adaptation of the ASQoL into Greek involved three procedures: translation, assessment of face and content validity, and formal validation. The measure was translated into Greek using two translation panels. Cognitive debriefing interviews were employed to determine face and content validity. Finally, the translation's psychometric properties were examined by administering it on two occasions, with a 14-day interval. The Nottingham Health Profile (NHP) was used as a comparator measure. The ASQoL proved straightforward to translate into Greek and interviewees found it relevant, comprehensible and easy to complete.  The measure had good internal consistency (α =0.92) and test-retest reliability (r =0.98). Predicted correlations with the NHP provided evidence of the convergent validity of the two measures. Construct validity was confirmed by the measure's ability to distinguish groups of AS patients varying by perceived disease severity and general health. The Greek ASQoL has been shown to be well-accepted, reliable and valid and can be recommended for use in clinical studies and routine clinical practice in AS. Hippokratia 2015; 19 (2):119-124.

  19. Postural deformities: potential morbidities to cause balance problems in patients with ankylosing spondylitis?

    Science.gov (United States)

    Çınar, Ece; Akkoç, Yeşim; Karapolat, Hale; Durusoy, Raika; Keser, Gökhan

    2016-03-01

    This study aimed to assess the impact of postural deformities caused by ankylosing spondylitis (AS) on balance problems. This study included 29 patients with AS and 21 healthy controls. For assessing exercise capacity and dynamic balance, timed up and go test, five times sit-to-stand test, gait speed, and 6-min walk test were performed. Romberg tests were used to evaluate static balance and proprioception, whereas Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Berg Balance Scale (BBS), Activity Specific Balance Confidence Scale (ABC), Dizziness Handicap Inventory (DHI), and functional reach test were used to assess dynamic balance and the risk of falling. Using Bath Ankylosing Spondylitis Metrology Index (BASMI) scores, patients with AS were divided into two groups: those with scores 0-4 were assigned to subgroup AS1, and those with scores 5-10 were assigned to subgroup AS2. In the whole group of patients with AS, five times sit-to-stand test, tandem Romberg test with eyes closed, and BBS and ABC scores were significantly worse than the healthy controls (ptest, 6-min walk test, functional reach test, FGA, and DHI scores were also significantly worse than the healthy controls (p<0.05). Comparing the two subgroups with each other, only BBS scores were significantly worse in the AS2 subgroup than in the AS1 subgroup. Although in clinical practice, poor balance is not a common problem in AS, possibly because of compensatory mechanisms, patients with AS have poorer static and dynamic balance than healthy subjects. Significantly worse BBS scores in the AS2 subgroup than in the AS1 subgroup may suggest the presence of more dynamic balance problems in advanced disease; however, future studies comprising larger samples are necessary to confirm this assumption.

  20. Circulating levels of Th1 and Th2 chemokines in patients with ankylosing spondylitis.

    Science.gov (United States)

    Wang, Jianing; Zhao, Qi; Wang, Gaoya; Yang, Chunshu; Xu, Yong; Li, Yujia; Yang, Pingting

    2016-05-01

    Although chemokines are critical elements for the selective attraction and activation of various leukocyte subsets in the inflammatory process, there are few findings concerning T helper (Th) 1 or Th2 chemokines in ankylosing spondylitis (AS). This study was designed to determine whether serum levels of chemokines that are preferentially chemotactic for Th1 (IFN-gamma-inducible protein-10, IP-10/CXCL10) and Th2 (thymus and activation regulated chemokine, TARC/CCL17) and (macrophage derived chemokine, MDC/CCL22) cells were elevated and whether they correlated with the clinical features in patients with AS. Forty-two patients with axial AS and 25 healthy controls were enrolled into the study. Serum levels of chemokines (IP-10, TARC and MDC) and cytokines (IFN-γ, TNF-α and IL-4) were examined using ELISA. The disease activity was evaluated by Ankylosing Spondylitis Disease Activity Score (ASDAS). Serum levels of IgG, IgA, IgM, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured. Serum chemokine levels of IP-10, TARC and MDC were significantly higher in patients with AS than those in healthy controls. Serum cytokine levels of IFN-γ, TNF-α were also significantly increased, but the levels of IL-4 were not. Furthermore, IP-10 levels in AS patients correlated with ESP, CRP and ASDAS, while the levels of TARC and MDC did not correlate with these clinic indexes. Correlation analysis between the levels of chemokines and cytokines revealed a positive correlation between IP-10 and TNF-α. The levels of both Th1 and Th2 chemokines decreased under blockade of TNF-α. Our results suggest that both a Th1 chemoattractant IP-10 and Th2 chemoattractants, TARC and MDC, cooperatively play a role in the development of AS. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. The association between ankylosing spondylitis and the risk of any, hip, or vertebral fracture

    Science.gov (United States)

    Zhang, Min; Li, Xiao-Mei; Wang, Guo-Sheng; Tao, Jin-Hui; Chen, Zhu; Ma, Yan; Li, Xiang-Pei

    2017-01-01

    Abstract Background: Ankylosing spondylitis (AS) is an inflammatory rheumatic disease and strongly associated with an increased risk of fractures. A great proportion of patients with AS are suffering from sustaining fractures and the aim of this study is to evaluate and quantify the association between the site of the fracture and AS by performing a meta-analysis. Methods: A systematic literature search was performed on Medline database from 1966 to August 15, 2016 and Embase database from 1980 to August 15, 2016. Studies were evaluated by 2 independent reviewers and quantitative estimates regarding the association between ankylosing spondylitis and the risk of any, hip, or vertebral fracture were presented. After the heterogeneity of selected studies was assessed by using Cochran I2 statistics, the random effect model was used to combine effect size. Publication bias was measured by Egger and Begg's regression tests. Results: A total of 6 articles were involved in our study. The results of meta-analysis revealed that AS was strongly associated with the risk of vertebral fracture (odds ratio [OR] = 4.25, 95% confidence interval [CI] = 1.07–7.42) and was not significantly associated with the risk of any fracture (OR=2.00, 95%CI = 0.94–3.06) or hip fracture (OR=1.28, 95%CI =0.16–2.40). Conclusion: In the present study, a general knowledge of the association between AS and the risk of 3 kinds of fractures were presented, which could improve the ways of prevention of fracture in the patients with AS. PMID:29390254

  2. Bone morphogenetic protein 6 polymorphisms are associated with radiographic progression in ankylosing spondylitis.

    Science.gov (United States)

    Joo, Young Bin; Bang, So-Young; Kim, Tae-Hwan; Shim, Seung-Cheol; Lee, Seunghun; Joo, Kyung Bin; Kim, Jong Heon; Min, Hye Joon; Rahman, Proton; Inman, Robert D

    2014-01-01

    Nearly 25 genetic loci associated with susceptibility to ankylosing spondylitis (AS) have been identified by several large studies. However, there have been limited studies to identify the genes associated with radiographic severity of the disease. Thus we investigated which genes involved in bone formation pathways might be associated with radiographic severity in AS. A total of 417 Korean AS patients were classified into two groups based on the radiographic severity as defined by the modified Stoke' Ankylosing Spondylitis Spinal Score (mSASSS) system. Severe AS was defined by the presence of syndesmophytes and/or fusion in the lumbar or cervical spine (n = 195). Mild AS was defined by the absence of any syndesmophyte or fusion (n = 170). A total of 251 single nucleotide polymorphisms (SNPs) within 52 genes related to bone formation were selected and genotyped. Odds ratios (OR) and 95% confidence interval (95% CI) were analysed by multivariate logistic regression controlling for age at onset of symptoms, sex, disease duration, and smoking status as covariates. We identified new loci of bone morphogenetic protein 6 (BMP6) associated with radiographic severity in patients with AS that passed false discovery rate threshold. Two SNPs in BMP6 were significantly associated with radiologic severity [rs270378 (OR 1.97, p = 6.74 × 10(-4)) and rs1235192 [OR 1.92, p = 1.17 × 10(-3)]) adjusted by covariates. This is the first study to demonstrate that BMP6 is associated with radiographic severity in AS, supporting the role wingless-type like/BMP pathway on radiographic progression in AS.

  3. Bone morphogenetic protein 6 polymorphisms are associated with radiographic progression in ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Young Bin Joo

    Full Text Available Nearly 25 genetic loci associated with susceptibility to ankylosing spondylitis (AS have been identified by several large studies. However, there have been limited studies to identify the genes associated with radiographic severity of the disease. Thus we investigated which genes involved in bone formation pathways might be associated with radiographic severity in AS.A total of 417 Korean AS patients were classified into two groups based on the radiographic severity as defined by the modified Stoke' Ankylosing Spondylitis Spinal Score (mSASSS system. Severe AS was defined by the presence of syndesmophytes and/or fusion in the lumbar or cervical spine (n = 195. Mild AS was defined by the absence of any syndesmophyte or fusion (n = 170. A total of 251 single nucleotide polymorphisms (SNPs within 52 genes related to bone formation were selected and genotyped. Odds ratios (OR and 95% confidence interval (95% CI were analysed by multivariate logistic regression controlling for age at onset of symptoms, sex, disease duration, and smoking status as covariates.We identified new loci of bone morphogenetic protein 6 (BMP6 associated with radiographic severity in patients with AS that passed false discovery rate threshold. Two SNPs in BMP6 were significantly associated with radiologic severity [rs270378 (OR 1.97, p = 6.74 × 10(-4 and rs1235192 [OR 1.92, p = 1.17 × 10(-3] adjusted by covariates.This is the first study to demonstrate that BMP6 is associated with radiographic severity in AS, supporting the role wingless-type like/BMP pathway on radiographic progression in AS.

  4. Radiologic Changes in the Symphysis Pubis of Male Patients with Ankylosing Spondylitis.

    Science.gov (United States)

    Koo, Bon San; Song, Yoonah; Joo, Kyung Bin; Lee, Seunghun; Kim, Tae-Hwan

    2016-02-01

    We aimed to evaluate the involvement of the symphysis pubis in patients with ankylosing spondylitis (AS), and to assess the correlations between symphysis pubis changes and clinical findings. We retrospectively evaluated a total of 222 male patients with AS who underwent pelvic and cervical/lumbar spine radiography at the Hanyang University Hospital for Rheumatic Diseases from August 2004 to February 2014. Radiographs were examined by 2 experienced radiologists, and radiographic damage was scored as follows: 0 (no damage), 1 (subtle irregularity and/or subchondral sclerosis), 2 (erosion), 3 (partial ankylosis), and 4 (total ankylosis). We evaluated the patients' clinical characteristics and analyzed their correlations with radiographic symphysis pubis changes. The mean patient age was 30.5 ± 8.3 years and mean disease duration was 7.1 ± 4.6 years; 105 patients (47.3%) exhibited radiologic damage in the symphysis pubis. Moreover, 75, 28, 0, and 2 patients had scores of 1, 2, 3, and 4, respectively. When comparing the normal (score 0) and abnormal (score 1-4) symphysis pubis groups, the latter had a longer symptom duration (10.1 ± 7.0 vs 7.6 ± 5.8 yrs, p = 0.004) and higher modified Stoke Ankylosing Spondylitis Spine Score (mSASSS; 18.6 ± 17.0 vs. 14.3 ± 13.4, p = 0.038). Moreover, a significant correlation was noted between the radiographic symphysis pubis damage score and mSASSS (r(2) = 0.147, p = 0.029). Among male patients with AS, 47.3% exhibited symphysis pubis involvement. Moreover, a correlation was observed between the radiographic symphysis pubis and spine changes.

  5. Anxiety, Depression, Problem Solving and Stress Management in Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Yasemin Özkan

    2018-04-01

    Full Text Available Objective: This study aims to determine anxiety, depression, self-esteem, stress management and problem solving skills in ankylosing spondylitis (AS patients compared to healthy subjects. Materials and Methods: The study involves 33 patients with AS according to the Modified New York Criteria and 31 healthy subjects as control group. A socio-demographic data form, the Hospital Anxiety and Depression Scale (HADS, the Rosenberg Self-Esteem Scale (RSES, the Problem Solving Inventory (PSI and the Coping Orientation to Problems Experienced (COPE scale were used to evaluate participants. Results: The mean ages of the patients and the control were 36.3±10.9 and 33.6±6.2 years respectively with no significant difference between the two groups (p>0.05. On the HADS scale, AS patients showed significantly higher anxiety and depression scores (p<0.05. AS patients had significantly lower self-esteem as determined by the RSES scores (p<0.05. When the study groups were compared using the PSI, a significant difference was observed only in the “approach-avoidance style” subscale. A positive correlation between Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and RSES was reported and there was a very strong negative correlation between BASDAI and overall PSI scores. A negative correlation was found between humor, mental disengagement and behavioral disengagement and BASDAI scores (p<0.05. Conclusion: Being a chronic rheumatic disease, AS not only limits daily living activities due to its physical manifestations but also causes psychological problems such as depression ve anxiety. However, it does not seem to impair problem solving skills and the ability to cope with stress significantly. It might be helpful to evaluate AS patients using a holistic approach and to be aware of the factors that are associated with difficulties in their social interactions.

  6. [Vitamin D levels in ankylosing spondylitis: does deficiency correspond to disease activity?].

    Science.gov (United States)

    Pokhai, Gabriel G; Bandagi, Sabiha; Abrudescu, Adriana

    2014-01-01

    Ankylosing spondylitis (AS) is an inflammatory disorder that presents with arthritis of the axial skeleton, including sacroiliac joints. Vitamin D is a secosteroid hormone with a long-established role in calcium and phosphate homeostasis, and in the regulation of bone formation and resorption. It is now known that vitamin D plays an immunosuppressive role in the body, and there is interest of late in the role of vitamin D in autoimmune diseases. Inflammation may be responsible for some of the loss of bone mineral density seen in AS. We reviewed the literature for studies assessing vitamin D level as a marker of AS disease activity and those examining vitamin D levels in AS in comparison to healthy controls. Four of 7 studies found a significant negative correlation between vitamin D levels and Bath Ankylosing Spondylitis Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In a review of 8 case-control studies, the mean level of 25-hydroxyvitamin D3 was 22.8 ± 14.1 ng/mL in 555 AS patients versus 26.6 ± 12.5 ng/mL in 557 healthy controls. When compared with a 2-sample t test, vitamin D levels were significantly higher in healthy controls (p < 0.01). We conclude that patients with AS appear to have lower vitamin D levels versus healthy controls; however, the cause is unclear. Existing studies do not demonstrate a consistent link between vitamin D levels and disease activity in AS. Further studies are in need to determine if a causative link exists between vitamin D deficiency and AS. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  7. Detection of active sacroiliitis with ankylosing spondylitis through intravoxel incoherent motion diffusion-weighted MR imaging

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    Zhao, Ying-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Li, Shao-lin; Zhao, Xiang-cheng; Hu, Shao-yong; Liu, Zhen-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Liu, Zai-yi; Chen, Xin; Liang, Chang-hong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Mei Ms, Ying-jie [Philips Healthcare, Guangzhou (China); Chan, Queenie [Philips Electronics Hong Kong Ltd, Hong Kong (China)

    2015-09-15

    To confirm feasibility and assess intravoxel incoherent motion (IVIM) to differentiate active sacroiliitis and ankylosing spondylitis. Forty-one patients were divided into two groups, an active group (n = 20) and a chronic group (n = 21), according to the Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) and laboratory parameters. In addition, 21 healthy volunteers were chosen as the control group. Tissue diffusivity (D{sub slow}), perfusion fraction (f), and pseudo-diffusion coefficient (D{sub fast}) values were obtained for all three groups. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. There was good interobserver agreement on the measurements between the two observers. The optimal cut-off values (with respective AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio) between active and chronic groups were D{sub slow} = 0.53 x 10{sup -3} mm{sup 2}/s (0.976, 90 %, 95.2 %, 18.9, 0.10) and f = 0.09 (0.545, 20 %, 95.5 %, 4.2, 0.84), and between chronic and control groups were D{sub slow} = 0.22 x 10{sup -3} mm{sup 2}/s (0.517, 9.52 %, 100 %, no number, 0.9) and f = 0.09 (0.935, 95.24 %, 80.95 %, 5, 0.059). D{sub slow} and f of IVIM diffusion-weighted (DW)-MRI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups. (orig.)

  8. Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population ?

    Science.gov (United States)

    Sandhya, Pulukool; Danda, Debashish; Jeyaseelan, Lakshmanan

    2015-04-01

    Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS) in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS) and matching Indian reference population. Consecutive male patients (December 2009- October 2012) with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also. There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33%) JAS patients were taller as compared to the reference population. Twenty six (86.67%) AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm) and AAS (168.2 ± 5.94 cm) patients were significantly higher than the reference value of 163.11 cm; both p0 growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different populations are required to confirm these findings.

  9. Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis

    Science.gov (United States)

    Oskay, Deran; Tuna, Zeynep; Düzgün, İrem; Elbasan, Bülent; Yakut, Yavuz; Tufan, Abdurrahman

    2017-11-13

    Background/aim: Our aim was to investigate the association of kinesiophobia with pain, quality of life, clinical measures, and depression in patients with ankylosing spondylitis (AS). Materials and methods: Patients with AS (n: 163) were enrolled in the study. Kinesiophobia was evaluated with the Tampa Scale of Kinesiophobia (TSK), pain with a visual analog scale (VAS), mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Bath AS Functional Index (BASFI), depression level with Beck's Depression Inventory (BDI), and quality of life with the AS Quality of Life Questionnaire (ASQoL). Besides correlation analysis, outcome measures were compared between patients with (TSK ? 37) and without (TSK 0.05). Patients with kinesiophobia had more pain and poorer BASFI, ASQoL, and BDI scores than patients without kinesiophobia (P quality of life.

  10. Association study of genes related to bone formation and resorption and the extent of radiographic change in ankylosing spondylitis.

    Science.gov (United States)

    Cortes, A; Maksymowych, W P; Wordsworth, B P; Inman, R D; Danoy, P; Rahman, P; Stone, M A; Corr, M; Gensler, Lianne S; Gladman, D; Morgan, A; Marzo-Ortega, H; Ward, M M; Learch, T J; Reveille, J D; Brown, M A; Weisman, M H

    2015-07-01

    To identify genetic associations with severity of radiographic damage in ankylosing spondylitis (AS). We studied 1537 AS cases of European descent; all fulfilled the modified New York Criteria. Radiographic severity was assessed from digitised lateral radiographs of the cervical and lumbar spine using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). A two-phase genotyping design was used. In phase 1, 498 single nucleotide polymorphisms (SNPs) were genotyped in 688 cases; these were selected to capture >90% of the common haplotypic variation in the exons, exon-intron boundaries, and 5 kb flanking DNA in the 5' and 3' UTR of 74 genes involved in anabolic or catabolic bone pathways. In phase 2, 15 SNPs exhibiting ppathways in the osteoproliferative changes in AS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis

    Science.gov (United States)

    Tsui, Florence WL; Tsui, Hing Wo; Akram, Ali; Haroon, Nigil; Inman, Robert D

    2014-01-01

    Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage–bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD), fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS). It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS. PMID:24971029

  12. MAGNETIC RESONANCE IMAGING DIAGNOSIS OF INFLAMMATORY CHANGES OF THE AXIAL SKELETON IN ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    A. V. Smirnov

    2016-01-01

    Full Text Available As of now, magnetic resonance imaging (MRI ranks high in the early diagnosis of inflammatory changes in the musculoskeletal system. The uniqueness of MRI is that this diagnostic technique can detect the signs of active and inactive inflammation at the pre-radiological stage of the disease, i.e. before the onset of radiological symptoms of sacroiliitis and the formation of spinal syndesmophytes. At the same time there is evidence that there is a temporary association between active inflammation and the development of radiological changes in the joints.The detection of bone marrow edema in the subchondral portions of bone tissue is of great importance not only for diagnosing the disease and verifying inflammatory activity, but also for predicting the development of chronic arthritis, choosing a treatment option, and evaluating the efficiency of performed therapy.Based on their long-term experience, the authors provided explanations of the MRI pattern of active and inactive chronic sacroiliitis and spondylitis, which can considerably facilitate the early diagnosis of injury to the sacroiliac joints and vertebral column in patients with ankylosing spondylitis.

  13. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Masiero, Stefano; Poli, Patrizia; Bonaldo, Lara; Pigatto, Maurizia; Ramonda, Roberta; Lubrano, Ennio; Punzi, Leonardo; Maffulli, Nicola

    2014-06-01

    To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. Patients' homes. A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis. © The Author(s) 2013.

  14. Cancer mortality among patients with ankylosing spondylitis not given X-ray therapy

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.; Radford, E.P.

    1977-01-01

    The causes of death among 1021 patients with ankylosing spondylitis not treated with X-rays (the 'untreated' group) have been compared with (i) those expected in a population of similar age and sex subject to the national mortality rates for England and Wales over the same period and (ii) those observed in 14000 similar patients given deep X-ray therapy (the 'treated' group). The untreated patients with spondylitis were enrolled in Great Britain and Northern Ireland during the period 1935 to 57 and have been followed up to 1965. The men in both treatment groups appear to have had spondylitis of similar severity, as judged from their death rates from various causes, but the 'untreated' women appear to have had a milder form of the disease. The number of deaths from cancer in the untreated group was not greater than that expected from national death rates, and there was no death from leukaemia. In the treated series the number of deaths from leukaemia was significantly raised (P = 0.03) when compared with that among patients not treated with X-rays. Deaths from cancers of sites classified as 'heavily irradiated' were also higher in the treated group though this difference was not statistically significant. Thus the excess leukaemia mortality in the treated patients, and possibly also the excess from other cancers, is likely to be associated with the X-ray treatment rather than with the disease process itself. Death rates from causes other than cancer were similar among treated and untreated patients. It is likely that modern X-ray treatment with smaller fields and lower dosage will carry a smaller risk of induced malignancy. This risk must be balanced against the possible therapeutic advantages of radiation treatment, the extent of which can be determined only by controlled trials. (author)

  15. Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Cho, Hyungpil; Kim, Taikon; Kim, Tae-Hwan; Lee, Seunghun; Lee, Kyu Hoon

    2013-10-01

    To investigate the relationships between spinal mobility, pulmonary function, structural change of the spine, pain, fatigue, and quality of life (QOL) in patients with ankylosing spondylitis (AS). Thirty-six patients with AS were recruited. Their spinal mobility was examined through seven physical tests: modified Schober test, lateral bending, chest expansion, occiput to wall, finger to ground, bimalleolar distance, and range of motion (ROM) of the spine. Pulmonary Function Test (PFT) was performed using a spirometer, and vertebral squaring was evaluated through the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). QOL, disease activity, functional capacity, and fatigue were evaluated by SF-36 Health Survey (SF-36), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Multidimensional Assessment of Fatigue (MAF) scale, respectively. Perceived physical condition and degree of pain were assessed using 10 cm visual analogue scale. Participants showed reduced spinal mobility, which was negatively correlated with mSASSS. PFT results showed reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and increased FEV1/FVC. Reduced FEV1 and FVC showed positive correlations with reduced spinal mobility and a negative relationship with mSASSS. Perceived physical condition and degree of pain were both significantly related to the SF-36, BASDAI, BASFI, and MAF scores. This study shows that both reduced spinal mobility and radiographic changes in the vertebral body may have a predictive value for pulmonary impairment in patients with AS. Likewise, pain and perceived physical condition may play an important role in the QOL, functional capacity, and fatigue level of these patients.

  16. Unilateral sternocostoclavicular hyperostosis in a patient with ankylosing spondylitis: A case report with color Doppler ultrasonogram findings

    International Nuclear Information System (INIS)

    Mondal, Sumantro; Sinha, Debanjali; Nag, Arijit; Ghosh, Alakendu

    2013-01-01

    Sternocostoclavicular hyperostosis is a chronic inflammatory disorder affecting the sternoclavicular joint and upper ribs. There is a strong association with seronegative spondyloarthropathy in which bilateral involvement is common. Ultrasonography and Color Doppler findings of this entity have not been described previously, to the best of our knowledge. We describe the findings in a patient of ankylosing spondylitis who was referred for unilateral sternoclavicular joint swelling

  17. Analysis of clinical indexes and RUNX3, TBKBP1, PPARGC1B polymorphisms in Chinese Han patients with ankylosing spondylitis.

    Science.gov (United States)

    Liu, Jun; Lian, Zijian; Xiao, Yu; Shi, Lewis L; Chai, Wei; Wang, Yan

    2015-01-01

    Ankylosing spondylitis (AS) is a genetically determined disease. Runt-related transcription factor 3 (RUNX3), tumor necrosis factor family member-associated NF-κB activator binding kinase 1 binding protein (TBKBP1), and peroxisome proliferator-activated receptor-gamma coactivator 1 beta (PPARGC1B) have recently been found to be associated with susceptibility to AS in patients of Western European descent. We hypothesize that these three genes may be related to clinical outcomes of Chinese Han AS patients. Blood samples were drawn from 396 HLA-B27-positive Chinese Han AS patients. Clinical indexes were scored for each patient, including the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), which measure patients' function of daily life and severity of AS. Twelve tagSNPs were selected from these three genes and genotyped. We analyzed the clinical indexes in different genotyped patients to investigate the relationship between severity of AS and different genotypes. The rs11249215 SNP in RUNX3 and the rs7379457 and rs32579 SNPs in PPARGC1B significantly affect the BASFI score in patients. The rs11249215, rs7551188, and rs1395621 SNPs in RUNX3 significantly affect the BASDAI scores. The two selected single nucleotide polymorphisms (SNPs) in TBKBP1 show no relationship with the clinical outcomes. None of the 12 SNPs is related to mSASSS. In conclusion, RUNX3 is related to both the severity of AS and the function of daily life. PPARGC1B is related to the function of daily life.

  18. Assessment of relation between neutrophil lympocyte, platelet lympocyte ratios and epicardial fat thickness in patients with ankylosing spondylitis.

    Science.gov (United States)

    Boyraz, Ismail; Onur Caglar, Sabri; Erdem, Fatma; Yazici, Mehmet; Yazici, Selma; Koc, Bunyamin; Gunduz, Ramazan; Karakoyun, Ahmet

    2016-02-01

    To investigate whether there is a relation between neutrophillymphocyte (N/L) and platelet- lymphocyte (P/L) ratios and epicardial adipose tissue (EAT) thickness in patients with ankylosing spondylitis (AS). Thirty patients diagnosed with ankylosing spondylitis and 25 healthy people (controls) were included in the study. Age, gender, body mass index (BMI), height, hemogram, sedimentation, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, CRP, hepatic and renal function tests, lipid profile of the all patients were recorded. Data related to duration of the disease, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) values of the cases in the patient group were obtained. A cardiologist measured EAT thickness by ECHO in both patient and control groups. In the patient group, mean BASDAI and BASFI scores were 2.48±2.21 and 1.5±2.07, respectively. Age, gender, BMI values did not show statistically significant difference between the patient and the control groups. N/L and P/L ratios did not change significantly in the patient group having higher EAT, BASFI values and taking anti-TNF compared to the control group. In patients with AS, EAT measurements, which are related to inflammatory response increase, can be used for monitoring of the risk of development of cardiac disease. We could not find the relation between EAT and N/L, P/L ratios in terms of evaluation of inflammatory response. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  19. Relationship of serum osteoprotegerin with arterial stiffness, preclinical atherosclerosis, and disease activity in patients with ankylosing spondylitis.

    Science.gov (United States)

    Serdaroğlu Beyazal, Münevver; Erdoğan, Turan; Türkyılmaz, Aysegül Kücükali; Devrimsel, Gül; Cüre, Medine Cumhur; Beyazal, Mehmet; Sahin, Ismail

    2016-09-01

    Patients with ankylosing spondylitis (AS) reportedly have a higher mortality and morbidity risk. Osteoprotegerin (OPG) was recently defined as an important cardiovascular (CV) marker in the general population. We aimed to assess the relationship of serum OPG levels with arterial stiffness, carotid intima media thickness (CIMT), and clinical and laboratory data in AS patients. We examined 60 AS patients without CV disease or risk factors and 50 healthy controls. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Serum OPG levels were measured with the enzyme-linked immunosorbent assay. Carotid-femoral pulse wave velocity (PWV) was used as an indicator of arterial stiffness, whereas CIMT (examined via carotid ultrasonography) was used to evaluate preclinical atherosclerosis. The mean serum OPG level, PWV, and CIMT were significantly higher in AS patients than in controls (106.7 ± 50.9 vs. 58.1 ± 12.7 pg/mL; 7.4 ± 1.8 vs. 6.2 ± 1.2 m/s; 0.72 ± 0.13 vs. 0.57 ± 0.07 mm, respectively; P < 0.001 for all). In AS patients, the serum OPG levels were not significantly correlated with PWV and CIMT but were significantly correlated with erthrocyte sedimentation rate, BASFI, and ASDAS. AS patients without CV disease or risk exhibited high OPG levels and increased PWV and CIMT values. Although OPG levels were not significantly correlated with PWV or CIMT, future long-term follow-up studies will help define the predictive value of OPG in these patients.

  20. Association of GSTM1, GSTT1, GSTP1-ILE105VAL and ACE I/D polymorphisms with ankylosing spondylitis.

    Science.gov (United States)

    İnal, Esra Erkol; Görükmez, Orhan; Eroğlu, Selma; Görükmez, Özlem; Solak, Özlem; Topak, Ali; Yakut, Tahsin

    2016-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin. The aim of this study is to clarify the relationships between susceptibility and severity of AS and GST-mu1 (GSTM1), GST-theta1 (GSTT1), GST-pi1 (GSTP1)-Ile105Val and angiotensin-converting enzyme (ACE) I/D polymorphisms in AS patients. One hundred thirty-eight AS patients and seventy-one healthy controls were enrolled in this study. Erythrocyte sedimentation rate and C-reactive protein (CRP) levels of the AS patients were recorded. The scores of the numeric rating scale (NRS) pain, the Bath Ankylosing Spondylitis Activity Index, the Bath Ankylosing Spondylitis Metrology Index and the Bath Ankylosing Spondylitis Functional Index were calculated. The genotypes distributions and allele frequencies of GSTM1, GSTT1, GSTP1-Ile105Val and ACE I/D polymorphisms were compared between patients and healthy controls. The Multiplex polymerase chain reaction (PCR) and the PCR-restriction fragment length polymorphism methods were used to detect the polymorphisms of ACE I/D, the GSTT1 and GSTM1 genes and the GSTP1-Ile105Val polymorphism, respectively. There were significantly higher levels of the GSTT1 null and the ACE II genotypes in AS patients compared to those in healthy controls (p = 0.002 and 0.005, respectively). We found significantly higher levels of CRP and the NRS pain scores in the patients with ACE ID or DD genotypes compared to those in the patients with ACE II genotypes (p = 0.005 and 0.035, respectively). The present results showed that genes involved in protection from oxidative stress and ACE gene may influence disease development and course in AS.

  1. Fertility potential in a man with ankylosing spondylitis as revealed by semen analysis by light, electron and fluorescence microscopy.

    Science.gov (United States)

    Chatzimeletiou, Katerina; Galanis, Nikiforos; Karagiannidis, Alexandros; Sioga, Antonia; Pados, George; Goulis, Dimitrios; Kalpatsanidis, Antonis; Tarlatzis, Basil C

    2018-01-01

    Ankylosing spondylitis affects 0.1%-0.5% of the adult population. The aim was to investigate the possible effects of both the disease and its treatment on semen quality by performing a highly detailed analysis in a man with ankylosing spondylitis, presenting for infertility. Sperm characteristics were evaluated by light microscopy, morphology by electron microscopy (transmission electron microscopy), DNA fragmentation by terminal deoxynucleotidyl transferase dUTP nick end labeling using fluorescence microscopy and chromosomal abnormalities by fluorescence in situ hybridisation using probes for chromosomes 13,15,16,18,21,22,X and Y. There was no evidence for an effect of either ankylosing spondylitis or its treatment with celecoxib and sulphasalazine on sperm quality as all parameters including concentration, motility, DNA fragmentation and aneuploidy incidence were within normal limits. Transmission electron microscopy, however, revealed a high incidence of head, neck and tail abnormalities, as well as the presence of immature sperm and phagocytes. Hysteroscopic removal of an endometrial polyp enabled the achievement of a spontaneous pregnancy and the delivery of a healthy boy.

  2. The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Saracoglu, Ismail; Kurt, Gamze; Okur, Eda Ozge; Afsar, Emrah; Seyyar, Gulce Kallem; Calik, Bilge Basakci; Taspinar, Ferruh

    2017-03-01

    The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO 2 , Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p  0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

  3. Immunogenicity, adalimumab levels and clinical response in ankylosing spondylitis patients during 24 weeks of follow-up.

    Science.gov (United States)

    Kneepkens, Eva L; Wei, James Cheng-Chung; Nurmohamed, Michael T; Yeo, Kai-Jieh; Chen, C Y; van der Horst-Bruinsma, Irene E; van der Kleij, Desiree; Rispens, Theo; Wolbink, Gertjan; Krieckaert, Charlotte L M

    2015-02-01

    Immunogenicity influences adalimumab levels and therefore clinical response in patients with rheumatic diseases. To study the relationship between clinical response, adalimumab levels and antidrug antibodies (ADAb) in ankylosing spondylitis (AS). Observational cohort study of 115 consecutive AS patients treated with adalimumab in the Netherlands (n=85) and Taiwan (n=30), monitored during 24 weeks. Adalimumab levels and ADAb titres were determined using an ELISA and an antigen binding test (ABT), respectively, designed by Sanquin Research, Amsterdam. Response to adalimumab treatment was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) response, and disease activity was measured using the Ankylosing Spondylitis Disease Activity Score using C-reactive protein (CRP) (ASDAS). At baseline, median BASDAI (IQR) was 6.4 (4.5-7.6) and mean ASDAS (SD) was 3.5 (1.0). After 24 weeks, 49 (42.6%) patients were BASDAI50 responders and mean ASDAS (SD) for responders was 1.5 (1.0) vs 2.6 (1.0) for non-responders (p100 AU/mL). In these patients, CRP and erythrocyte sedimentation rate remained elevated during treatment. Adalimumab levels are related to clinical response in AS patients measured with ASDAS and are influenced by ADAb detectable with an ABT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis.

    Science.gov (United States)

    Kisacik, Pinar; Unal, Edibe; Akman, Umit; Yapali, Gokmen; Karabulut, Erdem; Akdogan, Ali

    2016-02-01

    The purpose of this study is to investigate the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis (AS). The BATH Indexes, Dougados Functional Index (DFI), Health Assessment Questionnaire in Spondyloarthopathies (HAQ-S), Ankylosing Spondylitis Quality of Life (ASQoL) and Beck Depression Inventory (BDI) were used to evaluate twenty-four female AS patients. ESR, CRP, TNF-α and IL-6 were also analyzed. All patients were assessed at baseline and with 3 weeks intervals till 12 week. A multidimensional exercise program was applied for three times a week. There were significant differences in Bath Ankylosing Spondylitis Global Index (BAS-G) and Disease Activity Index (BASDAI), HAQ-S, ASQoL and BDI scores (p < 0.05). The level of the ESR, CRP and IL-6 fluctuated slightly. There was only significant difference at 3 and 12 weeks as compared to baseline levels in TNF-α values (p = 0.048, p < 0.001). We concluded that multidimensional exercise program should be taken into consideration for AS patients due to its positive effects on symptoms and antiinflammatory effects. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor alpha inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Hermann, Kay-Geert A

    2010-01-01

    To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).......To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA)....

  6. Combined Fascia Iliaca and Sciatic Nerve Block for Hip Surgery in the Presence of Severe Ankylosing Spondylitis: A Case-Based Literature Review.

    Science.gov (United States)

    Chen, Lingmin; Liu, Jin; Yang, Jing; Zhang, Yanzi; Liu, Yue

    2016-01-01

    Selecting an appropriate anesthetic technique for patients with ankylosing spondylitis undergoing hip surgery is challenging because of a potentially difficult airway, the risk of cardiovascular and respiratory complications, and the technical difficulty of performing central neuraxial blocks in patients with ankylosing spondylitis. Our objective was to report a case in which combination neural blockade was used successfully in an elderly patient with ankylosing spondylitis undergoing hip fracture surgery. In addition, a literature review of the anesthetic techniques reported for these patients was conducted. A 70-year-old man with severe ankylosing spondylitis and respiratory dysfunction was scheduled for a closed intertrochanteric fracture reduction and internal fixation. Combined fascia iliaca block and parasacral sciatic nerve block were used successfully for the surgery. Postoperative analgesia was accomplished by continuous fascia iliaca block. According to the literature review, general anesthesia is the most commonly performed anesthetic technique for patients with ankylosing spondylitis undergoing hip surgeries. Special intubation techniques and cautious airway management were very important for these patients. Although both general anesthesia and central neuraxial blockade pose considerable risks to the patients, this case report suggests that combined fascia iliaca block and sciatic nerve block might be a promising option.

  7. Kunxian capsules in the treatment of patients with ankylosing spondylitis: a randomized placebo-controlled clinical trial.

    Science.gov (United States)

    Li, Qiuxia; Li, Li; Bi, Liqi; Xiao, Changhong; Lin, Zhiming; Cao, Shuangyan; Liao, Zetao; Gu, Jieruo

    2016-07-22

    Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disease. Kunxian capsule, a Chinese patent medicine which has been used in the treatment of immunologic diseases for many years in China, has anti-inflammatory and immunoregulatory effects. This study investigates the efficacy and safety of Kunxian capsules in the treatment of AS. This was a randomized, double-blind, parallel control clinical trial involving 80 patients with AS who fulfilled the modified New York criteria (1984) and had active disease defined by a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥40 mm under background stable nonsteroidal anti-inflammatory drugs (NSAIDs) for more than 4 weeks. Patients were randomly divided into two groups, the Kunxian group and the placebo group, and Kunxian (0.6 g, three times per day) and the placebo were provided for 12 weeks. The primary endpoint was the Assessment of SpondyloArthritis international Society (ASAS) 20 response rate at week 12. The secondary endpoints were ASAS 40, BASDAI 50, the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and Ankylosing Spondylitis Disease Activity Score on the basis of C-reactive protein level (ASDAS-CRP) at weeks 2, 6, and 12. The primary endpoint of ASAS 20 at week 12 was achieved in 13 of 35 patients (37.1 %) among the Kunxian group, compared with 4 of 33 (12.1 %) in the placebo group (p < 0.05). Significant improvement (BASDAI 50) was also observed between the Kunxian group and the placebo group at week 6 (14 (40 %) and 5 (15.5 %), respectively, p < 0.05). At weeks 2, 6, and 12, the ASDAS-CRP level of the Kunxian group was significantly lower than that of the placebo group, especially at week 6 (p < 0.01). Kunxian obviously reduced CRP levels compared to placebo at weeks 2, 6, and 12 (p < 0.05). Compared with the placebo, Kunxian was associated with greater improvements in signs and symptoms of patients with AS

  8. Ankylosing Spondylitis

    Science.gov (United States)

    ... done carefully and increased gradually. Before beginning an exercise program, it’s important to speak with a doctor to decide on ... rehabilitation. A physical therapist, who provides stretching and exercise programs. Living With It These are important things you can do: See your doctor often. ...

  9. Serum from patients with ankylosing spondylitis can increase PPARD, fra-1, MMP7, OPG and RANKL expression in MG63 cells.

    Science.gov (United States)

    Hu, Zaiying; Lin, Dongfang; Qi, Jun; Qiu, Minli; Lv, Qing; Li, Qiuxia; Lin, Zhiming; Liao, Zetao; Pan, Yunfeng; Jin, Ou; Wu, Yuqiong; Gu, Jieruo

    2015-11-01

    To explore the effects of serum from patients with ankylosing spondylitis on the canonical Wnt/β-catenin pathway and to assess whether the serum has an osteogenic effect in MG63 cells. MG63 cells were cultured with serum from 45 ankylosing spondylitis patients, 30 healthy controls, or 45 rheumatoid arthritis patients. The relative PPARD, fra-1, MMP7, OPG and RANKL mRNA levels were measured using quantitative real-time polymerase chain reaction. Associations between gene expression and patient demographics and clinical assessments were then analyzed. MG63 cells treated with serum from ankylosing spondylitis patients had higher PPARD, fra-1, MMP7 and OPG gene expression than did cells treated with serum from controls or rheumatoid arthritis patients (all pankylosing spondylitis or rheumatoid arthritis than in those treated with serum from controls (both pankylosing spondylitis patients than in those treated with serum from controls (p0.05). Serum from ankylosing spondylitis patients increases PPARD, fra-1, MMP7, OPG and RANKL expression and the OPG/RANKL ratio in MG63 cells; these effects may be due to the stimulatory effect of the serum on the Wnt pathway.

  10. [Clinical-functional evolution of patients with ankylosing spondylitis following physio-kinetotheraphy].

    Science.gov (United States)

    Roşu, Mihaela Oana; Ancuţa, Codrina; Chirieac, Rodica

    2012-01-01

    Ankylosing spondylitis enigmatic from the etiologic point of view, appears with subjects who are still in school or involved in a productive activity. If detected in its early stages, under complex, constant and long-term treatment, patients have a good evolution. The objectives of the study are to describe the clinical and functional profile of patients with AS, sacroiliitis stage, and the evol ution of physical and functional parameters under traditional physio-kinetotherapy. This retrospective study was performed on 40 patients with ankylosing spondylitis (AS), who were hospitalized in the Clinic of Rheumatology Iaşi, during 2008-1010, who satisfied the amended New York criteria for this. Subjects underwent an initial evaluation (first admission) and another one at the end of the study (second admission), after approximately 6 months. The demographic characteristics, the clinical and functional elements of the study sample have indicated: the average age of 24.83 +/- 3.948, predominantly male (82.5%) and 62.5% were from rural areas. Most cases occurred at the age of 19-25 (57.5%), beginning at 18-25 (77.5%), with an average of 19.60 +/- 2.318. Following the radiological changes in the various stages of sacroiliitis, stage II prevailed (40%), then stage III (32.5%) and IV (15%). The evaluation of ASAS (Assessment of Spondylo Arthritis International Society) parameters and the respiratory system showed significant improvements of: BASDAI score with 31.53%, BASFI with 37.62%, BASMI with 20.66%, DIE % with 27.53 and of CV with 5.08% as well as a decrease in pain perception measured by VAS scale (p = 0.017). In the early stages of the disease, as far as the sample involved in the study is concerned, when the spine and vertebrae joints were not blocked by the evolution of the disease, corrective gymnastics and respiratory exercises, stretching and a good posture are very important, along with other therapies used to prevent axial ankylosis.

  11. Physical Activity in Ankylosing Spondylitis: evaluation and analysis of an eHealth tool.

    Science.gov (United States)

    Tyrrell, Jess Shelagh; Redshaw, Clare Helen

    2016-07-04

    Ankylosing spondylitis (AS) is a chronic inflammatory condition characterised by spinal arthritis and exercise is often recommended to reduce the symptoms and improve mobility. However, very little evidence exists for the value of exercise in AS. Firstly, this pilot study aimed to evaluate an eHealth tool, the AS Observer, specifically designed to monitor symptoms, quality of life and physical activity in AS, in terms of patient experience and suitability in generating data for epidemiological studies. Secondly, it also investigated the collected data to determine if physical activity benefited individuals with AS. The AS Observer was designed to enable weekly monitoring of AS symptoms and exercise using a web based platform. Participants with AS (n = 223) were recruited to use the AS observer. They provided baseline data and completed online weekly data entry for 12 weeks (e.g. Bath Ankylosing Spondylitis Activity Index (BASDAI), howRu, International Physical Activity Questionnaire (IPAQ)). Panel data analysis with fixed effects models investigated associations between variables. Activity type data and exit questionnaires were subjected to qualitative thematic analysis. In general, the AS Observer was well received and considered useful by participants, with 66% providing a positive response. The collected data suggested that IPAQ is inversely associated with total BASDAI, stiffness, tenderness and pain, but not fatigue. Stratified analysis demonstrated differential associations between BASDAI, IPAQ and howRU based on sex, HLA-B27 status and disease duration. Approximately half of the participants frequently did therapy and three-quarters undertook at least some vigorous activity ranging from formal exercise to recreation and (house) work. Despite some technical challenges, tool evaluation suggested that the AS Observer was a useful self-monitoring tool for participants. This pilot study demonstrated that increased exercise intensity and duration were associated

  12. Radiography of the spine and sacro-iliac joints in ankylosing spondylitis and psoriasis

    International Nuclear Information System (INIS)

    Dale, K.; Vinje, O.

    1985-01-01

    A grading system involving six stages of arthritis from grade O=normal joints to grade V=extensive bony ankylosis in the sacro-iliac joints and a scheme applicable for quantitative registration of the radiographic findings of the spine in ankylosing spondylitis (AS) are detailed. These radiographic grading systems were used in a study comprising 48 patients with psoriasis (group A), 19 patients with AS and psoriasis (group B), 103 patients with AS (group C) and 231 first-degree relatives of the patients belonging to groups B and C (group D). Radiographic abnormalities of the spine were found totally in 80 per cent of the patients belonging to groups B and C. In these groups sclerotic anterior borders of vertebrae (SABS) and/or straightened anterior surfaces of vertebrae were seen totally in 66 per cent. SABS were earlier findings than syndesmophyte formation which was found in 60 per cent of the patients belonging to groups B and C. Except for ankylosis of the apophyseal joints and ossified interspinous ligament most frequently found in the lower lumbar region in patients with duration of disease more than 20 years, all abnormalities of the spine were most frequent in the dorsolumbar junction. Grade V sacro-iliitis was associated with ankylosis of two or more segments of the spine. Such spinal changes were infrequently seen in patients with grade IV sacro-iliitis. This finding supports the previous notion that among patients fulfilling the criteria for AS, there is a group with a non-ankylosing disease. Thus two different subgroups of AS could be identified. Except for frequent unilateral sacro-iliitis and slight changes of the spine in group A no radiographic differences were found between the groups A, B and C. Sacro-iliitis was found in 22(9%) in group D, and 11 of those with sacro-iliitis had abnormalities of the spine compatible with AS. (orig.)

  13. Monitoring ankylosing spondylitis therapy by dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaspersic, Natasa [University Medical Centre, Department of Rheumatology, Ljubljana (Slovenia); Sersa, Igor [Jozef Stefan Institute, Ljubljana (Slovenia); Jevtic, Vladimir [Medical Faculty, Department of Radiology, Ljubljana (Slovenia); Tomsic, Matija; Praprotnik, Sonja [University Medical Centre, Department of Rheumatology, Ljubljana (Slovenia)

    2008-02-15

    The effects of different therapies on enthesitis/osteitis in active ankylosing spondylitis (AS) were evaluated by magnetic resonance imaging (MRI). The aim was to assess the role of quantitative MRI in the evaluation of AS treatment efficacy. Thirty patients with active spondylitis or bilateral sacroilitis were selected and followed up for 1 year. Ten of the patients were treated only with non-steroidal anti-inflammatory drugs, 10 patients additionally received at baseline an intravenous pulse of glucocorticoids and 10 patients were treated with regular infusions of infliximab. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, one selected inflamed lesion was followed from baseline through control visits quantitatively by diffusion-weighted imaging (DWI) measuring the apparent diffusion coefficient (ADC) and by dynamic contrast-enhanced imaging (DCEI) with evaluation of the enhancement factor (f{sub enh}) and enhancement gradient (g{sub enh}). Clinical and quantitative MRI parameters diminished significantly with regression of the inflammatory activity. The improvement in AS was most pronounced in patients treated with infliximab; after 12 months the ADC diminished from an average of 1.31 to 0.88 x 10{sup -3} mm{sup 2}/s, f{sub enh} from 1.85 to 0.60, and g{sub enh} from 3.09 to 1.40 %/s. Diffusion-weighted imaging and DCEI were shown to be effective in quantifying changes in inflammation in skeletal lesions during the treatment of AS, and could therefore be convenient for assessing treatment efficacy. To the best of our knowledge this is the first time DWI was used to evaluate the activity of skeletal inflammation in rheumatic diseases such as AS. (orig.)

  14. Mortality among patients with ankylosing spondylitis after a single treatment course with x-rays

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, R.; Smith, P.G.

    1985-01-01

    Court Brown and Doll identified over 14,000 patients with ankylosing spondylitis who had been treated with one or more courses of x-irradiation from 1935 to 1954 at one of 87 radiotherapy centers in Great Britain and Northern Ireland. The first reports from this study analyzed mortality among these patients from leukemia and other causes, particularly cancer, but these analyses included many patients who had been treated with x-rays for their spondylitis more than once. This complicated the interpretation of the late effects of the treatment on mortality, as it was not clear to what extent the subsequent treatments contributed to the excess of deaths that persisted for many years after the first treatment. Smith and Doll (1982) avoided this difficulty by examining the death rate from leukemia and other radiation-induced cancers at different times after a single course of treatment. A comparison of the mortality of this group with the mortality of Japanese atomic bomb survivors revealed good agreement between the two studies, thus increasing confidence in the belief that both studies are giving sensible estimates of the risk of cancer from high doses of radiation. The follow-up of those spondylitic patients who received a single course of treatment only has recently been extended until the end of 1982, that is, for an additional 13 years. A further 1406 patients are now known to have died, including an additional 335 deaths for which the certified cause is cancer. Detailed results of this further follow-up will be presented

  15. Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study.

    Science.gov (United States)

    Webers, Casper; Essers, Ivette; Ramiro, Sofia; Stolwijk, Carmen; Landewé, Robert; van der Heijde, Désirée; van den Bosch, Filip; Dougados, Maxime; van Tubergen, Astrid

    2016-03-01

    To investigate gender-attributable differences regarding clinical outcome [disease activity, physical function and quality of life (QoL)] and radiographic damage in patients with AS over time. Data from the Outcome in AS International Study were used. Disease activity was assessed by the BASDAI, ASDAS and CRP; physical function by BASFI; QoL by the Short Form-36, Ankylosing Spondylitis Quality of Life (ASQoL) score and European Quality Of Life scale; and radiographic damage by the modified Stoke AS Spine Score (mSASSS). Cross-sectional comparative analyses were done at baseline. Next, separate models were created to assess gender-attributable differences on each outcome measure over time using time-adjusted generalized estimating equations. A total of 216 patients [154 (72.3%) males, mean age 43.6 years (s.d. 12.7), symptom duration 20.5 years (s.d. 11.8), mean follow-up duration 8.3 years (s.d. 4.1)] were included. At baseline, male compared with female patients had lower self-reported disease activity (BASDAI 3.2 vs 3.9, P = 0.03) but more radiographic damage (mSASSS 13.8 vs 6.5, P = 0.02). No significant gender-attributable differences in other clinical parameters were found. In multivariable analysis, male gender was significantly associated with a better ASQoL (B = -1.18, 95% CI: -2.17, -0.20, P = 0.02), and in a separate model with a higher mSASSS over time (B = 8.24, 95% CI: 4.38, 12.09, P < 0.01). In this prospective cohort study, no gender-attributable differences in disease activity or physical function over time were found. However, radiographic damage was more severe in males. Furthermore, males had a better QoL over time. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Dongquan Shi

    2014-01-01

    Full Text Available Objective. Ankylosing spondylitis (AS, an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients’ quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT between AS and hip osteoarthritis. Methods. In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups. Results. The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P=0.89. The patients of AS group were much younger (P<0.0001 and thinner (P=0.018 compared with those of OA group. AS patients had higher ejection fraction (EF (P=0.016, higher platelet counts (P<0.0001, and lower hypertension rate (P=0.0004. The values of APTT, PT, and INR in AS patients were higher than those in OA patients (all P<0.0001. The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects. Conclusion. AS patients potentially had a lower incidence of DVT compared with OA patients.

  17. Application value of curved planar reconstruction in sacroiliac joint of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Wang Tuxing; Huan Xiao; Zhu Xiang; Fang Chun

    2008-01-01

    Objective: To determine the application value of curved planar reconstruction (CPR) of multislice spiral computed tomography(MSCT) in changes of sacroiliac joint of ankylosing spondylitis(AS). Methods: 33 patients with AS diagnosed clinically were chosen to take MSCT scanning of bilateral sacroiliac joints with the slice thick of 5mm and the slice interval of 5 mm. The primary images were transported to General Electric AW4.0 workstation, and the multiplanar reformatted sagittal images of sacrum were obtained by the reformat software, and further the coronary images of bilateral sacroiliac joints by CPR with the construction curves coincident with sacrums. Results: All coronary images of bilateral sacroiliac joints by CPR were excellent in density and space resolution, and showed complete sacroiliac joints and their changes clearly and directly. Of all 33 cases, 2 were graded as grade 0, 5 grade I, 11 grade II, 10 grade III, 5 glade IV, according to grading standard. Conclusion: The coronary images of sacroiliac joint by CPR are enough clear and eligible for clinical diagnosis, and, in combination with transversal images, are helpful to complete assessment about the grade and scope of changes of sacroiliac joint in AS patients. (authors)

  18. The Protective Effect of Chrysanthemum indicum Extract against Ankylosing Spondylitis in Mouse Models

    Science.gov (United States)

    2017-01-01

    In traditional Chinese and Korean homeopathic medicine, Chrysanthemum indicum Linné (Asteraceae) is a time-honored herb, prescribed for the resolution of symptoms associated with inflammatory and hypertensive conditions as well as those affecting the lungs and its associated structures. The goal of this work is to investigate the defensive role of Chrysanthemum indicum extract in fighting ankylosing spondylitis (AS) using mouse models, through which the manifestation and extent of the disease progression were measured with quantitative analysis of the intervertebral joints. Markers of inflammation as well as oxidative stress were also analysed. Western blot was used to quantify the levels of Nuclear Factor-κB (NF-κB) p65, Dickkopf-1 (DKK-1), and sclerostin (SOST). Consequently, the findings of this experiment demonstrated that AS in mice that were given Chrysanthemum indicum extract had lower level of TNF-α, IL-1β, and IL-6 (P Chrysanthemum indicum supplemented with diet contributed to a decrease in Nuclear Factor-κB (NF-κB) p65 protein expression (P Chrysanthemum indicum in AS is manifested through downregulating oxidative stress, inhibiting inflammatory mediators and NF-κB, and increasing DKK-1 and SOST levels. PMID:28261616

  19. Correction osteotomy of flexion deformity of cervical spine in ankylosing spondylitis--a case report.

    Science.gov (United States)

    Lin, S Y; Wu, H J; Chien, S H

    1990-08-01

    It is well known that severe flexion deformities of the spine may occur in patients suffering from ankylosing spondylitis. The prevention of these deformities by early recognition of the disease process should be the main aim of the medical profession in handling patients with specific spinal involvements. Yet, we still see all too often patients with advanced kyphotic deformities of the trunk who are very grossly disabled and thus present a major problem to definitive surgical correction of their deformities. Correction of rigid kyphosis by establishing a compensatory lordosis can be carried out in the lumbar or cervical area. Surgical intervention in the cervical region enables the chin to be lifted off the sternum, but great care has to be taken of the relatively bulky spinal cord, which practically fills the spinal canal. Excessive correction runs the risks of fatally damaging the nerves and vertebral vessels. Therefore, most centers perform correction osteotomies of the cervical spine progressively, with day-by-day adjustment of the external fixators. We present a case of cervical osteotomy in which, under local anesthesia and with the aid of S.S.E.P., cervical kyphosis was corrected by a one-stage procedure. The results and difficulties are described here-in.

  20. Quantitative Proteomic Analysis of Peripheral Blood Mononuclear Cells in Ankylosing Spondylitis by iTRAQ

    Science.gov (United States)

    Cai, Anji; Qi, Suwen; Su, Zhuowa; Shen, Huaqing; Yang, Yu; He, Liang

    2015-01-01

    Abstract This study was designed to identify and quantify the different proteins expression levels in ankylosing spondylitis (AS) and to explore the pathogenesis of AS. We performed isobaric tags for relative and absolute quantitation (iTRAQ) coupled with multiple chromatographic fractionation and tandem mass spectrometry to detect the proteins profiling in peripheral blood mononuclear cells (PBMCs) from AS patients and healthy controls. Mascot software and the International Protein Index and the Gene Ontology (GO) database were used to conduct the bioinformatics analysis. The differentially expressed proteins were validated by enzyme‐linked immunosorbent assay (ELISA). A total of 1,232 proteins were identified by iTRAQ, of which 183 showed differential expression and 18 differentially expressed proteins were acute phase reactants. Upon mapping of the differentially expressed proteins to GO database, we found four differentially expressed proteins involved in the biological process of cell killing, including up‐regulated cathepsin G (CTSG), neutrophil defensin3 (DEFA3), protein tyrosine phosphatase receptor type C (PTPRC), and down‐regulated peroxiredoxin‐1(PRDX1),which were consistent with the verified results of ELISA. Our proteomic analyses suggested that the proteins involved in the biological process of cell killing might play an important role in the pathogenesis of AS. PMID:25788137

  1. Non-pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

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    Abderrazak Hajjioui

    2014-01-01

    Full Text Available This cross-sectional study aimed to describe non-pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  2. What factors determine patients' preference for tumour necrosis factor inhibitors in ankylosing spondylitis?

    Science.gov (United States)

    Fajri, Dessy W; Brand, Caroline A; Dharmage, Shyamali C; Martin, Belinda J; Buchanan, Russell R C; Schachna, Lionel

    2009-05-01

    Tumour necrosis factor inhibitor (TNFi) therapy, either intravenous (IV) or subcutaneous (SQ), demonstrates similar efficacy in ankylosing spondylitis (AS). The objective of this study was to examine factors influencing patient preference of TNFi. Fifty-nine (79.7%) participants were male with mean age 43.9 years and disease duration of 22.0 years. Fifty-nine patients (79.7%) agreed with the statement 'My doctor gave me a choice and I made a decision based on my personal preference'. Patients commenced first on IV TNFi most commonly cited reduced frequency of injections (96.6%), administration by a trained professional (89.7%) and use of infusion time for leisure activities (86.2%). Patients commenced on SQ TNFi cited flexibility with timing of treatment (80%), shortened administration time (73.3%) and the convenience of home therapy (73.3%). Shared clinical decision-making between clinicians and patients may be desirable for AS patients commencing TNFi therapy.

  3. The role of balance between inhibitory and activating KIRs in determining susceptibility to Ankylosing Spondylitis

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    farhad Shahsavar

    2012-09-01

    Full Text Available Background : Ankylosing spondylitis (AS represents a progressive and debilitating disease that affects approximately 0.9% worldwide. So far the precise mechanisms underlying the initiation and progression of AS is still unclear. Linkage between HLA-B27 and AS remains the strongest association between a human leukocyte antigen (HLA class I molecule and disease. Despite intensive research, the pathogenic role of this gene and its product has not yet been resolved. Non-HLA-B27 genes exist that also seem to be involved in disease etiology. The killer immunoglobulin-like receptor (KIR gene cluster is located on chromosome 19q13.4 in the leukocyte receptor complex. The KIR genes encode a group of proteins that are expressed on natural killer (NK cells and in some T cells. KIR proteins act as receptors that recognize HLA class I molecules and are directly involved in the activation and inhibition of NK cells. KIRs and their HLA class I ligands contribute to the pathogenesis of diverse kinds of autoimmune diseases. The genetic imbalance of inhibitory and activating KIRs may be the key factor, which influences the pathogenesis of AS. However, the role of balance between inhibitory and activating KIRs in determining susceptibility to AS a topic of debatable. This review summarizes the major features of these genes and discusses how they may be involved in AS pathogenesis.

  4. The diagnostic value of sacroiliac CT for detecting early changes of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Park, Ju Hyun; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook

    2007-01-01

    We wanted to evaluate the diagnostic value of the various findings on sacroiliac CT for detecting the early changes of ankylosing spondylitis (AS). Between April 2005 and March 2006, 51 sacroiliac CT images with the clinical suspicion of AS, but no definite evidence of AS on the plain radiograph only, were retrospectively reviewed. Finally, 36 patients (mean age: 28.6 years; 34 males and 2 females), who were clinically diagnosed as AS (AS group, n = 26) or they had no evidence of AS (non-AS group, n = 10), were evaluated. Two musculoskeletal radiologists analyzed the presence of marginal irregularity, bony erosion and subchondral sclerosis. A statistical analysis was performed to evaluate the incidence, sensitivity and specificity of each finding. Marginal irregularity was seen in 21 of 26 AS subjects, and in 8 of 10 non-AS subjects. Bony erosion was only seen in 13 of 26 AS subjects. Subchondral sclerosis was observed in 19 of 26 AS subjects and in 8 of 10 non-AS subjects. The sensitivity/specificity for each findings were 72.4%/28.6%, 100%/43.5% and 70.4%/22.2%, respectively. Except for bony erosions, these results showed no statistical significance (ρ = .006). Bony erosion on CT is a very sensitive finding for the early changes of AS, whereas marginal irregularity or subchondral sclerosis is not so helpful in differentiating AS from non-AS. Attention to these results may further enhance the accurate diagnosis of the early changes in AS

  5. Common Mediterranean Fever (MEFV Gene Mutations Associated with Ankylosing Spondylitis in Turkish Population

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    Serbulent Yigit

    2012-01-01

    Full Text Available Ankylosing spondylitis (AS is a common inflammatory rheumatic disease. Mediterranean fever (MEFV gene, which has already been identified as being responsible for familial Mediterranean fever (FMF, is also a suspicious gene for AS because of the clinical association of these two diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations (M694V, M680I, V726A, E148Q and P369S in a cohort of Turkish patients with AS. Genomic DNAs of 103 AS patients and 120 controls were isolated and genotyped using polymerase chain reaction (PCR and restriction fragment length polymorphism (RFLP methods. There was a statistically significant difference of the MEFV gene mutation carrier rates between AS patients and healthy controls (p = 0.004, OR: 2.5, 95% CI: 1.32–4.76. This association was also observed in allele frequencies (p = 0.005, OR: 2.3, 95% CI: 1.27–4.2. A relatively higher frequency was observed for M694V mutation in AS patients than controls (10.7% versus 4.2% , p = 0.060. There were no significant differences between MEFV mutation carriers and non-carriers with respect to the clinical and demographic characteristics. The results of this study suggest that MEFV gene mutations are positively associated with a predisposition to develop AS.

  6. Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis

    Science.gov (United States)

    2015-01-01

    With the growing awareness of the impact of chronic back pain and axial spondyloarthritis and recent breakthroughs in genetics and the development of novel treatments which may impact best on early disease, the need for markers that can facilitate early diagnosis and profiling those individuals at the highest risk for a bad outcome has never been greater. The genetic basis of ankylosing spondylitis has been considerably advanced, and HLA-B27 testing has a role in the diagnosis. Knowledge is still incomplete of the rest of the genetic contribution to disease susceptibility, and it is likely premature to use extensive genetic testing (other than HLA-B27) for diagnosis. Serum and plasma biomarkers have been examined extensively in assessing disease activity, treatment response, and as predictors or radiographic severity. For assessing disease activity, other than C-reactive protein and erythrocyte sedimentation rate, the most work has been in examining cytokines (particularly interleukin 17 and 23), matrix metalloproteinase (MMP) markers (particularly MMP3). For assessing those at the highest risk for radiographic progression, biomarkers of bony metabolism, cartilage and connective tissue degradation products, and adipokines have been most extensively assessed. The problem is that no individual biomarkers has been reproducibly shown to assess disease activity or predict outcome, and this area still remains an unmet need, of relevance to industry stakeholders, to regulatory bodies, to the healthcare system, to academic investigators, and finally to patients and providers. PMID:25939520

  7. rs657075 (CSF2) Is Associated with the Disease Phenotype (BAS-G) of Ankylosing Spondylitis

    Science.gov (United States)

    Chen, Wei-Chiao; Wei, James Cheng-Chung; Lu, Hsing-Fang; Wong, Henry Sung-Ching; Woon, Peng Yeong; Hsu, Yu-Wen; Huang, Jin-Ding; Chang, Wei-Chiao

    2017-01-01

    Ankylosing spondylitis (AS) is a systemic autoimmune disease mainly affecting the lumbar spine and sacroiliac joints, and exhibits peripheral inflammatory arthropathy. More than 25 loci have been identified as associated with AS. Because both AS and rheumatoid arthritis (RA) are autoimmune diseases that may share some common genetic factors, we therefore examined if the newly identified RA genetic polymorphisms were associated with AS in a Taiwanese population. In this study, we enrolled 475 AS patients and 11,301 healthy subjects from a Taiwanese biobank as controls. Although none of single-nucleotide polymorphisms (SNPs) were associated with the susceptibility to AS, the AS disease index Bath AS Global (BAS-G) clinical phenotype was observed as significantly correlated to the AA genotype of rs657075 (CSF2). The significance remains after gender/age/disease duration adjustment and after group categorization by human leukocyte antigen-B 27 (HLA-B27) genotype. We further investigated the possible functions of rs657075 through bioinformatics approaches. Results revealed that polymorphism of rs657075 is able to influence the expression of acyl-CoA synthetase long-chain family member 6 (ACSL6). In conclusion, our study indicated that rs657075 (CSF2) is strongly associated with the AS disease index Bath AS Global (BAS-G) clinical phenotype. PMID:28054948

  8. Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes

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    Yikun Mou

    2015-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS with disease onset before 16 years of age differs from adult-onset AS (AAS in many respects. Objective. To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS. Methods. 145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded. Results. Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B*2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B*2705 than those with B27-negative. The onset age of HLA-B*2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B*2704 were significantly higher than those in AAS with HLA-B*2704. Conclusion. JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.

  9. Intravitreal Triamcinolone Acetonide for Macular Edema in HLA-B27 Negative Ankylosing Spondylitis

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    M.M. Moschos

    2010-12-01

    Full Text Available We report a case of a human leukocyte antigen B27 (HLA-B27-negative patient with cystoid macular edema (CME and ankylosing spondylitis (AS after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA and ocular coherent tomography (OCT showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.

  10. Associations between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis and improvements with etanercept therapy.

    Science.gov (United States)

    Hammoudeh, Mohammed; Zack, Debra J; Li, Wenzhi; Stewart, V Michelle; Koenig, Andrew S

    2013-08-01

    To investigate the relationships between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis (AS) and the impact of 12 weeks' etanercept treatment versus sulfasalazine or placebo. Data were combined from four clinical trials for patients with AS who received at least one dose of etanercept, sulfasalazine or placebo and had at least one postbaseline assessment value. Linear regression was performed (controlling for site, protocol and demographics), to explore the relationship between inflammation (C-reactive protein [CRP]), nocturnal back pain (visual analog scale [VAS] 0-100 mm) and fatigue (VAS 0-100 mm Bath AS Disease Activity Index fatigue item). Out of 1283 patients (etanercept, n = 867; sulfasalazine, n = 187; placebo, n = 229), improvement in nocturnal back pain was a significant predictor of improvement in fatigue. Significant correlations were found between nocturnal back pain and fatigue, but not CRP levels. Etanercept provided significantly greater pain/fatigue improvement than sulfasalazine or placebo. Improvements in nocturnal back pain and fatigue had weak relationships with improvement in inflammation (CRP level). AS patients treated with etanercept demonstrated superior improvement in nocturnal back pain and fatigue versus sulfasalazine or placebo. Decrease in nocturnal back pain can improve fatigue. Assessing treatment response using CRP levels alone may be misleading without also examining patient-reported outcomes such as back pain and fatigue.

  11. The Nonradiographic Axial Spondyloarthritis, the Radiographic Axial Spondyloarthritis, and Ankylosing Spondylitis: The Tangled Skein of Rheumatology

    Science.gov (United States)

    Rawat, Roopa; Agrawal, Neha; Patil, Nilesh S.

    2017-01-01

    Since 1984 the diagnosis of ankylosing spondylitis (AS) has been based upon the modified New York (mNY) criteria with mandatory presence of radiographic sacroiliitis, without which the diagnosis is not tenable. However, it may take years or decades for radiographic sacroiliitis to develop delaying the diagnosis for long periods. It did not matter in the past because no effective treatment was available. However, with the availability of a highly effective treatment, namely, tumour necrosis factor-α inhibitors (TNFi), the issue of early diagnosis of AS acquired an urgency. The Assessment of SpondyloArthritis International Society (ASAS) classification criteria published in 2009 was a significant step towards this goal. These criteria described an early stage of the disease where sacroiliitis was demonstrable only on MRI but not on standard radiograph. Therefore, this stage of the disease was labelled “nonradiographic axial SpA” (nr-axSpA). But questions have been raised if, in search of early diagnosis, specificity was compromised. The Federal Drug Administration (FDA, USA) withheld approval for the use of TNFi in patients with nr-axSpA because of issues related to the specificity of these criteria. This review attempts to clarify some of these aspects of the nr-axSpA-AS relationship and also tries to answer the question whether ASAS classifiable radiographic axial spondyloarthritis (r-axSpA) term can be interchangeably used with the term AS. PMID:28555158

  12. Long-term safety and efficacy of infliximab for the treatment of ankylosing spondylitis

    Science.gov (United States)

    Elalouf, Ofir; Elkayam, Ori

    2015-01-01

    The introduction of TNFα blockers has revolutionized the treatment of ankylosing spondylitis (AS). The objectives of this review are to summarize the most up-to-date data on long-term efficacy and safety of infliximab in AS, with special emphasis on axial and extra-articular disease, predictors of response, and radiological response. The general consensus of this literature search was that infliximab is highly efficacious in the treatment of AS. Most studies have demonstrated good clinical outcomes after 3 years of treatment, as measured by Spondyloarthritis International Society response in 75%–85% of treated AS patients. Reports on the long-term effects of infliximab as documented by radiological findings, however, are controversial. While some studies reported a similar progression rate as that of the historical OASIS cohort, others have suggested that infliximab may halt new bone formation. The long-term safety of infliximab is well known, mainly from data stored in national registries. While it has been suggested that side effects of infliximab may be fewer in AS compared to rheumatoid arthritis, data on this issue are sparse, with most of the information on long-term safety pertaining to rheumatoid arthritis. It can however be concluded that the long-term efficacy of infliximab is apparently maintained in AS and with an acceptable safety profile. PMID:26640380

  13. Genetic dissection of acute anterior uveitis reveals similarities and differences in associations observed with ankylosing spondylitis.

    Science.gov (United States)

    Robinson, Philip C; Claushuis, Theodora A M; Cortes, Adrian; Martin, Tammy M; Evans, David M; Leo, Paul; Mukhopadhyay, Pamela; Bradbury, Linda A; Cremin, Katie; Harris, Jessica; Maksymowych, Walter P; Inman, Robert D; Rahman, Proton; Haroon, Nigil; Gensler, Lianne; Powell, Joseph E; van der Horst-Bruinsma, Irene E; Hewitt, Alex W; Craig, Jamie E; Lim, Lyndell L; Wakefield, Denis; McCluskey, Peter; Voigt, Valentina; Fleming, Peter; Degli-Esposti, Mariapia; Pointon, Jennifer J; Weisman, Michael H; Wordsworth, B Paul; Reveille, John D; Rosenbaum, James T; Brown, Matthew A

    2015-01-01

    To use high-density genotyping to investigate the genetic associations of acute anterior uveitis (AAU) in patients with and those without ankylosing spondylitis (AS). We genotyped samples from 1,711 patients with AAU (either primary or combined with AS), 2,339 AS patients without AAU, and 10,000 control subjects on an Illumina Immunochip Infinium microarray. We also used data for AS patients from previous genome-wide association studies to investigate the AS risk locus ANTXR2 for its putative effect in AAU. ANTXR2 expression in mouse eyes was investigated by real-time quantitative reverse transcription-polymerase chain reaction. A comparison between all patients with AAU and healthy control subjects showed strong association over HLA-B, corresponding to the HLA-B27 tag single-nucleotide polymorphism rs116488202. The association of 3 non-major histocompatibility complex loci, IL23R, the intergenic region 2p15, and ERAP1, reached genome-wide significance (P pathways. Copyright © 2015 by the American College of Rheumatology.

  14. Immunogenetic study in Chinese population with ankylosing spondylitis: are there specific genes recently disclosed?

    Science.gov (United States)

    Zhai, Jiayu; Rong, Ju; Li, Qiuxia; Gu, Jieruo

    2013-01-01

    Ankylosing spondylitis (AS) is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing list of well-validated genes or genetic regions associated with AS susceptibility. So far, several genes or genetic regions have now been reported in the Han ethnic Chinese population, containing the major histocompatibility complex (MHC), ERAP1, IL-23R, 12q12, 2p15, 5q14.3, and so on. Different hypotheses for disease mechanisms have been investigated on the basis of the functional studies of these genes or genetic regions. This paper tries to summarize the association of several candidate genes with risk for AS in the Han ethnic Chinese population and aims to identify the novel inflammatory pathways and provide potential strategies for better therapies.

  15. Ankylosing spondylitis monocytes show upregulation of proteins involved in inflammation and the ubiquitin proteasome pathway.

    Science.gov (United States)

    Wright, C; Edelmann, M; diGleria, K; Kollnberger, S; Kramer, H; McGowan, S; McHugh, K; Taylor, S; Kessler, B; Bowness, P

    2009-10-01

    To determine if peripheral blood monocytes from patients with ankylosing spondylitis (AS) differed in protein expression compared to rheumatoid arthritis (RA) and healthy controls (HC). Monocyte protein expression was characterised by 2D gel electrophoresis and by label-free quantitative expression profiling, using nano-ultra performance liquid chromatography coupled to electrospray ionisation mass spectrometry (ESI-MS(E), where (E) refers to low/high collision energy switching). Data sets were analysed using the Waters expression profiling system and Ingenuity pathway analysis (IPA). Two-dimensional gel electrophoresis showed upregulation of proteasomal constituents in AS monocytes, including the beta subunit of proteasome activator (PA)28. Monocyte expression profiling and IPA showed that significant changes in protein expression within the ubiquitin proteasome pathway (UPP) were restricted to AS monocytes. Statistically significant differences in protein expression involving the leucocyte extravasation, vascular endothelial growth factor, integrin and Toll-like receptor signalling pathways were seen in AS and RA monocytes compared to healthy controls. No evidence of upregulation of proteins involved in the endoplasmic reticulum stress response pathway was found in either AS or RA monocytes. Finally, the PA28 complex was shown to increase the generation of human leucocyte antigen (HLA)-B27 antigenic epitopes by the proteasome in vitro. Our proteomic analyses support the hypothesis that monocytes play an important role in the pathogenesis of AS and RA, and further suggest a specific role in AS for the UPP. Quantitative proteomic expression profiling constitutes a powerful new tool for rheumatology research.

  16. A sub-pathway based method to identify candidate agents for Ankylosing Spondylitis.

    Science.gov (United States)

    Chen, Kai; Zhao, Yingchuan; Chen, Yu; Wang, Chuanfeng; Chen, Ziqiang; Bai, Yushu; Zhu, Xiaodong; Li, Ming

    2012-10-22

    The need for new therapeutics for Ankylosing Spondylitis (AS) is highlighted by the general lack of efficacy for most agents currently available for this disease. Many recent studies have detailed molecular pathways in AS, and several molecule-targeting agents are undergoing evaluation. We aimed to explore the mechanism of AS and identify biologically active small molecules capable of targeting the sub-pathways which were disregulated in the development of AS. By using the GSE25101 microarray data accessible from the Gene Expression Omnibus database, we first identified the differentially expressed genes (DEGs) between AS samples and healthy controls, followed by the sub-pathway enrichment analysis of the DEGs. In addition, we propose the use of an approach based on targeting sub-pathways to identify potential agents for AS. A total of 3,280 genes were identified as being significantly different between patients and controls with p-values pathway and some immune-associated pathways may be involved in the development of AS. Besides, our bioinformatics analysis revealed a total of 15 small molecules which may play a role in perturbing the development of AS. Our study proposes the use of an approach based on targeting sub-pathways to identify potential agents for AS. Candidate agents identified by our approach may provide the groundwork for a combination therapy approach for AS.

  17. ERAP1 structure, function and pathogenetic role in ankylosing spondylitis and other MHC-associated diseases.

    Science.gov (United States)

    Alvarez-Navarro, Carlos; López de Castro, José A

    2014-01-01

    The endoplasmic reticulum aminopeptidase 1 (ERAP1) is a multifunctional enzyme involved in the final processing of Major Histocompatibility Complex class I (MHC-I) ligands and with a significant influence in the stability and immunological properties of MHC-I proteins. ERAP1 polymorphism is associated with ankylosing spondylitis among HLA-B27-positive individuals and the altered enzymatic activity of natural variants has significant effects on the HLA-B27 peptidome, suggesting a critical pathogenetic role of peptides in this disease. Likewise, the association of ERAP1 with other MHC-I associated disorders and its epistasis with their susceptibility MHC alleles point out to a general role of the MHC-I peptidome in these diseases. The functional interaction between ERAP1 and HLA-B27 or other MHC-I molecules may be related to the processing of specific epitopes, or to a more general peptide-dependent influence on other biological features of the MHC-I proteins. In addition, from a consideration of the reported functions of ERAP1, including its involvement in angiogenesis and macrophage activation, a more complex and multi-level influence in the inflammatory and immune pathways operating in these diseases cannot be ruled out. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. A Sub-Pathway Based Method to Identify Candidate Agents for Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Ming Li

    2012-10-01

    Full Text Available The need for new therapeutics for Ankylosing Spondylitis (AS is highlighted by the general lack of efficacy for most agents currently available for this disease. Many recent studies have detailed molecular pathways in AS, and several molecule-targeting agents are undergoing evaluation. We aimed to explore the mechanism of AS and identify biologically active small molecules capable of targeting the sub-pathways which were disregulated in the development of AS. By using the GSE25101 microarray data accessible from the Gene Expression Omnibus database, we first identified the differentially expressed genes (DEGs between AS samples and healthy controls, followed by the sub-pathway enrichment analysis of the DEGs. In addition, we propose the use of an approach based on targeting sub-pathways to identify potential agents for AS. A total of 3,280 genes were identified as being significantly different between patients and controls with p-values < 0.1. Our study showed that neurotrophic signaling pathway and some immune-associated pathways may be involved in the development of AS. Besides, our bioinformatics analysis revealed a total of 15 small molecules which may play a role in perturbing the development of AS. Our study proposes the use of an approach based on targeting sub-pathways to identify potential agents for AS. Candidate agents identified by our approach may provide the groundwork for a combination therapy approach for AS.

  19. Effect of metformin on ossification and inflammation of fibroblasts in ankylosing spondylitis: An in vitro study.

    Science.gov (United States)

    Qin, Xiong; Jiang, Tongmeng; Liu, Sijia; Tan, Jiachang; Wu, Huayu; Zheng, Li; Zhao, Jinmin

    2018-01-01

    Ankylosing spondylitis (AS) is an autoimmune disease characterized by fibroblasts ossification. However, effective drug therapy for AS is lacking. As an antidiabetic drug, metformin has demonstrated an antiosteogenic effect on osteoblasts in vitro. And it is also a kind of specific agonists for adenosine 5'-monophosphate activated protein kinase (AMPK), which is blocked in the process of AS. Given the role in antiosteogenesis and AMPK activating, metformin was investigated of its effect on fibroblasts harvested from capsular ligament of patients with femoral neck fracture and AS. Osteogenic specific makers (Alp, Bglap, Runx2, Bmp2, and Col1) in fibroblasts administered with metformin (20 μg/mL) were detected by ALP staining, alizarin red staining, qPCR, and Western blotting after 7 and 14 days of culture. Inflammation genes (il1-β and il6) and pathway (Pi3k, Akt, and Ampk) associated markers were also evaluated. Our results showed that osteogenic specific markers were greatly downregulated and ossification was effectively inhibited in AS fibroblasts after addition of metformin. Levels of inflammation markers were also decreased by metformin. Thus, metformin exerts potent effect on suppression of ossification and inflammation in AS fibroblasts via the activation of Pi3k/Akt and AMPK pathways, which may be developed as a potential agent for treatment of AS. © 2017 Wiley Periodicals, Inc.

  20. Genome wide gene expression analysis of macrophages from ankylosing spondylitis patients under interferon-gamma treatment.

    Science.gov (United States)

    Ma, H; Ye, B; Wei, Q; Zhu, X D

    2013-10-01

    Ankylosing spondylitis (AS) is a common and highly heritable arthropathy, but the pathogenesis of which is poorly understood, especially the mechanisms in genomics. Our work is aim to study the mechanisms of AS in genomics. we used microarray dataset GSE11886 from Gene Expression Omnibus (GEO). According to our GSEA approach on the microarray datasets related to AS, we have identified the significantly associated pathways with this disease respectively dependent and independent to the factor of interferon-gamma (IFN-γ). As a result, we have identified 9 most significant pathways in the comparison of AS patients to control under none treatment, including 5 up-regulated and 4 down-regulated pathways in IFN-gamma-independent study. On the contrary, 11 most significantly up-regulated pathways such as renin-angiotensin system, O-Glycan biosynthesis and gap junction in the comparison of AS patients to control under the treatment of IFN in IFN-gamma-dependent study. These may be helpful for understanding the mechanisms of AS regulation under interferon-gamma treatment in genome wide.

  1. Integrated GC-MS and LC-MS plasma metabonomics analysis of ankylosing spondylitis.

    Science.gov (United States)

    Gao, Peng; Lu, Chen; Zhang, Fengxia; Sang, Ping; Yang, Dawei; Li, Xiang; Kong, Hongwei; Yin, Peiyuan; Tian, Jing; Lu, Xin; Lu, Aiping; Xu, Guowang

    2008-09-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis that predominantly affects the axial skeleton in adolescent patients. The natural history of the disease remains poorly characterized. In this study, we combined GC-MS and LC-MS techniques to evaluate the major metabolic changes in the plasma of AS patients in view of metabonomics. Univariate and multivariate analysis were employed for altered metabolite comparison and pattern recognition. Application of supervised partial least-squares discrminant analysis to either GC-MS or LC-MS data allowed accurate discrimination of AS patients from normal controls, demonstrating its potential diagnostic utilization. In addition, AS patients presented elevated plasma concentrations of proline, glucose, phosphate, urea, glycerol, phenylalanine and homocysteine but reduced levels of phosphocholines, tryptophan and a bipeptide - phenylalanyl-phenylalanine. In the context of their involved metabolic pathways, the identified metabolites were discussed accordingly. This investigation primarily proved that integrated chromatography-mass spectrometry and integrated uni- and multi-variate statistical analysis facilitated metabonomics to be a more promising tool in disease research.

  2. Immunogenetic Study in Chinese Population with Ankylosing Spondylitis: Are There Specific Genes Recently Disclosed?

    Directory of Open Access Journals (Sweden)

    Jiayu Zhai

    2013-01-01

    Full Text Available Purpose. Ankylosing spondylitis (AS is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. Recent Findings. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing list of well-validated genes or genetic regions associated with AS susceptibility. So far, several genes or genetic regions have now been reported in the Han ethnic Chinese population, containing the major histocompatibility complex (MHC, ERAP1, IL-23R, 12q12, 2p15, 5q14.3, and so on. Different hypotheses for disease mechanisms have been investigated on the basis of the functional studies of these genes or genetic regions. Summary. This paper tries to summarize the association of several candidate genes with risk for AS in the Han ethnic Chinese population and aims to identify the novel inflammatory pathways and provide potential strategies for better therapies.

  3. Insights into the pathophysiology of ankylosing spondylitis: contributions from animal models.

    Science.gov (United States)

    Braem, Kirsten; Lories, Rik J

    2012-05-01

    The introduction of anti-tumor necrosis factor strategies has significantly changed the perspective and outcome of patients with ankylosing spondylitis and related spondyloarthritides. This breakthrough has also boosted further research efforts into the mechanisms of disease. As human tissue specimens of the spine and sacroiliac joints are very difficult to obtain and rarely allow mechanistic studies, most of the new concepts have emerged from different animal models of disease. In this review, we summarize insights into the role of HLA-B27 based on transgenic rat and mouse models, efforts into the identification of cell populations stimulating inflammation and molecular studies of pathological bone formation leading to ankylosis. Important progress has been made and novel hypotheses were put forward. These include the impact of HLA-B27 on endoplasmic reticulum stress and the unfolded protein response, the role of stromal cells in inflammation, the entheseal stress hypothesis and the identification of the bone morphogenetic protein and WNT signaling pathways as therapeutic targets for ankylosis. Copyright © 2011 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  4. Arterial stiffness is not increased in patients with short duration rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Dzieża-Grudnik, Anna; Sulicka, Joanna; Strach, Magdalena; Siga, Olga; Klimek, Ewa; Korkosz, Mariusz; Grodzicki, Tomasz

    2017-04-01

    Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.

  5. Mortality among patients with ankylosing spondylitis after a single treatment course with x-rays

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.

    1982-01-01

    Mortality was studied in 14,111 patients with ankylosing spondylitis given a single course of x-ray treatment during 1935-54. Mortality from all causes was 66% greater than that of the general population of England and Wales. The substantial excesses of deaths from non-neoplastic conditions appeared to be associated with the disease itself rather than its treatment. A nearly fivefold excess of deaths from leukaemia and a 62% excess of deaths from cancers of sites that would have been in the radiation fields (''heavily irradiated sites'') were likely to have been a direct consequence of radiation treatment. Excess death rate from leukaemia was greatest three to five years after treatment and close to zero after 18 years. Excess of cancers of heavily irradiated sites did not become apparent until nine or more years after irradiation continuing for a further 11 years. More than 20 years after irradiation the excess risk declined but the fall was not statistically significant. The number of cancers of sites not considered to be in the radiation beams was 20% greater than expected. This excess, although not statistically significant, may have been due to scattered radiation. The risk of a radiation-induced leukaemia or other cancer was related to age at treatment time. (author)

  6. The Link between Ankylosing Spondylitis, Crohn's Disease, Klebsiella, and Starch Consumption

    Science.gov (United States)

    Rashid, Taha; Wilson, Clyde; Ebringer, Alan

    2013-01-01

    Both ankylosing spondylitis (AS) and Crohn's disease (CD) are chronic and potentially disabling interrelated conditions, which have been included under the group of spondyloarthropathies. The results of a large number of studies support the idea that an enteropathic pathogen, Klebsiella pneumoniae, is the most likely triggering factor involved in the initiation and development of these diseases. Increased starch consumptions by genetically susceptible individuals such as those possessing HLA-B27 allelotypes could trigger the disease in both AS and CD by enhancing the growth and perpetuation of the Klebsiella microbes in the bowel. Exposure to increased levels of these microbes will lead to the production of elevated levels of anti-Klebsiella antibodies as well as autoantibodies against cross-reactive self-antigens with resultant pathological lesions in the bowel and joints. Hence, a decrease of starch-containing products in the daily dietary intake could have a beneficial therapeutic effect on the disease especially when used in conjunction with the currently available medical therapies in the treatment of patients with AS and CD. PMID:23781254

  7. Ankylosing Spondylitis: HLA-B*27-Positive Versus HLA-B*27-Negative Disease.

    Science.gov (United States)

    Akkoç, Nurullah; Yarkan, Handan; Kenar, Gökçe; Khan, Muhammad A

    2017-05-01

    We review our current knowledge about the clinical features of patients with ankylosing spondylitis (AS) who possess HLA-B*27 versus those who lack this gene. ERAP1 association is present only in HLA-B*27+ patients, but other genetic associations are similar between the two groups. A genetic study supports the existence of an HLA-B27-independent common link between gut inflammation and AS. It is unusual to observe familial occurrence of primary AS among families of northern European extraction that show no segregation of HLA-B*27, psoriasis, or IBD. Although there are many similarities among AS patients possessing HLA-B*27 versus those lacking this gene, the former group has a younger age of onset, a shorter delay in diagnosis, a better clinical response to tumor necrosis factor inhibitors, a greater familial occurrence, a greater risk for occurrence of acute anterior uveitis, and a lower risk for occurrence of psoriasis and IBD. ERAP1 association is present only in HLA-B*27+ patients, but other genetic associations are similar between the two groups. It is unusual to observe occurrence of primary AS among families of northern European extraction that show no segregation of HLA-B*27, IBD, or psoriasis. A recent genetic study supports the existence of an HLA-B*27-independent common link between gut inflammation and AS.

  8. Iatrogenic Spinal Cord Injury in a Trauma Patient with Ankylosing Spondylitis.

    Science.gov (United States)

    Maarouf, Ahmad; McQuown, Colleen M; Frey, Jennifer A; Ahmed, Rami A; Derrick, Lisa

    2017-01-01

    The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients. To describe an iatrogenic injury resulting from the use of a rigid spinal board and advocate for the use of alternative immobilization methods or no immobilization at all. We present our case here of a 68-year-old male with a history of AS. The patient was ambulatory on scene after a low speed car accident, but immobilized with a rigid backboard by paramedics. He developed back pain and paraplegia suddenly when the backboard was lifted for transport to the hospital. A CT scan revealed an extension fraction of T10 to T11 with involvement of the posterior column. Emergency spinal fusion was performed. Patient died of complications in the hospital. This case shows that spinal immobilization should be avoided in cases of ambulatory patients without a clear indication. Alternative transport methods such as vacuum mattresses should be considered when spinal immobilization is indicated, especially for patients with predispositions to spinal injury, particularly AS, to maintain the natural alignment of the spinal curvature.

  9. The risk of asthma in patients with ankylosing spondylitis: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available The relationship between asthma and ankylosing spondylitis (AS is controversial. We examined the risk of asthma among AS patients in a nationwide population.We conducted a retrospective cohort study using data from the National Health Insurance (NHI system of Taiwan. The cohort included 5,974 patients newly diagnosed with AS from 2000 to 2010. The date of diagnosis was defined as the index date. A 4-fold of general population without AS was randomly selected frequency matched by age, gender and the index year. The occurrence and hazard ratio (HR of asthma were estimated by the end of 2011.The overall incidence of asthma was 1.74 folds greater in the AS cohort than in the non-AS cohort (8.26 versus 4.74 per 1000 person-years with a multivariable Cox method measured adjusted HR of 1.54 (95% confidence interval (CI, 1.34-1.76. The adjusted HR of asthma associated with AS was higher in women (1.59; 95% CI, 1.33-1.90, those aged 50-64 years (1.66; 95% CI, 1.31-2.09, or those without comorbidities (1.82; 95% CI, 1.54-2.13.Patients with AS are at a higher risk of developing asthma than the general population, regardless of gender and age. The pathophysiology needs further investigation.

  10. Role of Th1/Th2 cytokines in the diagnosis and prognostic evaluation of ankylosing spondylitis.

    Science.gov (United States)

    Wen, J T; Zhang, D H; Fang, P F; Li, M H; Wang, R J; Li, S H

    2017-03-16

    Ankylosing spondylitis (AS), a progressive disease of the spine, manifests as peripheral arthritis with tendon and ligament inflammation that restricts activity. AS is a rheumatoid autoimmune disease although the rheumatoid factor is absent in patients with AS. It is characterized by inflammatory changes such as elevated levels of serum inflammatory factors. The roles of Th1 and Th2 cytokines in autoimmune diseases are well known. However, the roles of these cytokines in the diagnosis and prognosis of AS is poorly understood. The aim of this study was to investigate the roles of Th1/Th2 cytokines in the diagnosis and prognosis of AS. The BASDAI activity, BASFI functional index, BASMI measurement score, and the levels of CRP and ESR were measured during the treatment of patients with active AS. The levels of IFN-γ and TNF-α (Th1 cytokines) and IL-4 and IL-10 (Th2 cytokines) were quantified. The levels of IL-4 and IL-10 were significantly low in the serum of patients with active AS, who also had high IFN-γ and TNF-α levels compared to those in the control individuals (P cytokines in patients with AS may reflect disease activity and prognosis.

  11. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort.

    Science.gov (United States)

    Landi, Margarita; Maldonado-Ficco, Hernán; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A; Citera, Gustavo; Arturi, Pablo; Sampaio-Barros, Percival D; Flores Alvarado, Diana E; Burgos-Vargas, Rubén; Santos, Elena; Palleiro, Daniel; Gutiérrez, Miguel A; Vieira-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O; Berman, Alberto; Barrezueta, Claudia Vera; Vazquez-Mellado, Janitzia; Collantes-Estevez, Eduardo

    2016-12-01

    The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P spondylitis according to the gender.Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.

  12. Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI.

    Science.gov (United States)

    Zhang, Mengchao; Zhou, Le; Huang, Ning; Zeng, Hong; Liu, Songyan; Liu, Lin

    2017-07-01

    To investigate the feasibility of using quantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to differentiate the active and inactive stage of sacroiliitis and the correlation between quantitative parameters and disease activity as measured by clinical scores. Forty-two patients with ankylosing spondylitis underwent DCE-MRI on a 3.0T MRI unit. According to the results of the blood sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the patients were grouped into inactive and active groups. Pharmacokinetic models were used to generate the semiquantitative and quantitative hemodynamic parameters of DCE-MRI. The between-group differences were analyzed using the Wilcoxon rank sum test, and the correlations between the pharmacokinetic parameters and BASDAI score were analyzed using Spearman's correlation coefficient. The efficacies of different parameters in differentiating the active and inactive phase of sacroiliitis were evaluated and compared using receiver operator characteristics (ROC) curve analysis. K trans , K ep , V e , time to peak (TTP), max concentration (MAX Conc), and area under the curve (AUC) of the active group were significantly higher than those of the inactive stage group (P 0.05), except between AUC and MAX Conc (P = 0.0012). Quantitative DCE-MRI parameters can differentiate between active and inactive ankylosing spondylitis. Among those, K trans had the highest correlation coefficient with the BASDAI score. 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:71-78. © 2016 International Society for Magnetic Resonance in Medicine.

  13. Treatment of Andersson lesion-complicating ankylosing spondylitis via transpedicular subtraction and disc resection osteotomy, a retrospective study.

    Science.gov (United States)

    Zhang, Xuesong; Wang, Yao; Wu, Bing; Hu, Wenhao; Zhang, Zhifa; Wang, Yan

    2016-08-01

    Andersson lesion (AL) can occur in patients with ankylosing spondylitis (AS). Surgical instrumentation and fusion is considered the principle management in symptomatic AL that fails to resolve from a conservative treatment. However, there is significant controversy over the ideal management. The purpose of this study is to introduce our experience and explore the efficacy and feasibility of transpedicular subtraction and disc resection osteotomy technique for patients with AL-complicating AS. From January 2009 to January 2013, 17 consecutive patients with Andersson lesion-complicating ankylosing spondylitis treated with transpedicular subtraction and disc resection osteotomy technique were retrospectively reviewed. All patients completed a follow-up of at least 2 years. The average surgical time was 219 min with a mean intraoperative blood loss of 876 ml. The average preoperative regional angle was 29.1°, 4.9° postoperatively, and 5.9° at the final follow-up. The global angle changed from 59.1° preoperatively to 24.7° after surgery with the sagittal vertical axis (SVA) changed from 153.7 to 41.1 mm. The mean VAS back pain scores decreased from 6.4 preoperatively to 1.1 postoperatively and the ODI score improved from 50.9 preoperatively to 16.9 at the final follow-up. Solid fusion was obtained in all patients. The transpedicular subtraction and disc resection osteotomy achieve satisfactory kyphosis correction, good fusion and favorable clinical outcomes with less blood loss and complications than other approaches, implying an alternative method in patients with Andersson lesion-complicating ankylosing spondylitis.

  14. The Comparative Safety of TNF Inhibitors in Ankylosing Spondylitis-a Meta-Analysis Update of 14 Randomized Controlled Trials.

    Science.gov (United States)

    Hou, Li-Qiong; Jiang, Ga-Xue; Chen, Yan-Fei; Yang, Xi-Mei; Meng, Lei; Xue, Miao; Liu, Xiao-Guang; Chen, Xi-Chao; Li, Xiao

    2017-07-17

    TNF inhibitors have been used in ankylosing spondylitis (AS). The efficacy of TNF inhibitors was already evaluated by meta-analysis of randomized controlled trials (RCTs). However, the safety of TNF inhibitors is still unclear. Therefore, we aimed to evaluate and update the safety data from RCTs of TNF inhibitors in patients treated for AS. A systematic literature search was conducted from 1990 through May 31, 2016. All studies included were randomized, double-blind, controlled trials of patients with ankylosing spondylitis that evaluated adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab treatment. The overall serious adverse events, the risk of serious infection events, and the risk of malignancy and discontinuation rates were abstracted, and risk estimates were calculated by Peto odds ratios (ORs). Fourteen randomized controlled trials involving 2032 subjects receiving TNF inhibitors and 1030 subjects receiving placebo and/or traditional disease-modifying anti-rheumatic drugs (DMARDs) were included. The overall serious adverse events (OR, 1.34; 95% CI, 0.87-2.05), the risk of serious infection events (OR, 1.59; 95% CI, 0.63-4.01), the risk of malignancy (OR, 0.98; 95% CI, 0.25-3.85), and discontinuation due to adverse events (OR, 1.55; 95% CI, 0.95-2.54) in patients treated with TNF inhibitors as a group were not significantly different from those treated with placebo in the control group. TNF inhibitors were generally safe for treatment of ankylosing spondylitis. These data may help guide clinical comparative decision making in the management of AS.

  15. The risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, psoriatic arthritis or ankylosing spondylitis

    DEFF Research Database (Denmark)

    Wu, J J; Penfold, R B; Primatesta, P

    2017-01-01

    BACKGROUND: Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients. OBJECTIVE: To estimate risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, PsA and AS, respectively...... among psoriasis, PsA or AS patients. LIMITATIONS: Patients were not excluded if previously diagnosed with depression, suicidal ideation or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe...

  16. Taylor′s approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists

    Directory of Open Access Journals (Sweden)

    Jindal Parul

    2009-01-01

    Full Text Available We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor′s approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

  17. Increased Risk of Ischemic Stroke in Young Patients with Ankylosing Spondylitis: A Population-Based Longitudinal Follow-Up Study

    OpenAIRE

    Lin, Chia-Wei; Huang, Ya-Ping; Chiu, Yueh-Hsia; Ho, Yu-Tsun; Pan, Shin-Liang

    2014-01-01

    BACKGROUND: Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. METHODS: A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of...

  18. [The relationship between pulmonary function and exercise capacity and quality of life in patients with ankylosing spondylitis].

    Science.gov (United States)

    Akyol, Gonca; Özalevli, Sevgi; Uçan, Eyüp Sabri

    2013-01-01

    Ankylosing spondylitis causes restrictive respiratory disorder by limiting the expansion of the chest because of the costosternal and costovertebral joints. Our study is planned to evaluate the respiratory functions of the ankylosing spondylitis patients who have a high rate of pulmonary involvement, and to compare the results with the exercise capacity and life quality of these patients. There were 27 (18 male, 9 female) Norvegian patients who came to Turkey and had ankylosing spondylitis diagnose according to Modified New York criterias, to have a routine physical therapy and rehabilitation programme with an average age of 50.6 ± 6.6 years. The patients' clinical histories were taken. Pulmonary function tests were performed with spirometry and pulmonary muscle strength was measured with mouth pressure measure. 6 minute walk test was performed to determine exercise capacity and Short Form-36 Life Quality Questionairre was used to evaluate life quality of the patients. The patients had 18.85 ± 10.64 average diagnose duration and the expected FEV1 value of the patients was 3.75 ± 0.88 L/sec, FEV1/FVC ratio was 80.44 ± 6.42, MIP was 62.96 ± 20.61 and MEP was 80.22 ± 21.12. 40.7% of the patients had positive smoking history while 14.8 % had dyspnea and 11.1% had symptoms of caughing-sputum. Walking distance was 595.50 ± 83.20 metre. Life quality category scores were 42.82 ± 16.78 minimally, 83.58 ± 23.06 maximally. Pulmonary function and pulmonary muscle strength values were similar in smoking and non-smoking patients. But in smoking patients, physical function and social function categories of quality of life survey scores were found lower than non-smoking patients. Respiratory and other parameters were high related to high standarts in treatment and following and exercise habit of the patients in Norway. Accordingly, it is thought that an appropriate medical treatment and exercise as a lifestyle habits of the patients reduce the negative effects of

  19. Inflammation-driven bone formation in a mouse model of ankylosing spondylitis: sequential not parallel processes.

    Science.gov (United States)

    Tseng, Hsu-Wen; Pitt, Miranda E; Glant, Tibor T; McRae, Allan F; Kenna, Tony J; Brown, Matthew A; Pettit, Allison R; Thomas, Gethin P

    2016-01-29

    Ankylosing spondylitis (AS) is an immune-mediated arthritis particularly targeting the spine and pelvis and is characterised by inflammation, osteoproliferation and frequently ankylosis. Current treatments that predominately target inflammatory pathways have disappointing efficacy in slowing disease progression. Thus, a better understanding of the causal association and pathological progression from inflammation to bone formation, particularly whether inflammation directly initiates osteoproliferation, is required. The proteoglycan-induced spondylitis (PGISp) mouse model of AS was used to histopathologically map the progressive axial disease events, assess molecular changes during disease progression and define disease progression using unbiased clustering of semi-quantitative histology. PGISp mice were followed over a 24-week time course. Spinal disease was assessed using a novel semi-quantitative histological scoring system that independently evaluated the breadth of pathological features associated with PGISp axial disease, including inflammation, joint destruction and excessive tissue formation (osteoproliferation). Matrix components were identified using immunohistochemistry. Disease initiated with inflammation at the periphery of the intervertebral disc (IVD) adjacent to the longitudinal ligament, reminiscent of enthesitis, and was associated with upregulated tumor necrosis factor and metalloproteinases. After a lag phase, established inflammation was temporospatially associated with destruction of IVDs, cartilage and bone. At later time points, advanced disease was characterised by substantially reduced inflammation, excessive tissue formation and ectopic chondrocyte expansion. These distinct features differentiated affected mice into early, intermediate and advanced disease stages. Excessive tissue formation was observed in vertebral joints only if the IVD was destroyed as a consequence of the early inflammation. Ectopic excessive tissue was predominantly

  20. How well are the ASAS/OMERACT Core Outcome Sets for Ankylosing Spondylitis implemented in randomized clinical trials? A systematic literature review

    NARCIS (Netherlands)

    Bautista-Molano, Wilson; Navarro-Compán, Victoria; Landewé, Robert B. M.; Boers, Maarten; Kirkham, Jamie J.; van der Heijde, Désirée

    2014-01-01

    This study aims to investigate how well the Assessment of SpondyloArthritis international Society (ASAS)/Outcome Measures in Rheumatology Clinical Trials (OMERACT) core set and response criteria for ankylosing spondylitis (AS) have been implemented in randomized controlled trials (RCTs) testing

  1. Willingness of patients with ankylosing spondylitis to pay for inpatient treatment is influenced by the treatment environment and expectations of improvement

    NARCIS (Netherlands)

    Boonen, A.; Severens, J. L.; van Tubergen, A.; Landewé, R.; Bonsel, G.; van der Heijde, D.; van der Linden, Sj

    2005-01-01

    Objective: To assess the willingness to pay (WTP) for treatment in a spa resort of patients with ankylosing spondylitis ( AS) and to assess if the experience of a spa influences the WTP. Methods: 120 patients participating in a randomised trial comparing 3 weeks' treatment in a spa resort in Austria

  2. Effects of tumor necrosis factor-α inhibitors in mothers and daughters concordant for HLA-B27-positive ankylosing spondylitis.

    Science.gov (United States)

    Caso, Francesco; Costa, Luisa; Del Puente, Antonio; Rigante, Donato; Selmi, Carlo; Fabbroni, Marta; Scarpa, Raffaele; Galeazzi, Mauro; Frediani, Bruno; Cantarini, Luca

    2015-01-01

    Pharmacogenomics is considered as the new frontier to predict the response to treatments and it can also be based on the comparison of family members being treated for the same condition. No data are available on the impact of anti-tumour necrosis factor (TNF)-α therapies in members of the same family with ankylosing spondylitis (AS). We describe three mother-daughter couples concordant for AS and HLA-B27, both treated with TNF-α inhibitors, for whom the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP were evaluated during a follow-up of 24 months. All patients manifested improvements of all scores, but the daughters had a more prominent effect achieving faster complete disease remission. We hypothesise that longer standing chronic inflammation and older age may cause a less prompt and effective response to treatment in SA when compared with their genetically related controls.

  3. Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis

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    Luo Michelle P

    2011-05-01

    Full Text Available Abstract Background We evaluated the psychometric characteristics of the Short Form 36 (SF-36 Health Survey and the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue subscale in patients with ankylosing spondylitis (AS. Methods We analyzed clinical and patient-reported outcome (PRO data collected during 12-week, double-blind, placebo-controlled periods of two randomized controlled trials comparing adalimumab and placebo for the treatment of active AS. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and other clinical measures were collected during the clinical trial. We evaluated internal consistency/reliability, construct validity, and responsiveness to change for the SF-36 and FACIT-Fatigue. Results The SF-36 (Cronbach alpha, 0.74-0.92 and FACIT-Fatigue (Cronbach alpha, 0.82-0.86 both had good internal consistency/reliability. At baseline, SF-36 and FACIT-Fatigue scores correlated significantly with Ankylosing Spondylitis Quality of Life scores (r = -0.36 to -0.66 and r = -0.70, respectively; all p Conclusions The SF-36 is a reliable, valid, and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS. These PROs may be useful in evaluating effectiveness of new treatments for AS. Trial Registration ClinicalTrials.gov: NCT00085644 and NCT00195819

  4. Can erosions on MRI of the sacroiliac joints be reliably detected in patients with ankylosing spondylitis? - A cross-sectional study

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    Weber, Ulrich; Pedersen, Susanne J; Østergaard, Mikkel

    2012-01-01

    Erosions of the sacroiliac joints (SIJ) on pelvic radiographs of patients with ankylosing spondylitis (AS) are an important feature of the modified New York classification criteria. However, radiographic SIJ erosions are often difficult to identify. Recent studies have shown that erosions can be ...

  5. The application of MR imaging in the detection of hip involvement in patients with ankylosing spondylitis

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    Huang, Zhen-Guo; Zhang, Xue-Zhe; Hong, Wen; Wang, Guo-Chun; Zhou, Hui-Qiong; Lu, Xin; Wang, Wu, E-mail: cjr.wangwu@vip.163.com

    2013-09-15

    Objective: To investigate the changes in hip MR imaging, evaluate the frequency of hip involvement and compare the value of clinical symptoms, radiographs, and MR imaging in the detection of hip involvement in patients with ankylosing spondylitis (AS). Methods: Anteroposterior radiographs of the pelvis, MR imaging of the hip and clinical evaluation were undertaken in 58 patients with definite AS. All patients were followed up 3 years. Annual radiographs and clinical evaluation were carried out. The imaging data were independently assessed by two experienced radiologists who were blinded to patient identity and clinical characteristics. Based on the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) scoring system, BASRI-hip scores ≥2 were defined as radiological hip involvement. On MR imaging, both acute and chronic inflammatory changes were considered positive signs for hip involvement. Symptomatic hip involvement was defined as current or past pain or limitation of the hip movement. The statistical analysis was performed using the χ{sup 2} test for comparison of sensitivity among clinical symptoms, radiographs, and MR imaging in the detection of hip involvement and the Student's t-test for comparison of disease duration between with and without hip involvement. A P value <0.05 was considered to be statistically significant. For interpreting MRI and radiographs, the percentage of agreement between the two assessors and the kappa coefficients were calculated. Results: On MR imaging, positive changes were detected in 86 (74.1%) hips among 116 hips in all 58 patients. Joint effusion was observed in 73 (62.9%) hips; 23 out of 27 patients who underwent fat-saturated contrast-enhanced T{sub 1}-weighted sequences had abnormal synovial enhancement in bilateral hips. The other abnormal MR findings included subchondral bone marrow edema in 35 (30.2%) hips, enthesitis in 22 (19.0%) hips, fatty accumulation of the bone marrow in 28 (24.1%) hips, bone erosive

  6. Social Role Participation in Patients With Ankylosing Spondylitis: A Cross-Sectional Comparison With Population Controls.

    Science.gov (United States)

    van Genderen, Simon; Plasqui, Guy; Landewé, Robert; Lacaille, Diane; Arends, Suzanne; van Gaalen, Floris; van der Heijde, Désirée; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Gignac, Monique; Boonen, Annelies

    2016-12-01

    Participation in social roles for persons with chronic disease is important for their quality of life, but interpretation of the data on participation is difficult in the absence of a benchmark. This study aimed to compare social role participation in patients with ankylosing spondylitis (AS) to population controls using the Social Role Participation Questionnaire (SRPQ). There were 246 AS patients and 510 population controls who completed the SRPQ, which assesses participation in 11 roles (with scores ranging 1-5) across 4 dimensions (importance, satisfaction with performance, satisfaction with time, and physical difficulty), and additionally ranked their 3 most important roles. The ranking of role importance, the SRPQ dimension scores, and the gap between importance and satisfaction with performance of roles were compared between patients and controls. Patients (62% male; mean ± SD age 51 ± 12 years) and controls (70% male; mean ± SD 42 ± 15 years) ranked intimate relationships, relationships with children/stepchildren/grandchildren, and employment as the most important roles. Compared to controls, patients gave higher scores on the SRPQ to importance (3.75 versus 3.43), but reported lower satisfaction with performance (3.19 versus 3.58) and greater physical difficulty (3.87 versus 4.67) (P ≤ 0.05 for all). The largest differences in gaps between importance and satisfaction with performance for patients compared to controls were seen in the physical leisure, hobbies, and traveling and vacation categories, in which patients assigned higher importance but reported especially low satisfaction. As society places increasing emphasis on individual responsibility to participate fully in social roles, the current data suggest that health care providers should pay more attention to participation restrictions experienced by patients with AS. © 2016, American College of Rheumatology.

  7. Somatic serogroups, capsular types, and species of fecal Klebsiella in patients with ankylosing spondylitis.

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    Toivanen, P; Hansen, D S; Mestre, F; Lehtonen, L; Vaahtovuo, J; Vehma, M; Möttönen, T; Saario, R; Luukkainen, R; Nissilä, M

    1999-09-01

    The purpose of the present study was to find out whether patients with ankylosing spondylitis (AS) carry fecal Klebsiella strains that belong to serotypes or species specific for AS. Somatic serotypes (O groups), capsular (K) serotypes, and biochemically identified species were determined for fecal klebsiellae isolated from 187 AS patients and 195 control patients. The controls were patients with fibromyalgia or rheumatoid arthritis. The 638 isolates of Klebsiella that were obtained represented 161 strains; 81 from AS patients and 80 from the controls. The average number of Klebsiella strains per patient was 1.7 for the AS group and 1.5 for the control group. The most common O group was O1, which was observed for isolates from 23 of 187 AS patients and 24 of 195 control patients. Next in frequency was group O2, which was observed for isolates from 17 AS patients and 15 control patients. Regarding the K serotypes, 59 different types were identified, revealing a heterogeneous representation of Klebsiella strains, without a predominance of any serotype. By biochemical identification, Klebsiella pneumoniae was the most frequently occurring species, being found in 45 AS patients and 45 control patients. Next in the frequency was K. oxytoca, which was observed in 26 AS patients and in 29 control patients. K. planticola and K. terrigena occurred in only a minority of patients. Altogether, when analyzed either separately or simultaneously according to O groups, K serotypes, and biochemically identified species, no evidence of the existence of AS-specific Klebsiella strains was obtained. These findings do not indicate participation of Klebsiella in the etiopathogenesis of AS.

  8. Demographic, clinical, and laboratory features of Turkish patients with late onset ankylosing spondylitis

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    Ahmet Karaarslan

    2015-07-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease, which typically begins in early decades of life with primarily axial joints involvement. This disease rarely affects patients older than 50 years of age. The aim of this study was to compare and evaluate the demographic, clinical, and laboratory features of late onset and early onset AS patients who were followed up in a single rheumatology center. A total of 339 patients who have been diagnosed with AS according to modified New York criteria were included in the study. The patients whose initial symptoms were observed after 50 years of age were accepted as late onset AS. Out of 339 patients, 27 (7.9% were diagnosed as late onset AS and 312 (92.3% patients were evaluated as early onset AS. Of 27 late onset patients, 10 were male and 17 were female. Delay in the diagnosis was 5.8 years for early onset AS, while it was 3.8 years for late onset AS (p = 0.001. Higher levels of acute phase reactants and more methotrexate (MTX use were detected in early onset AS patients compared to late onset AS (p = 0.001, p = 0.007, respectively. Statistically, there was no difference between these two groups, with regard to disease clinical activity indexes, anthropometric measurement parameters, uveitis and peripheral joint involvement. In this study, we showed that early and late onset AS patients may present with different clinical, genetic, and laboratory features. Late onset AS patients are characterized with lower human leukocyte antigen-B27 sequence, less inflammatory sign, delayed diagnosis, and less MTX and anti-tumor necrosis factor alpha drug usage.

  9. TREATMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS IN THE REAL CLINICAL PRACTICE OF A RHEUMATOLOGIST IN RUSSIA

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    Sh F Erdes

    2013-01-01

    Full Text Available Objective: to analyze the treatment of ankylosing spondylitis (AS in the real practice of a rheumatologist in Russia. Subjects and methods. The cross-sectional study included 330 AS patients who had been actively seeking medical advice from rheumatologists during 4 months in 24 cities and towns of the Russian Federation. The therapy performed was studied using the medical history data recorded by physicians in the specially designed clinical chart. Drug intake, its regularity, reasons for discontinuation of medications, and their clinical effect were elucidated in all the patients. The need to intensify the therapy and to use genetically engineered biological agents was determined by disease activity at the time of examination. Results. The medical histories indicated that 62% of the patients received nonsteroidal anti-inflammatory drugs (NSAIDs regularly, 34% had them periodically, and 4% were not treated; two thirds of the patients took diclofenac, nimesulide, or meloxicam. 33, 14, and 9% of the patients used sulfasalazine, methotrexate, and oral glucocorticosteroids, respectively. Sixty (18% patients received tumor necrosis factor-α (TNF-α inhibitors. Different physiotherapeutic methods were used in 30% of cases; only 46% did exercises regularly; as high as 4% of the patients had sanatorium-and-spa treatment. In the physicians' opinion, 81% of the patients needed intensified therapy and 62% did therapy with TNF-α inhibitors. At the same time TNF-α inhibitors were indicated in 38% of the patients according to the ASAS recommendations. Conclusion. In real clinical practice, AS treatment does not always meet the current recommendations: only 62% of the patients received continuous NSAID therapy; disease-modifying antirheumatic drugs were frequently used without any indications. 18% of the patients took TNF-α inhibitors and 38% really needed them.

  10. Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis

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    A. Caliri

    2011-09-01

    Full Text Available Patients with ankylosing spondylitis (AS may experience a progressive spinal kyphosis, which induces a forward and downward displacement of the centre of mass (COM of the trunk with consequent use of mechanisms to compensate for the displacement of the trunk. The analysis of patterns of movement gives an important opportunity for follow-up of patients and is an useful tool to plan a therapeutic and rehabilitative program. Objective: The aim of our study was to contribute to the description of abnormalities of gait biomechanics in patients with AS and to individualize, if existing, a typical pattern of these patients. Methods: Five patients with AS (3 men, 2 women were evaluated by gait analysis. Each patient was assessed with dynamic electromyography, with survey of phases of gait cycle and 3D video-analysis of gait related to data of platform (Digivec ® which allows to display real time the force vector of reaction foot-ground overlapping the screen image of patient. Results: The dynamometric platform located the following problems: increasing of the medium-lateral component of the reaction force on the ground in the mild and terminal stance. The anterior-posterior reaction force is diminished in both the initial and the terminal component. The timing of activation of the tibialis anterior results prolonged while the timing of activation of the gastrocnemius medialis results delayed. Conclusion: The patients with AS prefer therefore an eccentric contraction of the tibial anterior in comparison to a concentric contraction of the gastrocnemius medialis, “opting” for a gait strategy that confers greater stability but limited power.

  11. Evaluation of the smallest detectable difference in outcome or process variables in ankylosing spondylitis.

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    Auleley, Guy-Robert; Benbouazza, Karima; Spoorenberg, Anneke; Collantes, Eduardo; Hajjaj-Hassouni, Najia; van der Heijde, Desirée; Dougados, Maxime

    2002-12-15

    To evaluate the smallest detectable difference (SDD) of symptomatic outcome or process variables in ankylosing spondylitis (AS) patients from various countries. Thirty consecutive AS patients with axial involvement were recruited from 1 center in each of 4 countries (Spain, Morocco, France, The Netherlands), for a total of 120 patients. Fourteen variables were studied in 6 domains: pain (3 variables), stiffness (1 variable), function (2 variables), spinal mobility (3 variables), patient global assessment (4 variables), and the domain of enthesiopathy (1 variable). All patients were evaluated twice within a 1-week period during which no clinical or therapeutic change occurred. Intracenter reliability was evaluated using the intraclass correlation coefficient (ICC). The SDD was determined using the Bland-Altman method. Of the 14 variables evaluated in the 120 patients (82% males, 42 +/- 12 years old, with a mean disease duration of 17 +/- 13 years), only the SDD for the variable occiput-to-wall distance showed statistically significant difference among centers. For the entire group, the SDD, expressed as percentage of the range of the variable, varied from 10% (Mander enthesis index) to 39% (spinal pain at night last week). The intraobserver reliability was good (ICC > 0.80) except for the variables morning stiffness and modified Schober test (ICCs of 0.76 and 0.60, respectively). This study suggests that the evaluation of AS patients is homogenous and reliable in different centers of different European and North African countries. Evaluation of the SDD of the symptomatic outcome or process variables is a starting point to determine the minimum clinically important difference, permitting the presentation of results of clinical studies on an individual basis.

  12. Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables

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    Laura MUNTEAN

    2009-12-01

    Full Text Available Objective: To evaluate bone mineral density (BMD in patients with ankylosing spondylitis (AS and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA. Using the modified Schober’s test we assessed spine mobility. We examined the sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

  13. Choice of a nonsteroidal anti-inflammatory drug in ankylosing spondylitis

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    Rimma Mikhailovna Balabanova

    2014-01-01

    Full Text Available Ankylosing spondylitis (AS is a chronic systemic disease with predominant axial skeleton injury, peripheral articular and entheseal involvements, and extra-skeletal manifestations. 8–10 years elapse since the first manifestations of AC to its diagnosis, leading to delays in adequate therapy, to the progression of structural and functional impairments in the axial skeleton and peripheral joints and to the development of complications. According to the international and Russia's Association of Rheumatologists guidelines, nonsteroidal anti-inflammatory drugs (NSAIDs are an important component of AS therapy. It is necessary to carefully choose the safest NSAID for these patients, by taking into consideration that AS therapy should be long-term and continuous.The trial previously performed by the authors evaluated comorbidity in 220 AS patients long receiving nimesulide. Its long-term administration was shown to cause no increase in the level of liver enzymes. Esophagogastroduodenoscopy revealed antral gastritis in 23.6% of the patients, gastric mucosal erosions in 13, and gastric ulcer disease without an exacerbation in 3.6%. It was noted that the physicians had not prescribed gastroprotectors to the patients. Nimesulide caused no blood pressure (BP elevation even in patients who had baseline hypertension. Elevated BP occurred in 2.5% of the patients. There was no clear association of higher BP with nimesulide intake since the patients had previously used other NSAIDs, mainly diclofenac, to treat severe pain syndrome. These findings suggest that in addition to its analgesic activity, nimesulide shows good tolerability in patients with AS, which permits its long-term use, but in this case the gastrointestinal tract and BD should be carefully monitored, which will be able to prevent the possible adverse events characteristic of the entire group of NSAIDs.

  14. Granulation Tissue Eroding the Subchondral Bone Also Promotes New Bone Formation in Ankylosing Spondylitis.

    Science.gov (United States)

    Bleil, Janine; Maier, Rene; Hempfing, Axel; Sieper, Joachim; Appel, Heiner; Syrbe, Uta

    2016-10-01

    We previously suggested that fibroblast-rich granulation tissue eroding the subchondral bone is instrumental in the joint remodeling that occurs in ankylosing spondylitis (AS). The purpose of this study was to determine if this granulation tissue also carries bone-forming capabilities, which we approached by searching for bone-forming cells (hypertrophic chondrocytes, osteoblasts) in its vicinity. We also assessed adipogenic tissue transformation, which has been suggested to be an intermediate feature in AS bone formation based on imaging studies. The facet joints of AS patients, osteoarthritis (OA) patients, and autopsy subjects (controls) were screened for subchondral granulation tissue. We searched for hypertrophic chondrocytes by assessing RUNX-2, type X collagen, and matrix metalloproteinase 13 (MMP-13) expression, for osteoblasts by analyzing RUNX-2, CD56, and type I collagen expression, as well as for signs of new bone formation. Adipocytes and lipid accumulation were assessed in Safranin O-stained sections. In the joints of AS and OA patients, RUNX-2-positive cells were found to be lining the granulation tissue. These cells coexpressed type I collagen but lacked type X collagen and MMP-13 expression, confirming their osteoblastic nature. In 91% of AS joints and in 20% of OA joints (P granulation tissue and the cartilage. Joints containing bony spots showed greater replacement of the adjacent bone marrow by granulation tissue than did joints without bone formation (P granulation tissue often contained adipocytes and lipid accumulations. Replacement of the subchondral bone marrow by fat tissue was also frequently found but was not associated with new bone formation. The subchondral granulation tissue carries osteoblasts, which promote new bone formation, leading to intraarticular ankylosis of the facet joints in AS. © 2016, American College of Rheumatology.

  15. Association Study of IL-12B Polymorphisms Susceptibility with Ankylosing Spondylitis in Mainland Han Population.

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    Li Zhang

    Full Text Available This study aims to determine whether the genetic polymorphisms of IL-12B gene is a susceptibility factor to Ankylosing spondylitis (AS in mainland Han Chinese population.Eight single-nucleotide polymorphisms (SNPs (rs10045431, rs11167764, rs3212227, rs6556412, rs6556416, rs6871626, rs6887695 and rs7709212 in the IL-12B gene were genotyped by iMLDR Assay technology in 400 patients [96% (384/400 HLA-B27(+] and 395 geographically and ethnically matched healthy controls in mainland Han Chinese population. The correlation between IL-12B genetic polymorphisms and AS activity index (BASDAI, BASFI were tested.The significant difference was found in genotype distribution between AS and healthy controls (χ2 = 6.942, P-value = 0.031 of the SNP rs6871626. Furthermore, significant evidence was also detected under the recessive model for minor allele A. The AA genotype carrier had 1.830 fold risk compared with C allele carrier (with CC and AC genotypes [OR (95% CI = 1.830 (1.131-2.961, P-value = 0.014]. Nevertheless, the difference was no longer significant after Bonferroni correction. Subset analysis on cases with HLA-B27(+ did find the same results. Three genotypic groups (AA, CC and CA in rs6871626 site was highly associated with the BASDAI and BASFI (P-value = 0.012 and P-value = 0.023, respectively, after adjustment for effect of age, sex, and disease duration, the P-value was 0.031 and 0.041, respectively. The AA genotype of rs6871626 was also significantly correlated with an increased BASDAI and BASFI compared to the AC and CC genotypes in AS patients.Our findings suggest that rs6871626 may be associated AS susceptibility and with disease activity (BASDAI, BASFI in mainland Han Chinese population.

  16. Clinical characteristics and frequency of TLR4 polymorphisms in Brazilian patients with ankylosing spondylitis

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    Natalia Pereira Machado

    Full Text Available ABSTRACT Objectives: Innate immunity is involved in the physiopathology of ankylosing spondylitis (AS, with the participation of Gram-negative bacteria, modulation of human leukocyte antigen (HLA B27 and the involvement of pattern recognition receptors, such as Toll-like receptors (TLRs. The aim of this study was to investigate the clinical characteristics and frequency of TLR4 polymorphisms (Asp299Gly and Thr 399Ile in a cohort of Brazilian patients with AS. Methods: A cross-sectional study was carried out involving 200 patients with a diagnosis of AS and a healthy control group of 200 individuals. Disease activity, severity and functional capacity were measured. The study of TLR4 polymorphisms was performed using the restriction fragment length polymorphism method. HLA-B27 was analyzed by conventional polymerase chain reaction. The IBM SPSS Statistics 20 program was used for the statistical analysis, with p-values less than 0.05 considered significant. Results: Mean age and disease duration were 43.1 ± 12.7 and 16.6 ± 9.2 years, respectively. The sample was predominantly male (71% and non-Caucasian (52%. A total of 66% of the group of patients were positive for HLA-B27. The sample of patients was characterized by moderate functional impairment and a high degree of disease activity. No significant association was found between the two TLR4 polymorphisms and susceptibility to AS. Conclusions: TLR4 polymorphisms 399 and 299 were not more frequent in patients with AS in comparison to the health controls and none of the clinical variables were associated with these polymorphisms.

  17. Macrophage Migration Inhibitory Factor Induces Inflammation and Predicts Spinal Progression in Ankylosing Spondylitis.

    Science.gov (United States)

    Ranganathan, Vidya; Ciccia, Francesco; Zeng, Fanxing; Sari, Ismail; Guggino, Guiliana; Muralitharan, Janogini; Gracey, Eric; Haroon, Nigil

    2017-09-01

    To investigate the role of macrophage migration inhibitory factor (MIF) in the pathogenesis of ankylosing spondylitis (AS). Patients who met the modified New York criteria for AS were recruited for the study. Healthy volunteers, rheumatoid arthritis patients, and osteoarthritis patients were included as controls. Based on the annual rate of increase in modified Stoke AS Spine Score (mSASSS), AS patients were classified as progressors or nonprogressors. MIF levels in serum and synovial fluid were quantitated by enzyme-linked immunosorbent assay. Predictors of AS progression were evaluated using logistic regression analysis. Immunohistochemical analysis of ileal tissue was performed to identify MIF-producing cells. Flow cytometry was used to identify MIF-producing subsets, expression patterns of the MIF receptor (CD74), and MIF-induced tumor necrosis factor (TNF) production in the peripheral blood. MIF-induced mineralization of osteoblast cells (SaOS-2) was analyzed by alizarin red S staining, and Western blotting was used to quantify active β-catenin levels. Baseline serum MIF levels were significantly elevated in AS patients compared to healthy controls and were found to independently predict AS progression. MIF levels were higher in the synovial fluid of AS patients, and MIF-producing macrophages and Paneth cells were enriched in their gut. MIF induced TNF production in monocytes, activated β-catenin in osteoblasts, and promoted the mineralization of osteoblasts. Our findings indicate an unexplored pathogenic role of MIF in AS and a link between inflammation and new bone formation. © 2017, American College of Rheumatology.

  18. Predicting pathway cross-talks in ankylosing spondylitis through investigating the interactions among pathways.

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    Gu, Xiang; Liu, Cong-Jian; Wei, Jian-Jie

    2017-11-13

    Given that the pathogenesis of ankylosing spondylitis (AS) remains unclear, the aim of this study was to detect the potentially functional pathway cross-talk in AS to further reveal the pathogenesis of this disease. Using microarray profile of AS and biological pathways as study objects, Monte Carlo cross-validation method was used to identify the significant pathway cross-talks. In the process of Monte Carlo cross-validation, all steps were iterated 50 times. For each run, detection of differentially expressed genes (DEGs) between two groups was conducted. The extraction of the potential disrupted pathways enriched by DEGs was then implemented. Subsequently, we established a discriminating score (DS) for each pathway pair according to the distribution of gene expression levels. After that, we utilized random forest (RF) classification model to screen out the top 10 paired pathways with the highest area under the curve (AUCs), which was computed using 10-fold cross-validation approach. After 50 bootstrap, the best pairs of pathways were identified. According to their AUC values, the pair of pathways, antigen presentation pathway and fMLP signaling in neutrophils, achieved the best AUC value of 1.000, which indicated that this pathway cross-talk could distinguish AS patients from normal subjects. Moreover, the paired pathways of SAPK/JNK signaling and mitochondrial dysfunction were involved in 5 bootstraps. Two paired pathways (antigen presentation pathway and fMLP signaling in neutrophil, as well as SAPK/JNK signaling and mitochondrial dysfunction) can accurately distinguish AS and control samples. These paired pathways may be helpful to identify patients with AS for early intervention.

  19. Decreased Serotonin Levels and Serotonin-Mediated Osteoblastic Inhibitory Signaling in Patients With Ankylosing Spondylitis.

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    Klavdianou, Kalliopi; Liossis, Stamatis-Nick; Papachristou, Dionysios J; Theocharis, Georgios; Sirinian, Chaido; Kottorou, Anastasia; Filippopoulou, Alexandra; Andonopoulos, Andrew P; Daoussis, Dimitrios

    2016-03-01

    Evidence suggests that serotonin is an inhibitor of bone formation. We aimed to assess: 1) serum serotonin levels in patients with ankylosing spondylitis (AS), a prototype bone-forming disease, compared with patients with rheumatoid arthritis (RA) and healthy subjects; 2) the effect(s) of TNFα blockers on serum serotonin levels in patients with AS and RA; and 3) the effect(s) of serum of AS patients on serotonin signaling. Serum serotonin levels were measured in 47 patients with AS, 28 patients with RA, and 40 healthy subjects by radioimmunoassay; t test was used to assess differences between groups. The effect of serum on serotonin signaling was assessed using the human osteoblastic cell line Saos2, evaluating levels of phospho-CREB by Western immunoblots. Serotonin serum levels were significantly lower in patients with AS compared with healthy subjects (mean ± SEM ng/mL 122.9 ± 11.6 versus 177.4 ± 24.58, p = 0.038) and patients with RA (mean ± SEM ng/mL 244.8 ± 37.5, p = 0.0004). Patients with AS receiving TNFα blockers had significantly lower serotonin levels compared with patients with AS not on such treatment (mean ± SEM ng/mL 95.8 ± 14.9 versus 149.2 ± 16.0, p = 0.019). Serotonin serum levels were inversely correlated with pCREB induction in osteoblast-like Saos-2 cells. Serotonin levels are low in patients with AS and decrease even further during anti-TNFα treatment. Differences in serotonin levels are shown to have a functional impact on osteoblast-like Saos-2 cells. Therefore, serotonin may be involved in new bone formation in AS. © 2015 American Society for Bone and Mineral Research.

  20. Genetic Dissection of Acute Anterior Uveitis Reveals Similarities and Differences in Associations observed with Ankylosing Spondylitis

    Science.gov (United States)

    Robinson, Philip C.; Claushuis, Theodora A.M.; Cortes, Adrian; Martin, Tammy M.; Evans, David M.; Leo, Paul; Mukhopadhyay, Pamela; Bradbury, Linda A.; Cremin, Katie; Harris, Jessica; Maksymowych, Walter P.; Inman, Robert D.; Rahman, Proton; Haroon, Nigil; Gensler, Lianne; Powell, Joseph E.; van der Horst-Bruinsma, Irene E.; Hewitt, Alex W.; Craig, Jamie E.; Lim, Lyndell L.; Wakefield, Denis; McCluskey, Peter; Voigt, Valentina; Fleming, Peter; Degli-Esposti, Mariapia; Pointon, Jennifer J.; Weisman, Michael H.; Wordsworth, B. Paul; Reveille, John D.; Rosenbaum, James T.; Brown, Matthew A.

    2015-01-01

    Objective To use high density genotyping to investigate the genetic associations of acute anterior uveitis (AAU) in patients both with and without ankylosing spondylitis (AS). Method We genotyped 1,711 patients with AAU (either primary or with AAU and AS), 2,339 AS patients without AAU, and 10,000 controls on the Illumina Immunochip Infinium microarray. We also used data on AS patients from previous genomewide association studies to investigate the AS risk locus ANTXR2 for its putative effect in AAU. ANTXR2 expression in mouse eyes was investigated by RT-PCR. Results Comparing all AAU cases with HC, strong association was seen over HLA-B corresponding to the HLA-B27 tag SNP rs116488202. Three non-MHC loci IL23R, the intergenic region 2p15 and ERAP1 were associated at genome-wide significance (P < 5×10−8). Five loci harboring the immune-related genes IL10-IL19, IL18R1-IL1R1, IL6R, the chromosome 1q32 locus harboring KIF21B, as well as the eye related gene EYS, were also associated at a suggestive level of significance (P < 5×10−6). A number of previously confirmed AS associations demonstrated significant differences in effect size between AS patients with AAU and AS patients without AAU. ANTXR2 expression was found to vary across eye compartments. Conclusion These findings, with both novel AAU specific associations, and associations shared with AS demonstrate overlapping but also distinct genetic susceptibility loci for AAU and AS. The associations in IL10 and IL18R1 are shared with inflammatory bowel disease, suggesting common etiologic pathways. PMID:25200001

  1. Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis

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    Osman Kuloglu

    2012-05-01

    Full Text Available Ankylosing spondylitis (ASpis a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI. 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D echocardiography, M-mode, pulsed-wave (PW and tissue Doppler echocardiography. The peak systolic velocity (Sm, early diastolic myocardial peak velocity (m, late diastolic myocardial peak velocity (Am, isovolumic acceleration (IVA, myocardial precontraction time (PCTm, myocardial contraction time (CTm, myocardial relaxation time (RTm, and myocardial performance index (MPI were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P>0.05. Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P>0.05. We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI.

  2. [Ankylosing spondylitis and non-radiographic axial spondyloarthritis: Two stages of disease?

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    Rumyantseva, D G; Dubinina, T V; Demina, A B; Rumyantseva, O A; Agafonova, E M; Smirnov, A V; Erdes, Sh F

    To compare the clinical manifestations of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nrAxSpA). A Moscow early spondyloarthritis cohort has now included 132 patients with axial spondyloarthritis, of whom 69 patients who have been followed up at least 12 months are to be involved in a preliminary analysis. The mean age at the time of inclusion in the study was 28.1±5.5 years; the mean disease duration was 24.7±15.8 months; 63 (91.3%) patients were HLA-B27 positive; 41 and 28 included patients were diagnosed with AS and nrAxSpA, respectively. Men were significantly more in the AS group than in the nrAxSpA group (58.5 and 32.1%, respectively; p=0.05). The patients of the two groups did not differ in main clinical parameters (the presence of arthritis and enthesitis), disease activity (BASDAI, ASDAS-CRP) and functional status (BASFI). All indicators of inflammatory activity decreased nearly 2-fold in both groups after 12 months of follow up. In 7 (25%) patients with nrAxSpA, radiologically detectable sacroiliitis (SI) developed over 12 months and the diagnosis of AS was verified. Among them, 2 (28.5%) patients had initially active SI detected by magnetic resonance imaging (MRI); 4 (57.1%) had chronic SI, and 1 (14.4%) had no pathological MRI changes. Due to the fact that the clinical manifestations of AS and nrAxSpA are comparable, it can be assumed that the latter is an early stage of AS.

  3. Effect of Tumor Necrosis Factor Inhibitor Therapy on Osteoclasts Precursors in Ankylosing Spondylitis.

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    Perpétuo, Inês P; Raposeiro, Rita; Caetano-Lopes, Joana; Vieira-Sousa, Elsa; Campanilho-Marques, Raquel; Ponte, Cristina; Canhão, Helena; Ainola, Mari; Fonseca, João E

    2015-01-01

    Ankylosing Spondylitis (AS) is characterized by excessive local bone formation and concomitant systemic bone loss. Tumor necrosis factor (TNF) plays a central role in the inflammation of axial skeleton and enthesis of AS patients. Despite reduction of inflammation and systemic bone loss, AS patients treated with TNF inhibitors (TNFi) have ongoing local bone formation. The aim of this study was to assess the effect of TNFi in the differentiation and activity of osteoclasts (OC) in AS patients. 13 AS patients treated with TNFi were analyzed at baseline and after a minimum follow-up period of 6 months. 25 healthy donors were recruited as controls. Blood samples were collected to assess receptor activator of nuclear factor kappa-B ligand (RANKL) surface expression on circulating leukocytes and frequency and phenotype of monocyte subpopulations. Quantification of serum levels of bone turnover markers and cytokines, in vitro OC differentiation assay and qRT-PCR for OC specific genes were performed. RANKL+ circulating lymphocytes (B and T cells) and IL-17A, IL-23 and TGF-β levels were decreased after TNFi treatment. We found no differences in the frequency of the different monocyte subpopulations, however, we found decreased expression of CCR2 and increased expression of CD62L after TNFi treatment. OC number was reduced in patients at baseline when compared to controls. OC specific gene expression was reduced in circulating OC precursors after TNFi treatment. However, when cultured in OC differentiating conditions, OC precursors from AS TNFi-treated patients showed increased activity as compared to baseline. In AS patients, TNFi treatment reduces systemic pro osteoclastogenic stimuli. However, OC precursors from AS patients exposed to TNFi therapy have increased in vitro activity in response to osteoclastogenic stimuli.

  4. Fatigue in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Analysis from a Longitudinal Observation Cohort.

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    Bedaiwi, Mohamed; Sari, Ismail; Thavaneswaran, Arane; Ayearst, Renise; Haroon, Nigil; Inman, Robert D

    2015-12-01

    In this study, we aimed to address the prevalence of fatigue, its associated factors, and the effect of tumor necrosis factor inhibitors (TNFi) on this subgroup of patients in a large axial spondyloarthritis (axSpA) cohort. The study included 681 patients [ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA)]. The Fatigue Severity Scale (FSS) and the Bath AS Disease Activity Index question 1 (BASDAI Q1) indices were used for fatigue assessment. Severe fatigue was defined as an FSS ≥ 4 or a BASDAI Q1 ≥ 5. Disease activity, function, and quality of life (QoL) measures were recorded. Patients who had been treated with TNFi were identified, and baseline and followup data were analyzed. Of the cohort, 67.3% had severe fatigue, and the prevalence was similar between AS (67.2%) and nr-axSpA (68.2%). Severely fatigued patients tended to have higher disease activity scores, increased acute-phase proteins, and decreased QoL measures. TNFi therapy was associated with improvement in disease activity, and although this treatment led to significantly decreased fatigue scores, this reduction was not optimal in the majority of patients with 80% continuing to have severe fatigue according to their posttreatment scores. Health Assessment Questionnaire, mean scores of BASDAI Q5 and Q6, and BASDAI enthesitis were independent predictors of fatigue severity. Fatigue is a common symptom in axSpA, and the burden of fatigue among patients with nr-axSpA is similar to that seen in AS. While biologics are effective in improving disease activity, their effect on fatigue is more limited. In axSpA, fatigue remains unresponsive to TNFi in nearly 80% of patients.

  5. Predicting pathway cross-talks in ankylosing spondylitis through investigating the interactions among pathways

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    Xiang Gu

    2017-11-01

    Full Text Available Given that the pathogenesis of ankylosing spondylitis (AS remains unclear, the aim of this study was to detect the potentially functional pathway cross-talk in AS to further reveal the pathogenesis of this disease. Using microarray profile of AS and biological pathways as study objects, Monte Carlo cross-validation method was used to identify the significant pathway cross-talks. In the process of Monte Carlo cross-validation, all steps were iterated 50 times. For each run, detection of differentially expressed genes (DEGs between two groups was conducted. The extraction of the potential disrupted pathways enriched by DEGs was then implemented. Subsequently, we established a discriminating score (DS for each pathway pair according to the distribution of gene expression levels. After that, we utilized random forest (RF classification model to screen out the top 10 paired pathways with the highest area under the curve (AUCs, which was computed using 10-fold cross-validation approach. After 50 bootstrap, the best pairs of pathways were identified. According to their AUC values, the pair of pathways, antigen presentation pathway and fMLP signaling in neutrophils, achieved the best AUC value of 1.000, which indicated that this pathway cross-talk could distinguish AS patients from normal subjects. Moreover, the paired pathways of SAPK/JNK signaling and mitochondrial dysfunction were involved in 5 bootstraps. Two paired pathways (antigen presentation pathway and fMLP signaling in neutrophil, as well as SAPK/JNK signaling and mitochondrial dysfunction can accurately distinguish AS and control samples. These paired pathways may be helpful to identify patients with AS for early intervention.

  6. Reducing work disability in Ankylosing Spondylitis – development of a work instability scale for AS

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    Helliwell Philip

    2009-06-01

    Full Text Available Abstract Background The Work Instability Scale for Rheumatoid Arthritis (RA-WIS is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands in Ankylosing Spondylitis (AS and develop a Work Instability Scale specific to this population. Methods New items generated from qualitative interviews were combined with items from the RA-WIS to form a draft AS-WIS. Rasch analysis was used to examine the scaling properties of the AS-WIS using data generated through a postal survey. The scale was validated against a gold standard of expert assessment, a test-retest survey examined reliability. Results Fifty-seven participants who were in work returned the postal survey. Of the original 55 items 38 were shown to fit the Rasch model (χ2 37.5; df 38; p 0.494 and free of bias for gender and disease duration. Following analysis for discrimination against the gold standard assessments 20 items remained with good fit to the model (χ2 24.8; df 20; p 0.21. Test-retest reliability was 0.94. Conclusion The AS-WIS is a self-administered scale which meets the stringent requirements of modern measurement. Used as a screening tool it can identify those experiencing a mismatch at work who are at risk of job retention problems and work disability. Work instability is emerging as an important indication for the use of biologics, thus the AS-WIS has the potential to become an important outcome measure.

  7. Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial.

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    Dundar, U; Solak, O; Toktas, H; Demirdal, U S; Subasi, V; Kavuncu, V; Evcik, D

    2014-11-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p aquatic exercise group. It is concluded that a water-based exercises produced better improvement in pain score and quality of life of the patients with AS compared with home-based exercise.

  8. Posttraumatic stress disorder and correlates of disease activity among veterans with ankylosing spondylitis.

    Science.gov (United States)

    Liew, Jean; Lucas Williams, J; Dobscha, Steven; Barton, Jennifer L

    2017-10-01

    The objective of this retrospective study was to evaluate the prevalence of comorbid Posttraumatic stress disorder (PTSD) and the association of PTSD with pain, disease activity, and medication use in ankylosing spondylitis (AS). Veterans with one or more visit to an outpatient rheumatology clinic at a single Veterans Affairs site during a 2-year study period were identified by ICD codes for AS and included if there was documentation of AS diagnosis by a rheumatologist. Data were collected on PTSD diagnosis, demographics, pain scores, disease activity by the Bath AS Disease Activity Index (BASDAI), and medication use. Characteristics were compared by PTSD status using t tests for continuous variables and Chi-square or Fischer's exact test for categorical variables. Of 113 Veterans with AS, 20 (18%) had a diagnosis of PTSD. Those with PTSD were significantly younger, 52 ± 17 years, as compared to those without PTSD, 59 ± 14 years (p = 0.04). BASDAI was recorded for 30% with a mean score of 4.3 ± 2.0. Those with PTSD had higher mean pain and BASDAI scores as compared to those without PTSD (p = 0.06 for both comparisons). Prescribed medications were similar for both groups in regards to synthetic disease modifying antirheumatic drugs (DMARDs), biologics, and opioids, although those with PTSD were significantly more likely to receive NSAIDs (p = 0.03). Veterans with AS and comorbid PTSD were younger and had higher reported pain and disease activity scores compared to those without PTSD in this single site study. These findings underscore the importance of identifying PTSD in patients with AS.

  9. Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature.

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    Tarhan, Figen; Argın, Mehmet; Can, Gerçek; Özmen, Mustafa; Keser, Gökhan

    2014-03-01

    The coexistence of systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) is very rare, and, to the best of our knowledge, there are only 8 reported cases in the English literature. Here, we present another case with the coexistence of these two diseases, and review the clinical and laboratory features of the previously reported cases. A 55 year-old female patient, with a diagnosis of SLE with locomotor, skin, renal and hematopoietic system involvement, which had been confirmed by relevant autoantibody positivity, and hypocomplementemia and biopsy-proven membranous lupus nephritis, was referred to our clinic suffered from typical inflammatory low-back pain after eight years of follow-up. Sacroiliac magnetic resonance imaging (MRI) confirmed the presence of bilateral active sacroiliitis with bone marrow oedema. HLA-B27 was positive and bilateral calcaneal spurs were also detected by conventional radiography. Therefore, the additional diagnosis of AS was made, eight years after the diagnosis of SLE. Inflammatory low-back pain typically responded to treatment with non-steroidal anti-inflammatory drugs. Including the present case, most of the reported cases of the coexistence of SLE and AS are female, and SLE generally precedes the occurrence of AS. The present case is also notable as the patient had both MRI confirmation of bilateral active sacroiliitis and HLA-B27 positivity. The coexistence of these two diseases with different genetic backgrounds in the same patient is much lower than expected based upon their prevalence in the general population. Although it has been suggested that the very rare combination of the susceptibility genes of each disease may explain the rarity of coexistence, epidemiological data concerning the genetic risks for the coexistence of SLE and AS are not available.

  10. A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes.

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    Aydin, Sibel Zehra; Can, Meryem; Alibaz-Oner, Fatma; Keser, Gokhan; Kurum, Esra; Inal, Vedat; Yazisiz, Veli; Birlik, Merih; Emmungil, Hakan; Atagunduz, Pamir; Direskeneli, Haner; McGonagle, Dennis; Pay, Salih

    2016-03-01

    Spinal new bone formation is a major but incompletely understood manifestation of ankylosing spondylitis (AS). We explored the relationship between spinal new bone formation and ultrasound (US)-determined Achilles enthesophytes to test the hypothesis that spinal new bone formation is part of a generalized enthesis bone-forming phenotype. A multicenter, case control study of 225 consecutive AS patients and 95 age/body mass index (BMI) matched healthy controls (HC) was performed. US scans of Achilles tendons and cervical and lumbar spine radiographs were obtained. All images were centrally scored by one investigator for US and one for radiographs, blinded to medical data. The relation between syndesmophytes (by modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the number of syndesmophytes) and enthesophytes (with a semi-quantitative scoring of the US findings) was investigated. AS patients had significantly higher US enthesophyte scores than HCs (2.1(1.6) vs. 1.6(1.6); p = 0.004). The difference was significant in males (p = 0.001) but not in females (p = 0.5). The enthesophyte scores significantly correlated with mSASSS scores (ρ = 0.274, p formation.

  11. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis

    Science.gov (United States)

    Vidal-Castiñeira, Jose Ramón; López-Vázquez, Antonio; Diaz-Peña, Roberto; Diaz-Bulnes, Paula; Martinez-Camblor, Pablo; Coto, Eliecer; Coto-Segura, Pablo; Bruges-Armas, Jacome; Pinto, Jose Antonio; Blanco, Francisco Jose; Sánchez, Alejandra; Mulero, Juan; Queiro, Ruben; Lopez-Larrea, Carlos

    2016-01-01

    The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS). We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005). This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005). Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS. PMID:27415816

  12. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis.

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    Jose Ramón Vidal-Castiñeira

    Full Text Available The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS. We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005. This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005. Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS.

  13. Impact of treatment with TNF antagonists on total cholesterol in patients with ankylosing spondylitis and psoriatic arthritis.

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    Maneiro, Jose Ramon; Souto, Alejandro; Gomez-Reino, Juan J

    2017-05-01

    The objective of the study was to analyze the impact of TNF antagonists (TNFa) on the total cholesterol and triglycerides on ankylosing spondylitis (AS) and psoriatic arthritis (PsA). In this single-centre observational study of AS and PsA patients, differences in triglyceride and total cholesterol levels and frequency of hypertriglyceridemia and hypercholesterolemia at 3 and 6 months were analysed in patients treated and not treated with TNFa. General estimation equations and linear regression analysis were used to investigate associations between disease activity and lipid levels and to identify predictors of change. One hundred fifty-seven patients treated, and 157 not treated with TNFa, were included in the study. A transient increase in cholesterol level from baseline to 3 months in TNFa-treated patients was the only statistically significant effect (P Ankylosing Spondylitis Disease Activity Index (P = 0.011) and CRP (P < 0.001), but not Disease Activity Score in 28 Joints (P = 0.095) were found in the whole group. In AS and PsA patients treated with TNFa, mild and transient changes in cholesterol but not in triglyceride levels were associated with changes in disease activity.

  14. Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome.

    Science.gov (United States)

    Corli, Justine; Flipo, René-Marc; Philippe, Peggy; Bera-Louville, Anne; Béhal, Hélène; Wibaux, Cécile; Paccou, Julien

    2015-12-01

    The purpose of this study was to (1) evaluate baseline characteristics of nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) treated with tumor necrosis factor-α inhibitors (TNFi), (2) assess the response to first TNFi treatment, and (3) compare drug-survival duration and rates. Inclusion criteria were patients with axSpA who initiated first TNFi treatment between April 2001 and July 2014 and were followed up for at least 3 months. Efficacy criteria were an improvement of at least 2 points (on a 0-10 scale) or a 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Baseline characteristics, responses at 12 months, and drug survival were compared between AS and nr-axSpA. A total of 361 patients were included in the study (AS, n = 263 and nr-axSpA, n = 98). Patients with AS were more often men (65.02% vs 45.92%, p = 0.001) and had longer symptom duration (11.71 ± 9.52 vs 7.34 ± 9.30 yrs, p Treatment response and drug survival were similar in patients with AS and nr-axSpA after first TNFi initiation.

  15. Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, anti-TNF-α therapy and other novel approaches

    Science.gov (United States)

    Braun, Juergen; Sieper, Joachim

    2002-01-01

    Therapeutic options for patients with more severe forms of spondyloarthritis (SpA) have been rather limited in recent decades. There is accumulating evidence that anti-tumor-necrosis-factor (anti-TNF) therapy is highly effective in SpA, especially in ankylosing spondylitis and psoriatic arthritis. The major anti-TNF-α agents currently available, infliximab (Remicade®) and etanercept (Enbrel®), are approved for the treatment of rheumatoid arthritis (RA) in many countries. In ankylosing spondylitis there is an unmet medical need, since there are almost no disease-modifying antirheumatic drugs (DMARDs) available for severely affected patients, especially those with spinal manifestations. Judging from recent data from more than 300 patients with SpA, anti-TNF therapy seems to be even more effective in SpA than in rheumatoid arthritis. However, it remains to be shown whether patients benefit from long-term treatment, whether radiological progression and ankylosis can be stopped and whether long-term biologic therapy is safe. PMID:12223105

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

    Science.gov (United States)

    Yu, Hui-Chun; Lu, Ming-Chi; Huang, Kuang-Yung; Huang, Hsien-Lu; Liu, Su-Qin; Huang, Hsien-Bin; Lai, Ning-Sheng

    2015-12-29

    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.

  17. [The relevance of ADC value, T₁intensive rate and the clinical activities in ankylosing spondylitis sacroiliitis].

    Science.gov (United States)

    Zhao, Yinghua; Han, Xinai; Hu, Shaoyong; Shi, Xingliang; Zhao, Jing; Sun, Erwei; Li, Shaolin

    2014-09-23

    To evaluate the value of judging for the activity in AS by diffusion-weighted sequences (DWI) and enhance sequences MRI(DCE-MRI), to explore the correlation of Apparent diffusion coefficient(ADC) values, intensive rate and the clinical activity index in sacroiliitis (SIJ) of ankylosing spondylitis (AS). 56 patients prospectively choiced and diagnosed were divided into two groupsas, active group (n = 32) and chronic group (n = 24) by rheumatologist according to BASDAI and laboratory parameters. Twenty healthy adults were as control group. The values of ADC and intensive rate of all sacroiliac joints (SIJs) were measured on MRI. BASDAI score were got by Bath ankylosing spondylitis disease activity index. ESR, CPR and were got by laboratory. Statisticaly to analysis whether the parameters were significantly different amang AS active, chronic, and the control group. To assess the correlation of the values of ADC, intensive rate and BASDAI score, ESR, CPR and in SIJ. the values of ADC and intensive rate were significantly different among AS active, chronic and the control group. There were the significant correlation between the values of ADC, intensive rate and BASDAI score. Diffusion-weighted sequences and Contrast-enhanced sequences is superior to other methods in judging the activity in AS.combined with clinical activity index, the accuracy can significantly be improved to explore whether the activities of AS are.

  18. Inhibition of Klebsiella pneumoniae growth by selected Australian plants: natural approaches for the prevention and management of ankylosing spondylitis.

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    Winnett, V; Sirdaarta, J; White, A; Clarke, F M; Cock, I E

    2017-04-01

    A wide variety of herbal remedies are used in traditional Australian medicine to treat inflammatory disorders, including autoimmune inflammatory diseases. One hundred and six extracts from 40 native Australian plant species traditionally used for the treatment of inflammation and/or to inhibit bacterial growth were investigated for their ability to inhibit the growth of a microbial trigger for ankylosing spondylitis (K. pneumoniae). Eighty-six of the extracts (81.1%) inhibited the growth of K. pneumoniae. The D. leichardtii, Eucalyptus spp., K. flavescens, Leptospermum spp., M. quinquenervia, Petalostigma spp., P. angustifolium, S. spinescens, S. australe, S. forte and Tasmannia spp. extracts were effective K. pneumoniae growth inhibitors, with MIC values generally <1000 µg/mL. The T. lanceolata peppercorn extracts were the most potent growth inhibitors, with MIC values as low as 16 µg/mL. These extracts were examined by non-biased GC-MS headspace analysis and comparison with a compound database. A notable feature was the high relative abundance of the sesquiterpenoids polygodial, guaiol and caryophyllene oxide, and the monoterpenoids linalool, cineole and α-terpineol in the T. lanceolata peppercorn methanolic and aqueous extracts. The extracts with the most potent K. pneumoniae inhibitory activity (including the T. lanceolata peppercorn extracts) were nontoxic in the Artemia nauplii bioassay. The lack of toxicity and the growth inhibitory activity of these extracts against K. pneumoniae indicate their potential for both preventing the onset of ankylosing spondylitis and minimising its symptoms once the disease is established.

  19. The effect of anti-TNF treatment on osteoblastogenesis in ankylosing spondylitis: the number of circulating osteoblast-lineage cells in peripheral blood decreased after infliximab therapy in patients with ankylosing spondylitis.

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    Kwon, Seong-Ryul; Jung, Kyong-Hee; Lim, Mie-Jin; Son, Min-Jung; Choi, Byung Hyune; Park, Shin-Goo; Park, Won

    2017-01-01

    The full effect of anti-TNF therapy on new bone formation is still in debate in spondylitis fields. We sought to obtain circulating osteoblast-lineage cells in peripheral blood from ankylosing spondylitis (AS) patients and healthy control subjects, and to evaluate the effect of before and after anti TNF-α therapy on osteoblastogenesis in patients with AS. Sixteen male patients with AS slated for infliximab therapy and 19 controls were recruited. We cultured osteoblast-lineage cells from peripheral blood and measured the optical density of their Alizarin red S staining. We also measured serum P1NP (procollagen type 1 N-terminal propeptide) as an early osteoblast differentiation marker, osteocalcin as a late osteoblast differentiation marker, and inflammatory markers. There were significantly more circulating osteoblast-lineage cells in patients than in controls. The number of circulating osteoblast-lineage cells and optical density of Alizarin red S staining decreased 14 weeks after infliximab therapy (p=0.028); serum level of P1NP decreased, but that of osteocalcin increased (p=0.002 and 0.007, respectively). Our data reveals that first, the circulating osteoblast-lineage cells are recoverable and increased in AS patients, and also that they decrease after infliximab therapy; second, infliximab therapy resolves early inflammation, but allows mature osteoblast differentiation in late inflammation. The culture of osteoblast-lineage cells in peripheral blood may be a candidate for a new modality with which to study spondylitis and other autoimmune diseases.

  20. Raised incidence of ankylosing spondylitis among Inuit populations could be due to high HLA-B27 association and starch consumption.

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    Rashid, Taha; Wilson, Clyde; Ebringer, Alan

    2015-06-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis mainly affecting the spinal joints. It would appear that the most likely causative agent in the development of AS is an environmental factor in the genetically susceptible, HLA-B27 positive, individuals. Extensive data from several countries support the notion that Klebsiella pneumonia bacteria are the most likely culprit in the causation of AS. These microbes possess antigens which resemble HLA-B27 and spinal collagens. Increased intake of high-starch diet is directly proportional to the gut-associated bacterial load, especially in the large intestine, and among these microbial agents, Klebsiella is considered as one of the main constituting components. Therefore, a low-starch diet intake alongside the currently used medical therapeutic modalities could be beneficial in the management of patients with early AS. It is suggested that a change in the dietary habits from high protein, low-starch marine components to the Westernized high-starch diet among the Inuit peoples of Alaska and Canada could be considered as one of the main contributing factors in the increased prevalence of AS during the last few decades within this genetically unmixed native population.

  1. Adverse events of anti-tumor necrosis factor α therapy in ankylosing spondylitis.

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    Qiang Tong

    Full Text Available This study aims to investigate the prevalence of short-term and long-term adverse events associated with tumor necrosis factor-α (TNF-α blocker treatment in Chinese Han patients suffering from ankylosing spondylitis (AS.The study included 402 Chinese Han AS patients treated with TNF-α blockers. Baseline data was collected. All patients were monitored for adverse events 2 hours following administration. Long-term treatment was evaluated at 8, 12, 52 and 104 weeks follow-up for 172 patients treated with TNF-α blockers.Short-term adverse events occurred in 20.15% (81/402, including rash (3.5%; 14/402, pruritus (1.2%; 5/402, nausea (2.2%; 9/402, headache (0.7%; 3/402, skin allergies (4.0%; 16/402, fever (0.5%; 2/402, palpitations (3.0%; 12/402, dyspnea (0.5%; 2/402, chest pain (0.2%; 1/402, [corrected] abdominal pain (1.0%; 4/402, hypertension (2.2%; 9/402, papilledema (0.5%; 2/402, laryngeal edema (0.2%; 1/402 and premature ventricular contraction (0.2%; 1/402. Long-term adverse events occurred in 59 (34.3%; 59/172 patients, including pneumonia (7.6%; 13/172, urinary tract infections (9.9%; 17/172, otitis media (4.7%; 8/172, tuberculosis are (3.5%; 6/172 [corrected], abscess (1.2%; 2/172, oral candidiasis (0.6%; 1/172, elevation of transaminase (1.7%; 3/172, anemia (1.2%; 2/172, hematuresis (0.6%; 1/172, constipation (2.3%; 4/172, weight loss (0.6%; 1/172, exfoliative dermatitis (0.6%; 1/172. CRP, ESR and disease duration were found to be associated with an increased risk of immediate and long-term adverse events (P<0.05. Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc (P<0.01.This study reports on the prevalence of adverse events in short-term and long-term treatment with TNF-α blocker monotherapy in Chinese Han AS patients. Duration of disease, erythrocyte sedimentation rate, and c-reactive protein serum levels were found to be associated with increased adverse events with anti-TNF-α therapy. Long

  2. Operative strategy for different types of thoracolumbar stress fractures in ankylosing spondylitis.

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    Zhang, WenSheng; Zheng, MinQian

    2014-12-01

    There are no accurate guidelines on the operative treatment of ankylosing spondylitis (AS)-related thoracolumbar stress fractures. For this reason, we categorized such bone fractures into 2 types: vertebral body type and intervertebral space type, according to the damage mechanism, cross-section spot, and iconography, and devised a targeted surgical plan based on the characteristics of each fracture type. To investigate the types and surgical treatment of thoracolumbar stress fractures in AS. Thoracolumbar stress fractures are complications of AS. The patients with AS have a higher fracture risk that is approximately 3.5 times than the healthy. As the mechanism of injury, clinical manifestations, imaging characteristics, and principles of treatment of these fractures differ from those of general spinal fractures, the surgical approach is different from that of AS kyphosis orthopedic surgery. In this study, we summarize the clinical data of 11 AS patients with thoracolumbar fractures and discuss the clinical efficacy of the surgical approach based on the mechanism of injury and radiographic features. We reviewed the data of 11 patients who underwent surgery for AS-related thoracolumbar stress fractures. Five patients with vertebral body-type fractures underwent vertebral wedge osteotomy through the pedicle and posterior internal fixation, whereas 6 patients with intervertebral space-type fractures underwent anterior spinal decompression with strut grafting and posterior internal fixation. The follow-up period was 2-4 years. After surgery, all kyphosis deformities were corrected, low back pain was relieved immediately, and scores on the visual analog scale improved by >70%. At the final follow-up, kyphosis correction had no significant loss. In the radiographic images, neither nonunion signs of pseudarthrosis plane nor neurologic or infectious complications were observed. Choosing an anterior or posterior surgical approach based on the type of AS

  3. Second-line biologic therapy optimization in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

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    Cantini, Fabrizio; Niccoli, Laura; Nannini, Carlotta; Cassarà, Emanuele; Kaloudi, Olga; Giulio Favalli, Ennio; Becciolini, Andrea; Benucci, Maurizio; Gobbi, Francesca Li; Guiducci, Serena; Foti, Rosario; Mosca, Marta; Goletti, Delia

    2017-10-01

    The Italian board for the TAilored BIOlogic therapy (ITABIO) reviewed the most consistent literature to indicate the best strategy for the second-line biologic choice in patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), and psoriatic arthritis (PsA). Systematic review of the literature to identify English-language articles on efficacy of second-line biologic choice in RA, PsA, and ankylosing spondylitis (AS). Data were extracted from available randomized, controlled trials, national biologic registries, national healthcare databases, post-marketing surveys, and open-label observational studies. Some previously stated variables, including the patients׳ preference, the indication for anti-tumor necrosis factor (TNF) monotherapy in potential childbearing women, and the intravenous route with dose titration in obese subjects resulted valid for all the three rheumatic conditions. In RA, golimumab as second-line biologic has the highest level of evidence in anti-TNF failure. The switching strategy is preferable for responder patients who experience an adverse event, whereas serious or class-specific side effects should be managed by the choice of a differently targeted drug. Secondary inadequate response to etanercept (ETN) should be treated with a biologic agent other than anti-TNF. After two or more anti-TNF failures, the swapping to a different mode of action is recommended. Among non-anti-TNF targeted biologics, to date rituximab (RTX) and tocilizumab (TCZ) have the strongest evidence of efficacy in the treatment of anti-TNF failures. In PsA and AS patients failing the first anti-TNF, the switch strategy to a second is advisable, taking in account the evidence of adalimumab efficacy in patients with uveitis. The severity of psoriasis, of articular involvement, and the predominance of enthesitis and/or dactylitis may drive the choice toward ustekinumab or secukinumab in PsA, and the latter in AS. Taking in account the paucity of controlled trials

  4. [APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS].

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    Wang, Fei; Tao, Huiren; Liu, Zhibin; Zhang, Jianhua; Han, Fangmin

    2015-02-01

    To introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. Between March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). No complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P 0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2 ± 10.5) degrees and (33.7 ± 9.7) degrees respectively, showing no significant difference (t = 0.84, P = 0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P 0.05). At last follow-up, no failures

  5. Ankylosing spondylitis, late osteoarthritis, vascular calcification, chondrocalcinosis and pseudo gout: toward a possible drug therapy.

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    Mebarek, S; Hamade, E; Thouverey, C; Bandorowicz-Pikula, J; Pikula, S; Magne, D; Buchet, R

    2011-01-01

    In this review we consider diseases associated with pathological mineralization/ossification, namely, ankylosing spondylitis (AS), osteoarthritis (OA), generalized artery calcification of infancy (GACI), vascular calcification as well as chondrocalcinosis (CC) and pseudo gout. Deciphering the key enzymes implicated in the calcification process is an objective of prime importance and the ultimate goal is to synthesize inhibitors of these enzymes in order to provide efficient alternate therapeutic strategies that will slow down the pathologic mineralization and complement the arsenal of anti-inflammatory drugs. One of the difficulties in the definition of diseases associated with pathologic mineralization/ossification lies in the controversial relationship between the type of calcification and the nature of the disease. Here, we propose to clarify this relationship by making a distinction between diseases associated with hydroxyapatite (HA) and calcium pyrophosphate dihydrate (CPPD) deposits. AS, OA, GACI and vascular calcification are usually characterized by mineralization/ossification associated with HA deposits, while CC and pseudo gout are mostly characterized by CPPD deposits. Although both HA and CPPD deposits may occur concomitantly, as in chronic pyrophosphate arthritis or in OA with CPPD, they are formed as a result of two antagonistic processes indicating that treatment of distinct diseases can be only achieved by disease-specific drug therapies. The hydrolysis of PPi, an inhibitor of HA formation, is mostly controlled by tissue non-specific alkaline phosphatase TNAP, while PPi production in the extracellular medium is controlled by ANK, a PPi transporter, and/or NPP1 which generates PPi from nucleotide triphosphates. Low PPi concentration may lead to a preferential deposition of HA while high PPi concentration will favor the formation of CPPD deposits. Thus, HA and CCPD deposition cannot occur concomitantly because they are determined by the Pi/PPi ratio

  6. The information needs of people living with ankylosing spondylitis: a questionnaire survey

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    Cooksey Roxanne

    2012-12-01

    Full Text Available Abstract Background Today, health care is patient-centred with patients more involved in medical decision making and taking an active role in managing their disease. It is important that patients are appropriately informed about their condition and that their health care needs are met. We examine the information utilisation, sources and needs of people with Ankylosing Spondylitis (AS. Methods Participants in an existing AS cohort study were asked to complete a postal or online questionnaire containing closed and open-ended questions, regarding their information access and needs. Participants were stratified by age and descriptive statistics were performed using STATA 11, while thematic analysis was performed on open-ended question narratives. Qualitative data was handled in Microsoft Access and explored for emerging themes and patterns of experiences. Results Despite 73% of respondents having internet access, only 49% used the internet to access information regarding AS. Even then, this was only infrequently. Only 50% of respondents reported accessing written information about AS, which was obtained mainly in specialist clinics. Women were more likely than men to access information (63% (women 46% (men regardless of the source, while younger patients were more likely to use online sources. The main source of non-written information was the rheumatologist. Overall, the respondents felt there was sufficient information available, but there was a perception that the tone was often too negative. The majority (95% of people would like to receive a regular newsletter about AS, containing positive practical and local information. Suggestions were also made for more information about AS to be made available to non-specialist medical professionals and the general public. Conclusions There appears to be sufficient information available for people with AS in the UK and this is mostly accessed by younger AS patients. Many patients, particularly men, choose

  7. Bone formation rather than inflammation reflects ankylosing spondylitis activity on PET-CT: a pilot study.

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    Bruijnen, Stefan T G; van der Weijden, Mignon A C; Klein, Joannes P; Hoekstra, Otto S; Boellaard, Ronald; van Denderen, J Christiaan; Dijkmans, Ben A C; Voskuyl, Alexandre E; van der Horst-Bruinsma, Irene E; van der Laken, Conny J

    2012-04-02

    Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in imaging AS activity was tested using different tracers, with Magnetic Resonance Imaging (MRI) and conventional radiographs as reference. In a stepwise approach different PET tracers were investigated. First, whole body [18F]FDG and [11C](R)PK11195 PET-CT scans were obtained of ten AS patients fulfilling the modified New York criteria. According to the BASDAI five of these patients had low and five had high disease activity. Secondly, an extra PET-CT scan using [18F]Fluoride was made of two additional AS patients with high disease activity. MRI scans of the total spine and sacroiliac joints were performed, and conventional radiographs of the total spine and sacroiliac joints were available for all patients. Scans and radiographs were visually scored by two observers blinded for clinical data. No increased [18F]FDG and [11C](R)PK11195 uptake was noticed on PET-CT scans of the first 10 patients. In contrast, MRI demonstrated a total of five bone edema lesions in three out of 10 patients. In the two additional AS patients scanned with [18F]Fluoride PET-CT, [18F]Fluoride depicted 17 regions with increased uptake in both vertebral column and sacroiliac joints. In contrast, [18F]FDG depicted only three lesions, with an uptake of five times lower compared to [18F]Fluoride, and again no [11C](R)PK11195 positive lesions were found. In these two patients, MRI detected nine lesions and six out of nine matched with the anatomical position of [18F]Fluoride uptake. Conventional radiographs showed structural

  8. COMPARATIVE EVALUATION OF PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS

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    I. А. Cherentsova

    2016-01-01

    Full Text Available Objective: to study clinical presentations, disease activity, and functional impairments  in patients with ankylosing spondylitis (AS and non-radiographic axial spondyloarthritis  (nr-axSpA.Subjects and methods. A total of 153 patients were examined in the period 2010 to 2013. They were divided into two groups: 1 119 patients with a valid diagnosis of AS; 2 34 with nr-axSpA. BASDAI, BASFI, BASMI, MASES, erythrocyte sedimentation rate, and HLA-B27 antigen were determined  in both groups. The mean age of the patients was 36.5±0.7 years and 27.0±1.2 years and the disease duration 14.7±0.6 and 4.1±0.5 years in Groups 1 and 2, respectively.Results and discussion. Among the patients with AS and those with nr-axSpA, men accounted  for 68.9 and 70.6%, respectively. The axial type was predominant in both groups (53.7% in Group 1 and 67.6% in Group 2. The mean visual analogue scale (VAS pain score was 40.6±1.6 mm in Group 1 and 31.6±2.4 mm in Group 2 (p < 0.01. High BASDAI was seen in 51.2% of the patients with AS and 41.1% of those with nr-axSpA. Group 2 had significantly lower mean BASDAI values (3.4±0.2  than Group 1 (4.0±0.1.  Functional impairments  by BASFI were more obvious in the patients with AS ((3.2±0.2 than in those with nr-axSpA (1.5±0.2.  BASFI >4 was not noted in Group 2. Higher BASMI scores were found in the patients with AS (1.9±0.1  than in those with nr-axSpA (0.5±0.1. Conclusion. The ASAS criteria for axSpA enable one to establish its diagnosis in the early stage until stable functional impairments  emerge. In the pre-radiographic stage, the patients have lower disease activity and pain.

  9. Increased arterial wall inflammation in patients with ankylosing spondylitis is reduced by statin therapy.

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    van der Valk, Fleur M; Bernelot Moens, Sophie J; Verweij, Simone L; Strang, Aart C; Nederveen, Aart J; Verberne, Hein J; Nurmohamed, Michael T; Baeten, Dominique L; Stroes, Erik S G

    2016-10-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease with involvement of axial and sacroiliac joints. In addition, patients with AS have increased risk of cardiovascular disease (CVD), which might be attributed to enhanced inflammatory activity of the arterial wall. In the present study, we compared the level of carotid arterial wall inflammation in patients with AS with healthy controls using (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography with CT. As arterial wall inflammation is reduced by statin therapy, we subsequently assessed the effect of 3-month statin therapy on arterial wall inflammation in AS. We included 24 patients with AS (age 44±10, 72% males) without a history of CVD and 20 controls matched for age and gender. Patients with AS had lower high-density lipoprotein cholesterol and increased C reactive protein (CRP) compared with controls. The 10-year CVD risk was 2% in both groups. Notwithstanding, patients with AS had a 20% increase in arterial wall (18)F-FDG uptake compared with controls. Three-month atorvastatin 40 mg daily significantly lowered low-density lipoprotein cholesterol (baseline 3.55±1.15 mmol/L, -53%) and CRP (baseline 5.0 (1.5-9.3) mg/L, -58%) with a concomitant decrease of carotid arterial wall inflammation (maximum target-to-background ratio from 1.90±0.30 to 1.67±0.27; p=0.009). Patients with AS and without other CVD risk factors have increased arterial wall inflammation, which decreases upon statin therapy. These subjects are not identified as being at risk in current cardiovascular prevention guidelines. Our data support the need to revise CV disease management in AS, with perhaps a role for early statin therapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Screening for key genes and transcription factors in ankylosing spondylitis by RNA-Seq.

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    Xu, Zhongyang; Wang, Xiuyu; Zheng, Yanping

    2018-02-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis and autoimmune disease, the etiology and pathogenesis of which remain largely unknown. In the present study, blood samples were harvested from patients with AS and from healthy volunteers as a normal control (NC) for RNA-sequencing. Differentially expressed genes (DEGs) in the AS group compared with the NC group were identified, and gene ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were subsequently performed. Protein-protein interaction (PPI) network and AS-specific transcriptional regulatory network construction was performed for the DEGs. A total of 503 DEGs, including 338 upregulated and 165 downregulated DEGs, were identified in patients with AS compared with the NC group. Three upregulated DEGs identified, interferon-induced protein with tetratricopeptide repeats (IFIT)1, IFIT3 and radical S-adenosyl methionine domain containing (RSAD)2, are interferon (IFN)-stimulated genes that serve a role in the IFN signaling pathway. The most significantly enriched GO term was response to other organisms. Osteoclast differentiation was a significantly enriched pathway for eight DEGs [High affinity immunoglobulin gamma Fc receptor (FCGR)1A, FCGR2B, four and a half LIM domains 2, integrin β3, signal transducer and activator of transcription 2 (STAT2), suppressor of cytokine signaling 3 (SOCS3), leukocyte immunoglobulin like receptor (LILR)A4 and LILRA6]. The six hub genes in the PPI network constructed were interferon-stimulated gene 15, heat shock protein β1, microtubule-associated proteins 1A/1B light chain 3A, IFIT1, IFIT3 and SOCS3. POU domain class 2 transcription factor 1 (1-Oct) and ecotropic virus integration site-1 (Evi-1) were identified as two important transcription factors (TFs) in AS according to the AS-specific transcriptional regulatory network constructed. In addition, IFIT1 and IFIT3 were identified as targets of 1-Oct. The results of the

  11. Dysbiosis and zonulin upregulation alter gut epithelial and vascular barriers in patients with ankylosing spondylitis.

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    Ciccia, Francesco; Guggino, Giuliana; Rizzo, Aroldo; Alessandro, Riccardo; Luchetti, Michele Maria; Milling, Simon; Saieva, Laura; Cypers, Heleen; Stampone, Tommaso; Di Benedetto, Paola; Gabrielli, Armando; Fasano, Alessio; Elewaut, Dirk; Triolo, Giovanni

    2017-06-01

    Dysbiosis has been recently demonstrated in patients with ankylosing spondylitis (AS) but its implications in the modulation of intestinal immune responses have never been studied. The aim of this study was to investigate the role of ileal bacteria in modulating local and systemic immune responses in AS. Ileal biopsies were obtained from 50 HLA-B27 + patients with AS and 20 normal subjects. Silver stain was used to visualise bacteria. Ileal expression of tight and adherens junction proteins was investigated by TaqMan real-time (RT)-PCR and immunohistochemistry. Serum levels of lipopolysaccharide (LPS), LPS-binding protein (LPS-BP), intestinal fatty acid-BP (iFABP) and zonulin were assayed by ELISA. Monocyte immunological functions were studied in in vitro experiments. In addition the effects of antibiotics on tight junctions in human leukocyte antigen (HLA)-B27 transgenic (TG) rats were assessed. Adherent and invasive bacteria were observed in the gut of patients with AS with the bacterial scores significantly correlated with gut inflammation. Impairment of the gut vascular barrier (GVB) was also present in AS, accompanied by significant upregulation of zonulin, and associated with high serum levels of LPS, LPS-BP, iFABP and zonulin. In in vitro studies zonulin altered endothelial tight junctions while its epithelial release was modulated by isolated AS ileal bacteria. AS circulating monocytes displayed an anergic phenotype partially restored by ex vivo stimulation with LPS+sCD14 and their stimulation with recombinant zonulin induced a clear M2 phenotype. Antibiotics restored tight junction function in HLA-B27 TG rats. Bacterial ileitis, increased zonulin expression and damaged intestinal mucosal barrier and GVB, characterises the gut of patients with AS and are associated with increased blood levels of zonulin, and bacterial products. Bacterial products and zonulin influence monocyte behaviour. Published by the BMJ Publishing Group Limited. For permission to use

  12. Increased CCL19 and CCL21 levels promote fibroblast ossification in ankylosing spondylitis hip ligament tissue.

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    Qin, Yang; He, Li Da; Sheng, Zhou Jian; Yong, Miao Ming; Sheng, Yang Sheng; Wei Dong, Xu; Wen Wen, Tong; Ming, Zou Yu

    2014-09-26

    It is well-documented that both chemokine (C-C motif) ligand 19 (CCL19) and 21 (CCL21) mediate cell migration and angiogenesis in many diseases. However, these ligands' precise pathological role in ankylosing spondylitis (AS) has not been elucidated. The objective of this study was to examine the expression of CCL19 and CCL21 (CCL19/CCL21) in AS hip ligament tissue (LT) and determine their pathological functions. The expression levels of CCL19, CCL21 and their receptor CCR7 in AS (n = 31) and osteoarthritis (OA, n = 21) LT were analyzed via real-time polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC). The expression of CCL19, CCL21 and CCR7 in AS ligament fibroblasts was also detected. The proliferation of ligament fibroblasts was measured via a cell counting kit-8 (CCK8) assay after exogenous CCL19/CCL21 treatment. Additionally, the role of CCL19/CCL21 in osteogenesis was evaluated via RT-PCR and enzyme-linked immunosorbent assay (ELISA) in individual AS fibroblast cultures. Furthermore, the expression of the bone markers alkaline phosphatase (ALP), osteocalcin (OCN), collagenase I (COL1), integrin-binding sialoprotein (IBSP) and the key regulators runt-related transcription factor-2 (Runx-2) and osterix were investigated. Moreover, the CCL19/CCL21 levels in serum and LT were measured via ELISA. The mRNA levels of CCL19/CCL21 in AS hip LT were significantly higher than that in OA LT, and IHC analysis revealed a similar result. Exogenous CCL19/CCL21 treatment did not affect the proliferation of ligament fibroblasts but significantly up-regulated the expression of bone markers, including ALP and OCN, and the key regulators Runx-2 and osterix. In addition, the serum levels of CCL19/CCL21 were apparently elevated in AS patients compared to healthy controls (HC), and the expression of the two chemokines correlated significantly in AS patients. CCL19 and CCL21, two chemokines displaying significantly associated expression in serum, indicating a

  13. Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study.

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    Drăgoi, Răzvan-Gabriel; Amaricai, Elena; Drăgoi, Mihai; Popoviciu, Horatiu; Avram, Claudiu

    2016-04-01

    To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis. Randomized controlled study. Rheumatic Rehabilitation Centre. A total of 54 ankylosing spondylitis patients, all males, were randomized to a conventional exercise training associated with an inspiratory muscle training group, or to a conventional exercise training group. Group 1 (27 patients) performed eight weeks of conventional exercise training (supervised weekly group sessions followed by a home-based exercise programme) associated with inspiratory muscle training sessions. Group 2 (27 patients) received eight weeks of conventional exercise training only. Resting pulmonary function (forced vital capacity - FVC, forced expiratory volume in one second - FEV1); effort ventilatory efficiency (lowest ventilatory equivalent ratio for oxygen and carbon dioxide - VE/VO2 and VE/VCO2) and aerobic capacity (peak oxygen uptake - VO2peak) were assessed at baseline and after eight weeks of exercise-based intervention. After eight weeks follow-up, patients in Group 1 had a significant increased chest expansion and VO2peak compared with Group 2 (3.6 ±0.8 cm vs. 3.2 ±0.5 cm, P = 0.032; 2.0 ±0.5 l/min vs. 1.8 ±0.3 l/min, P = 0.033). There were no significant differences of spirometric measurements, except FVC which significantly improved in patients who performed inspiratory muscle training (82.7 ±5.1% vs. 79.5 ±3.5%, P = 0.014). VE/VCO2 also improved significantly in Group 1 (26.6 ±3.6 vs. 29.2 ±4.7, P = 0.040). Ankylosing spondylitis patients who performed eight weeks of inspiratory muscle training associated to conventional exercise training had an increased chest expansion, a better aerobic capacity, resting pulmonary function and ventilatory efficiency than those who performed conventional exercise training only. © The Author(s) 2015.

  14. Disease activity, quality of life and indirect costs of reduced productivity at work, generated by Polish patients with ankylosing spondylitis

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    Paweł Kawalec

    2016-02-01

    Full Text Available Objectives: The aim of the study was to investigate the association between activity of ankylosing spondylitis (AS and decrease in quality of life as well as productivity loss of affected patients in a specified group of patients in the Polish setting. Material and methods : An questionnaire survey was conducted using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI to assess disease activity, as well as the Work Productivity and Activity Impairment Questionnaires to assess productivity loss; quality of life was presented as utility calculated using the EuroQol 5 questionnaire and also measured on a visual analogue scale (VAS. Indirect costs were assessed with the human capital approach implying gross domestic product per capita or gross value added per worker in Poland in 2014 and were expressed in Polish zlotys (PLN as well as in euros. Correlation was presented using Spearman’s rank correlation coefficient. Results : We performed our analysis based on 78 full questionnaires collected. A mean BASDAI score of 5.91 in the analysed group of patients was detected and mean utility of 0.5135 was observed. Average quality of life measured on the visual analogue scale was 46.55. Mean number of days off work was 45.26 days per year and mean on-the-job productivity loss was 49.29%. Average annual indirect costs per patient were €4241 (17 686 PLN calculated using gross domestic product and €10 172 (42 417 PLN estimated using gross value added. Total productivity loss was significantly correlated with disease activity (strong correlation of 0.6005 and utility (moderate correlation of –0.3698. Conclusions : Ankylosing spondylitis causes a great decrease in quality of life as well as patients’ productivity loss associated with both absenteeism and presenteeism. The greater the disease activity is, the lower is the utility, the lower is the quality of life measured on the VAS, and the greater are the total annual indirect costs. Total

  15. Association of variants at 1q32 and STAT3 with ankylosing spondylitis suggests genetic overlap with Crohn's disease.

    Science.gov (United States)

    Danoy, Patrick; Pryce, Karena; Hadler, Johanna; Bradbury, Linda A; Farrar, Claire; Pointon, Jennifer; Ward, Michael; Weisman, Michael; Reveille, John D; Wordsworth, B Paul; Stone, Millicent A; Maksymowych, Walter P; Rahman, Proton; Gladman, Dafna; Inman, Robert D; Brown, Matthew A

    2010-12-02

    Ankylosing spondylitis (AS) is a common inflammatory arthritic condition. Overt inflammatory bowel disease (IBD) occurs in about 10% of AS patients, and in addition 70% of AS cases may have subclinical terminal ileitis. Spondyloarthritis is also common in IBD patients. We therefore tested Crohn's disease susceptibility genes for association with AS, aiming to identify pleiotropic genetic associations with both diseases. Genotyping was carried out using Sequenom and Applied Biosystems TaqMan and OpenArray technologies on 53 markers selected from 30 Crohn's disease associated genomic regions. We tested genotypes in a population of unrelated individual cases (n = 2,773) and controls (n = 2,215) of white European ancestry for association with AS. Statistical analysis was carried out using a Cochran-Armitage test for trend in PLINK. Strong association was detected at chr1q32 near KIF21B (rs11584383, P = 1.6 × 10(-10), odds ratio (OR) = 0.74, 95% CI:0.68-0.82). Association with disease was also detected for 2 variants within STAT3 (rs6503695, P = 4.6 × 10(-4). OR = 0.86 (95% CI:0.79-0.93); rs744166, P = 2.6 × 10(-5), OR = 0.84 (95% CI:0.77-0.91)). Association was confirmed for IL23R (rs11465804, P = 1.2 × 10(-5), OR = 0.65 (95% CI:0.54-0.79)), and further associations were detected for IL12B (rs10045431, P = 5.2 × 10(-5), OR = 0.83 (95% CI:0.76-0.91)), CDKAL1 (rs6908425, P = 1.1 × 10(-4), OR = 0.82 (95% CI:0.74-0.91)), LRRK2/MUC19 (rs11175593, P = 9.9 × 10(-5), OR = 1.92 (95% CI: 1.38-2.67)), and chr13q14 (rs3764147, P = 5.9 × 10(-4), OR = 1.19 (95% CI: 1.08-1.31)). Excluding cases with clinical IBD did not significantly affect these findings. This study identifies chr1q32 and STAT3 as ankylosing spondylitis susceptibility loci. It also further confirms association for IL23R and detects suggestive association with another 4 loci. STAT3 is a key signaling molecule within the Th17 lymphocyte differentiation pathway and further enhances the case for a major role

  16. Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study

    Directory of Open Access Journals (Sweden)

    Nannini C

    2013-01-01

    Full Text Available Fabrizio Cantini, Laura Niccoli, Emanuele Cassarà, Olga Kaloudi, Carlotta NanniniDivision of Rheumatology, Misericordia e Dolce Hospital, Prato, ItalyBackground: The aim of this study was to evaluate the proportion of patients with ankylosing spondylitis maintaining clinical remission after reduction of their subcutaneous etanercept dose to 50 mg every other week compared with that in patients receiving etanercept 50 mg weekly.Methods: In the first phase of this randomized, prospective, follow-up study, all biologic-naïve patients identified between January 2005 and December 2009 as satisfying the modified New York clinical criteria for ankylosing spondylitis treated with etanercept 50 mg weekly were evaluated for disease remission in January 2010. In the second phase, patients meeting the criteria for remission were randomized to receive subcutaneous etanercept as either 50 mg weekly or 50 mg every other week. The randomization allocation was 1:1. Remission was defined as Bath Ankylosing Spondylitis Disease Activity Index < 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis, or iridocyclitis, and normal acute-phase reactants. The patients were assessed at baseline, at weeks 4 and 12, and every 12 weeks thereafter. The last visit constituted the end of the follow-up.Results: During the first phase, 78 patients with ankylosing spondylitis (57 males and 21 females, median age 38 years, median disease duration 12 years were recruited. In January 2010, after a mean follow-up of 25 ± 11 months, 43 (55.1% patients achieving clinical remission were randomized to one of the two treatment arms. Twenty-two patients received etanercept 50 mg every other week (group 1 and 21 received etanercept 50 mg weekly (group 2. At the end of follow-up, 19 of 22 (86.3% subjects in group 1 and 19 of 21 (90.4% in group 2 were still in remission, with no significant difference between the two groups. The mean follow-up duration in group

  17. Espondilite anquilosante e anestesia Espondilitis anquilosante y anestesia Ankylosing spondylitis and anesthesia

    Directory of Open Access Journals (Sweden)

    Carlos Rogério Degrandi Oliveira

    2007-04-01

    40 años; es rara después de los 50 años. Las mujeres corresponden solamente a la minoría de pacientes. Existe poca información sobre la EA en la literatura anestésica. El objetivo de este artículo fue revisar aspectos de la EA de interés para el anestesiólogo, permitiendo un adecuado manoseo perioperatorio. CONTENIDO: Están definidas las características de la espondilitis anquilosante en cuanto a la clínica y la conducta anestésica. CONCLUSIONES: Los pacientes con enfermedades crónicas de la columna vertebral presentan desafíos específicos para el anestesiólogo. El manoseo de la vía aérea y el acceso al neuro-eje podrán ser difíciles. La preferencia ha sido dada a la anestesia general, incluso con la vía aérea de difícil acceso, evitando la anestesia en el neuro-eje. El grado de involucración de la columna cervical determinará cuanto podrá ser difícil la intubación traqueal. Un cuidado especial debe tenerse para evitar la manipulación excesiva de la columna cervical, lo que podría conllevar al trauma de la médula espinal.BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS is a chronic inflammatory disease of the joints, included in the group of seronegative spondyloarthropathies. Its main characteristic is the fusion of the bones in the spine, which causes loss of flexibility of the back and neck. Other large articulations and connective tissues can be affected by the inflammatory process. It affects mainly men between the ages of 20 and 40; it is rare after the age of 50. Women represent a minority of patients. There is little information about AS in the anesthetic literature. The objective of this article was to review the characteristics of AS pertaining anesthesiology for an adequate perioperative handling. CONTENTS: The clinical characteristics of ankylosing spondylitis pertaining to the anesthetic conduct are reviewed. CONCLUSIONS: Patients with chronic diseases of the spine represent specific challenges to the anesthesiologist

  18. Association between copy number variations of HLA-DQA1 and ankylosing spondylitis in the Chinese Han population.

    Science.gov (United States)

    Wang, J; Yang, Y; Guo, S; Chen, Y; Yang, C; Ji, H; Song, X; Zhang, F; Jiang, Z; Ma, Y; Li, Y; Du, A; Jin, L; Reveille, J D; Zou, H; Zhou, X

    2013-12-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease with complex genetic traits. Multiple sequence variations have been associated with AS, but explained only a proportion of heritability. The studies herein aimed to explore potential associations between genomic copy number (CN) variation (CNV) and AS in Han Chinese. Five AS patients were examined with the high-density comparative genomic hybridization microarrays in the first screen test for AS-associated CNVs. A total of 533 AS patients and 792 unrelated controls were examined in confirmation studies with the AccuCopy assays. A significant association was observed between the CNV of HLA-DQA1 and that of AS. Compared with controls, AS patients showed an aberrant CN, and a significantly increased number of patients had more than two copies of HLA-DQA1. Therefore, the CNV of HLA-DQA1 may have an important role in susceptibility to AS in the Han Chinese population.

  19. A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis.

    Science.gov (United States)

    Albayrak, Ilknur; Bağcacı, Sinan; Sallı, Ali; Kucuksen, Sami; Uğurlu, Hatice

    2013-09-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

  20. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Wichuk, Stephanie; Chiowchanwisawakit, Praveena

    2014-01-01

    OBJECTIVE: Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging (MRI) scans may develop after resolution of inflammation in patients with ankylosing spondylitis (AS) and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated...... step in this pathway. METHODS: We used the Spondyloarthritis Research Consortium of Canada (SPARCC) SI structural lesion score (SSS) method to assess fat metaplasia, erosions, backfill, and ankylosis on MRIs of the SI joints in 147 patients with AS monitored for 2 years. Univariate and multivariate...... a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway....

  1. Functional Genomics and Its Bench-to-Bedside Translation Pertaining to the Identified Susceptibility Alleles and Loci in Ankylosing Spondylitis.

    Science.gov (United States)

    Kenna, Tony J; Hanson, Aimee; Costello, Mary-Ellen; Brown, Matthew A

    2016-10-01

    Ankylosing spondylitis (AS) is a highly heritable disease for which there is a great unmet need for improved therapies. Genetics research has identified several major pathways involved in the disease, from which treatments have either now entered clinical practice or are in development. In particular, therapies targeting the IL-23 pathway were repositioned for use in AS following the discovery of multiple genes in the pathway as determinants of AS risk. Discovery of the association of aminopeptidase genes with AS, and subsequently with psoriasis, inflammatory bowel disease and other conditions, has triggered research into therapies targeting this pathway. The AS-genetic associations point to involvement of gut mucosal immunity in driving disease, and metagenomic studies have provided strong support that AS is a disease driven by interaction between the gut microbiome and host immune system, providing a rationale for the exploration of gut-targeted therapies for the disease.

  2. Estimated radiation doses to different organs among patients treated for ankylosing spondylitis with a single course of X rays

    International Nuclear Information System (INIS)

    Lewis, C.A.; Smith, P.G.; Stratton, I.M.; Darby, S.C.; Doll, R.

    1988-01-01

    A follow-up study of over 14000 patients treated with a single course of X rays for ankylosing spondylitis demonstrated substantial excess risk of developing cancer. Previously the excess risk of leukaemia has been related to the estimated mean radiation dose to active bone marrow but detailed estimates were not made of the radiation doses to other organs. Data extracted from the original treatment records of a random sample of one in 15 patients have been used to make dose estimates, using Monte Carlo methods, for 30 specific organs or body regions and 12 bone marrow sites. Estimates of mean and median organ doses, standard deviations and ranges have been tabulated. Detailed distributions are presented for six organs (lung, bronchi, stomach, oesophagus, active bone marrow and total body). Comparison with the earlier bone marrow estimates and more recent theoretical estimates shows good agreement. (author)

  3. Cardiovascular risk profiles in a hospital-based population of patients with psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Nissen, Christoffer B; Hørslev-Petersen, Kim; Primdahl, Jette

    2017-01-01

    The objective of the study was to investigate the frequency of traditional risk factors for the cardiovascular (CV) disease, to calculate the Systematic COronary Risk Evaluation (SCORE) for CV-related mortality in Danish patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS......), and to compare with results from patients with rheumatoid arthritis (RA) from the same settlement. All PsA and AS patients aged 18-85 years from one outpatient clinic were invited. A rheumatology nurse conducted 30-min screening consultation, preceded by a lipid and glucose profile. High SCORE risk led...... to recommendation of follow-up by general practitioners. Multiple and logistic regression analyses, adjusted for age and gender, were performed, to compare risk factors and risk SCOREs. Participants were 116 AS (29.3% female) and 170 PsA (54.7% female). AS had opposed PsA patients' lower 10-year risk SCOREs of CV...

  4. Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial.

    Science.gov (United States)

    O'Dwyer, Tom; Monaghan, Ann; Moran, Jonathan; O'Shea, Finbar; Wilson, Fiona

    2017-01-01

    Does a 3-month behaviour change intervention targeting physical activity (PA) increase habitual physical activity in adults with ankylosing spondylitis (AS)? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up? Parallel-group, randomised, controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Forty adults with a diagnosis of AS, on stable medication, and without PA-limiting comorbidities. Over a 3-month period, the experimental group engaged in individually-tailored, semi-structured consultations aiming to motivate and support individuals in participating in PA. The control group continued with usual care. The primary outcome was PA measured by accelerometry over 1 week. Secondary outcomes included clinical questionnaires and measures of health-related physical fitness. Measures were taken at baseline, post-intervention, and after a 3-month follow-up period. Baseline characteristics were similar across groups, except age and body composition. There were statistically significant, moderate-to-large time-by-group effects in health-enhancing PA (mixed-design ANOVA for overall effect F(2, 76)=14.826, pmobility (F(2, 76)=5.691, pquality of life (χ 2 (2)=8.400, pmobility and quality of life were significantly improved after the intervention, and improvements were maintained at 3-month follow-up. NCT02374502. [O'Dwyer T, Monaghan A, Moran J, O'Shea F, Wilson F (2016) Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial.Journal of PhysiotherapyXX: XX-XX]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  5. Inflammation Intensity-dependent Expression of Osteoinductive Wnt Proteins is Critical for Ectopic New Bone Formation in Ankylosing Spondylitis.

    Science.gov (United States)

    Li, Xiang; Wang, Jianru; Zhan, Zhongping; Li, Sibei; Zheng, Zhaomin; Wang, Taiping; Zhang, Kuibo; Pan, Hehai; Li, Zemin; Zhang, Nu; Liu, Hui

    2018-02-26

    To investigate the molecular mechanism underlying the inflammation- related ectopic new bone formation in ankylosing spondylitis (AS). Spinal tissues and sera were collected from patients or normal volunteers to detect the expression of Wnt proteins. An in vitro cell culture system mimicking the local inflammatory microenvironment of bone-forming sites was established to study the relationship between inflammation and Wnt expression, the regulatory mechanism of inflammation-induced Wnt expression and the role of Wnt signaling in new bone formation. A modified collagen-induced arthritis (mCIA) and a proteoglycan -induced spondylitis (PGIS) animal model were used to confirm the key findings in vivo. The levels of osteoinductive Wnt proteins were obviously increased in the sera and spinal ligament tissues of patients with AS. Only constitutive low-intensity TNF-α stimulation, but not short-term or high-intensity TNF-α stimulation, induced persistent expression of osteoinductive Wnt proteins and subsequent bone formation through NF-κB (p65) and JNK/AP-1 (c-Jun) signaling pathways. Furthermore, inhibition of either Wnt/β-catenin or Wnt/PKCδ pathway significantly suppressed new bone formation. The increased expression of Wnt proteins was confirmed in both mCIA and PGIS models. A kyphotic and ankylosing phenotype of the spine was observed during long-term observation in mCIA model. Inhibition of either Wnt/β-catenin or Wnt/PKCδ signaling pathway significantly reduced the incidence and severity of this phenotype. Inflammation intensity-dependent expression of osteoinductive Wnt proteins is a key link between inflammation and ectopic new bone formation in AS. Activation of both canonical Wnt/β-catenin and noncanonical Wnt/PKCδ pathways is required for inflammation-induced new bone formation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. The role of Vitamin D in immuno-inflammatory responses in Ankylosing Spondylitis patients with and without Acute Anterior Uveitis.

    Science.gov (United States)

    Mitulescu, T C; Stavaru, C; Voinea, L M; Banica, L M; Matache, C; Predeteanu, D

    2016-01-01

    Hypothesis: Abnormal Vitamin D (Vit D) level could have consequences on the immuno-inflammatory processes in Ankylosing Spondylitis (AS). Aim: The purpose of this study was to analyze the role of Vitamin D in the interplay between immune and inflammation effectors in AS associated-Acute Anterior Uveitis (AAU). Methods and Results: 25-hydroxyvitamin D (Vit D), LL-37 peptide, IL-8 and Serum Amyloid A (SAA) were identified and quantified in the serum/ plasma of thirty-four AS patients [eleven AS patients presenting AAU (AAU AS patients) and twenty-three AS patients without AAU (wAAU AS patients)] and eighteen healthy individuals (Control) using enzyme-linked immunosorbent assay. Acute-phase SAA level was significantly higher in AS patients compared to Controls. Contrary with wAAU AS patients, significantly elevated levels of IL-8, and diminished levels of Vit D characterized AAU AS patients. Regarding LL-37, its level decreased concomitantly with the level of Vit D. When AS patients were subgrouped based on AAU presence or on Vit D level, important associations between immuno-inflammatory assessed markers and AS features were noticed. Generally, Vit D levels were associated indirectly with leukocytes/ neutrophils number or with ESR, CRP, and Fibrinogen levels. The levels of SAA and IL-8 associated directly with AAU or with AAU relapses, especially in AS patients with Vit D insufficiency, while SAA associated directly with infection/ inflammatory markers and with disease activity indexes or with the degree of functional limitation. Discussion: Altered levels of Vit D affect the balance between LL-37, IL-8 and SAA, suggesting an association with AAU, an extra-articular manifestation of AS. Abbreviations: Vit D = Vitamin D, AS = Ankylosing Spondylitis, AAU = Acute Anterior Uveitis, AAU AS = AS patients with AAU, wAAU AS = AS patients without AAU, SSZ = Sulphasalazine, Leu = Leukocytes, Neu = Neutrophils.

  7. The relationship between disease activity, quality of life, and personality types in rheumatoid arthritis and ankylosing spondylitis patients.

    Science.gov (United States)

    Donisan, T; Bojincă, V C; Dobrin, M A; Bălănescu, D V; Predețeanu, D; Bojincă, M; Berghea, F; Opriș, D; Groșeanu, L; Borangiu, A; Constantinescu, C L; Ionescu, R; Bălănescu, A R

    2017-07-01

    We hypothesized that clinical outcomes might be influenced by personality type (A, B, C, D) in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). One hundred ninety-four patients (104 with RA, 90 with AS) participated in a questionnaire study. We evaluated health-related quality of life (HRQoL) using the Medical Outcome Study Short-Form 36 (SF-36), personality type A/B with the Jenkins Activity Survey, type C with the State-Trait Anger Expression Inventory Anger-in Scale, type D with the Type D Personality Scale, and disease activity with Disease Activity Score with 28 joints for RA and Bath Ankylosing Spondylitis Disease Activity Index for AS. We used Pearson's correlation coefficient, independent samples t tests, and multivariate analyses of variance. In the RA group, type D personality was significantly correlated with 7/12 SF-36 components. AS patients with type D personality had deficits in all SF-36 subscales. Type D was related with higher disease activity in RA and AS. Both RA and AS type C patients had more active disease forms and negatively affected HRQoL subscales. In the RA group, type A personality did not correlate with HRQoL, but it positively influenced pain visual analog scale scores. In AS patients, type A personality was linked with higher HRQoL and with less active disease. Type C and type D personality types were correlated with decreased HRQoL and higher disease activity in RA and AS patients. Type A personality was associated with less active disease and higher HRQoL in AS patients and with less pain in RA patients.

  8. Analysis of Killer Cell Immunoglobulin-like Receptor Genes and Their HLA Ligands in Iranian Patients with Ankylosing Spondylitis.

    Science.gov (United States)

    Mahmoudi, Mehdi; Jamshidi, Ahmad Reza; Karami, Jafar; Mohseni, Alireza; Amirzargar, Ali Akbar; Farhadi, Elham; Ahmadzadeh, Nooshin; Nicknam, Mohammad Hossein

    2016-02-01

    Ankylosing Spondylitis (AS) is a chronic rheumatic disease which mainly involves the axial skeleton. It seems that non-HLA genes, as well as HLA-B27 gene, are linked to the etiology of the disease. Recently, it has been documented that KIRs and their HLA ligands are contributed to the Ankylosing Spondylitis. The aim of this study was to evaluate the KIR genes and their HLA ligands in Iranian AS patients and healthy individuals. The present study includes 200 AS patient samples and 200 healthy control samples. KIR genotyping was performed using the polymerase chain reaction sequence-specific primer (PCR-SSP) method to type the presence or absence of the 16 KIR genes, 6 known specific HLA class I ligands and also, two pseudogenes. Two KIR genes (KIR-2DL3 and KIR2DL5), and among the HLA ligands, two HLA ligands (HLA-C2Lys80 and HLA-B27) genes were significantly different between case and control groups. In addition, we found some interesting KIR/HLA compound genotypes, which were associated with AS susceptibility. Our results suggest that the AS patients present more activating and less inhibitory KIR genes with combination of their HLA ligands than healthy controls. Once the balance of signal transduction between activating and inhibitory receptors is disturbed, the ability of NK cells to identify and lyse the targets in immune responses will be compromised. Accordingly, imbalance of activating and inhibitory KIR genes by up-regulating the activation and losing the inhibition of KIRs signaling or combination of both might be one of the important factors which underlying the pathogenesis of AS.

  9. Digital tomosynthesis as a new diagnostic tool for evaluation of spine damage in patients with ankylosing spondylitis.

    Science.gov (United States)

    Joo, Young Bin; Kim, Tae-Hwan; Park, Jina; Joo, Kyung Bin; Song, Yoonah; Lee, Seunghun

    2017-02-01

    We aimed to compare digital tomosynthesis (DTS) with radiographs for the assessment of spinal bone damage in patients with ankylosing spondylitis (AS). The study comprised 68 patients with AS who underwent both DTS and radiographs of the cervical and lumbar spine on the same day. Spinal bone damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and the presence of facet joint damage. The Wilcoxon signed-rank test and McNemar's test were used to compare spinal bone damage between the two modalities. In 68 AS patients with mean 4.5 years of disease duration, the mean mSASSS was 11.7 ± 11.3 with radiographs and 13.1 ± 11.5 with DTS (p = 0.001). A grade 1 (erosion, sclerosis, or squaring) score in the mSASSS system was higher with DTS than with radiographs (p = 0.001), but grade 2 (syndesmophyte) and grade 3 (bridge) scores (p > 0.005 each) were not. In particular, the grade 1 score was higher with DTS than with radiographs at the cervicothoracic (p < 0.001) and thoracolumbar (p = 0.003) junctions. With regard to facet joint damage, erosion/sclerosis of facet joints was better depicted by DTS than by radiographs in the cervical (54.4 vs. 22.1%, p < 0.001) and lumbar spine (72.1 vs. 11.8%, p < 0.001). DTS depicted more subtle damage of spinal vertebrae in patients with AS than radiographs did. Moreover, erosion/sclerosis of facet joints was better detected with DTS than with radiographs.

  10. CRP and a biomarker of type I collagen degradation, C1M, can differentiate anti-inflammatory treatment response in ankylosing spondylitis.

    Science.gov (United States)

    Siebuhr, Anne Sofie; Bay-Jensen, Anne C; Karsdal, Morten Asser; Lories, Rik J; de Vlam, Kurt

    2016-01-01

    To investigate if tissue turnover biomarkers were efficacy biomarkers in ankylosing spondylitis and if the biomarkers at baseline predicted a good outcome (BASDAI50). Twenty-two etanercept treated ankylosing spondylitis patients were investigated for inflammation (CRP, ESR, CRPM) and tissue turnover (C1M, C2M, C3M) during the first year of treatment. Biomarkers profiles and treatment response were investigated. ESR, CRP, BASDAI and C1M were decreased with treatment (p ≤ 0.04). C1M and CRP segregated patients into two populations predicting treatment efficacy. C1M and CRP were efficacy biomarkers and baseline biomarkers could select who benefited (by biomarkers) from treatment. C1M was not superior to CRP, but the biomarkers evaluate different pathologic events, indicating that C1M and CRP identify different events.

  11. Long term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, R.; Gill, S.K.; Smith, P.G.

    1987-01-01

    Mortality to 1 January 1983 was studied in 14,106 ankylosing spondylitis patients after a single course of X-rays (1935-1954). For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than the general population of England and Wales, proportional increase reaching a maximum 71% between 10.0 and 12.4 years post-irradiation. There was 7% mortality increase more than 25.0 years post-irradiation and only for oesophageal cancer was the relative risk significantly raised. Neither the relative risk, nor its post-irradiation temporal pattern, were greatly influenced by the patient's age. There was a threefold increase in leukaemia mortality, the relative risk highest between 2.5 and 4.9 years post-treatment, but not disappearing being nearly twice that of the general population more than 25 years post-treatment. There was evidence that acute myeloid, acute lymphatic and chronic myeloid leukaemia risks were increased, but no evidence of increase in chronic lymphatic leukaemia. The relative risk appeared greatest for acute myeloid leukaemia. Colon cancer mortality increased by 30%. Non-neoplastic conditions showed a 51% mortality increase, likely to be associated with the disease itself, and not confined to diseases associated with spondylitis. (UK)

  12. Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index in Turkish patients with ankylosing spondylitis: relationship with disease activity and quality of life.

    Science.gov (United States)

    Zahiroglu, Yeliz; Ulus, Yasemin; Akyol, Yesim; Tander, Berna; Durmus, Dilek; Bilgici, Ayhan; Kuru, Omer

    2014-02-01

    The aim of this study was to investigate the relationship between Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index and disease activity and health-related quality of life in patients with ankylosing spondylitis (AS). Eighty-six AS patients not receiving antitumour necrosis factor (TNF) therapy were included in the study. Spinal pain by visual analogue scale (pain VAS rest and activity), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional capacity by Bath Ankylosing Spondylitis Functional Index (BASFI), enthesitis severity by SPARCC index, quality of life by Short Form-36 (SF-36), and Bath Ankylosing Spondylitis Metrology Index (BASMI) were assessed in patients. In the laboratory evaluations, the erythrocyte sedimentation rates and serum C-reactive protein levels of the patients were determined. All participants were aged between 18 and 65 years, with a mean age of 36.9 ± 11.13 years. The most frequent region of enthesitis was Achilles tendon insertion into calcaneum (55.8%). Pain VAS rest and activity, BASFI and all parameters of SF-36 were significantly different in AS patients with and without enthesitis. SPARCC index was significantly correlated with pain VAS activity (P  0.05). The clinical assessment of enthesitis in AS is an important outcome measure, and enthesitis indexes such as SPARCC enthesitis index can be valuable tools in the evaluation of disease activity in AS patients not receiving anti-TNF therapy. © 2013 The Authors International Journal of Rheumatic Diseases © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  13. Gene Expression Analysis before and after Treatment with Adalimumab in Patients with Ankylosing Spondylitis Identifies Molecular Pathways Associated with Response to Therapy

    OpenAIRE

    Dolcino, Marzia; Tinazzi, Elisa; Pelosi, Andrea; Patuzzo, Giuseppe; Moretta, Francesca; Lunardi, Claudio; Puccetti, Antonio

    2017-01-01

    The etiology of Ankylosing spondylitis (AS) is still unknown and the identification of the involved molecular pathogenetic pathways is a current challenge in the study of the disease. Adalimumab (ADA), an anti-tumor necrosis factor (TNF)-alpha agent, is used in the treatment of AS. We aimed at identifying pathogenetic pathways modified by ADA in patients with a good response to the treatment. Gene expression analysis of Peripheral Blood Cells (PBC) from six responders and four not responder p...

  14. Investigation of two novel biochemical markers of inflammation, matrix metalloproteinase and cathepsin generated fragments of C-reactive protein, in patients with ankylosing spondylitis

    DEFF Research Database (Denmark)

    Skjøt-Arkil, Helene; Schett, Georg; Zhang, Chen

    2012-01-01

    Ankylosing spondylitis (AS) is a chronic inflammation of the spine and the sacroiliac joints. Current markers of inflammation, such as C-reactive protein (CRP), are reflecting the production of an acute phase reactant rather than tissue specific inflammation, but the use of CRP as a diagnostic an...... additional information on systemic inflammation as compared to that of full-length CRP. We investigated whether these CRP degradation products would provide additional diagnostic value in AS patients compared to full-length CRP....

  15. INVESTIGATION OF A ROLE OF THE IMMUNOGENICITY OF INFLIXIMAB IN THE THERAPY OF ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    O. A. Rumyantseva

    2016-01-01

    Full Text Available At present, there are a number of unsolved problems associated with unawareness of the causes and ways to prevent the inefficacy of tumor necrosis factor-α  inhibitors.Objective: to study the causes of secondary inefficacy of infliximab (INF, by analyzing its concentrations and antidrug antibody levels in the serum of ankylosing spondylitis (AS patients receiving long INF,  as well as a possibility to overcome its secondary inefficacy through plasmapheresis.Subjects and methods. 54 patients with active AS (BASDAI > 4 underwent regular long-term  (1-to-10-year treatment with INF 5 mg/kg according to the standard scheme. During the therapy blood samples were taken before a regular INF infusion to quantify the levels of antibodies to the drug and its concentration. According to the efficiency of the drug, two groups were formed: 1 27 (50% patients with INF inefficacy (an exacerbation occurred 2–4 weeks after infusion; 2 27 patients with drug efficacy. The levels of anti-double stranded DNA antibodies and antinuclear factor were estimated in 27 patients to investigate a relationship between the immunogenicity of INF and the presence of autoantibodies in its secondary inefficacy. A plasmapheresis session was carried out in 5 patients before a regular IFN infusion.Results and discussion. Anti-INF antibodies were found in 28 (52% patients, these being more common  in the patients with drug inefficacy than in the others (67 and 37%, respectively; p < 0.05. In the patients with INF inefficacy, anti-INF antibody levels were significantly higher than in those with preserved drug effect (18.33 and 4.67 U/ml, respectively; р < 0.05. Moreover, the serum concentration of INF was not significantly different in these groups (1.6 and 2.96 μg/ml. There was an inverse correlation  between INF concentrations and anti-INF antibodies (r = -0.7; p < 0.05. The level of autoantibodies  did not correlate with that of anti-INF antibodies. Following

  16. PROGRESSION OF AORTIC AND VALVULAR HEART DISEASES IN PATIENTS WITH ANKYLOSING SPONDYLITIS

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    A. A. Godzenko

    2017-01-01

    Full Text Available Involvement of the aorta and heart valves in ankylosing spondylitis (AS is a manifestation of the systemic inflammatory process. Data on the frequency, clinical significance, and evolution of these manifestations are controversial.Objective: to estimate the time course of echocardiographic (EchoCG changes in the aorta and heart valves from the results of a prospective follow-up study of patients with AS.Subjects and methods. In 2008 to 2015, the V.A. Nasonova Research Institute of Rheumatology followed up 45 patients (35 men and 10 women with documented AS that was consistent with the modified New York criteria and the original EchoCG changes in the aorta and heart valves. All the patients underwent transthoracic echocardiography at baseline and after 1–5 years. At baseline, there was aortic root dilatation (>37 mm in 15 patients, thickening of the aortic walls and aortic valve (AV cusps in 21 and 32 patients, respectively, as well as thickening of the mitral valve (MV cusps in 15, and valve prostheses in 5 patients (2 had AV and MV prostheses. Aortic regurgitation (AR was recorded in 19 patients (grades 1–2 AR in 15 patients and grades 3–4 in 4 patients; grades 1–2 mitral regurgitation (MR was seen in 20 patients. Ten patients had subaortic pectinate thickening (SPT in the aortomitral junction area. Of the 45 patients, 16 took biological agents (BA; 29 received traditional therapy, including 14 patients who used nonsteroidal anti-inflammatory drugs, 11 and 4 patients had sulfasalazine and methotrexate, respectively.Results and discussion.Repeated examinations revealed negative changes in 27 (60% of the 45 patients. Progressive aortic dilatation (1 to 6 mm was found in 12 (80% of the 15 patients; dilatation appeared during follow-up in 2 patients. Fourteen patients were noted to have negative valve changes: the emergence of cusp thickening in the valves (that in AV and MV in 9 and 4 patients, respectively; both in 1 patient

  17. Anti-interleukin-17A monoclonal antibody secukinumab in treatment of ankylosing spondylitis: a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Baeten, Dominique; Baraliakos, Xenofon; Braun, Jürgen; Sieper, Joachim; Emery, Paul; van der Heijde, Désirée; McInnes, Iain; van Laar, Jacob M; Landewé, Robert; Wordsworth, Paul; Wollenhaupt, Jürgen; Kellner, Herbert; Paramarta, Jacqueline; Wei, Jiawei; Brachat, Arndt; Bek, Stephan; Laurent, Didier; Li, Yali; Wang, Ying A; Bertolino, Arthur P; Gsteiger, Sandro; Wright, Andrew M; Hueber, Wolfgang

    2013-11-23

    Ankylosing spondylitis is a chronic immune-mediated inflammatory disease characterised by spinal inflammation, progressive spinal rigidity, and peripheral arthritis. Interleukin 17 (IL-17) is thought to be a key inflammatory cytokine in the development of ankylosing spondylitis, the prototypical form of spondyloarthritis. We assessed the efficacy and safety of the anti-IL-17A monoclonal antibody secukinumab in treating patients with active ankylosing spondylitis. We did a randomised double-blind proof-of-concept study at eight centres in Europe (four in Germany, two in the Netherlands, and two in the UK). Patients aged 18-65 years were randomly assigned (in a 4:1 ratio) to either intravenous secukinumab (2×10 mg/kg) or placebo, given 3 weeks apart. Randomisation was done with a computer-generated block randomisation list without a stratification process. The primary efficacy endpoint was the percentage of patients with a 20% response according to the Assessment of SpondyloArthritis international Society criteria for improvement (ASAS20) at week 6 (Bayesian analysis). Safety was assessed up to week 28. This study is registered with ClinicalTrials.gov, number NCT00809159. 37 patients with moderate-to-severe ankylosing spondylitis were screened, and 30 were randomly assigned to receive either intravenous secukinumab (n=24) or placebo (n=6). The final efficacy analysis included 23 patients receiving secukinumab and six patients receiving placebo, and the safety analysis included all 30 patients. At week 6, ASAS20 response estimates were 59% on secukinumab versus 24% on placebo (99·8% probability that secukinumab is superior to placebo). One serious adverse event (subcutaneous abscess caused by Staphylococcus aureus) occurred in the secukinumab-treated group. Secukinumab rapidly reduced clinical or biological signs of active ankylosing spondylitis and was well tolerated. It is the first targeted therapy that we know of that is an alternative to tumour necrosis factor

  18. Association of variants at 1q32 and STAT3 with ankylosing spondylitis suggests genetic overlap with Crohn's disease.

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    Patrick Danoy

    2010-12-01

    Full Text Available Ankylosing spondylitis (AS is a common inflammatory arthritic condition. Overt inflammatory bowel disease (IBD occurs in about 10% of AS patients, and in addition 70% of AS cases may have subclinical terminal ileitis. Spondyloarthritis is also common in IBD patients. We therefore tested Crohn's disease susceptibility genes for association with AS, aiming to identify pleiotropic genetic associations with both diseases. Genotyping was carried out using Sequenom and Applied Biosystems TaqMan and OpenArray technologies on 53 markers selected from 30 Crohn's disease associated genomic regions. We tested genotypes in a population of unrelated individual cases (n = 2,773 and controls (n = 2,215 of white European ancestry for association with AS. Statistical analysis was carried out using a Cochran-Armitage test for trend in PLINK. Strong association was detected at chr1q32 near KIF21B (rs11584383, P = 1.6 × 10(-10, odds ratio (OR = 0.74, 95% CI:0.68-0.82. Association with disease was also detected for 2 variants within STAT3 (rs6503695, P = 4.6 × 10(-4. OR = 0.86 (95% CI:0.79-0.93; rs744166, P = 2.6 × 10(-5, OR = 0.84 (95% CI:0.77-0.91. Association was confirmed for IL23R (rs11465804, P = 1.2 × 10(-5, OR = 0.65 (95% CI:0.54-0.79, and further associations were detected for IL12B (rs10045431, P = 5.2 × 10(-5, OR = 0.83 (95% CI:0.76-0.91, CDKAL1 (rs6908425, P = 1.1 × 10(-4, OR = 0.82 (95% CI:0.74-0.91, LRRK2/MUC19 (rs11175593, P = 9.9 × 10(-5, OR = 1.92 (95% CI: 1.38-2.67, and chr13q14 (rs3764147, P = 5.9 × 10(-4, OR = 1.19 (95% CI: 1.08-1.31. Excluding cases with clinical IBD did not significantly affect these findings. This study identifies chr1q32 and STAT3 as ankylosing spondylitis susceptibility loci. It also further confirms association for IL23R and detects suggestive association with another 4 loci. STAT3 is a key signaling molecule within the Th17 lymphocyte differentiation pathway and further enhances the case for a major role of

  19. Working life and physical activity in ankylosing spondylitis pre and post anti-tumor necrosis factor-alpha therapy.

    Science.gov (United States)

    Prince, David S; McGuigan, Louis E; McGirr, Ellen E

    2014-02-01

    To assess effects of ankylosing spondylitis (AS) on working life and physical activity in Australia; to quantify changes in working life and physical activity that occur after anti-tumor necrosis factor-alpha (TNF-α) treatment; and to assess efficacy of anti-TNF-α therapy for AS in an Australian context. This is a multi-centre observational study of people with AS on anti-TNF-α therapy. All participants satisfied the New York Modified Criteria and had active and refractory disease at anti-TNF-α therapy commencement. Participation involved a standardized interview, a metrology assessment, assessment of disease remission and medical record review. Interviews and patients' records were used to compare working life (employment, sick leave and productivity) and physical activity (participation rate, hours/week, and physical intensity) between the pre-AS, post-AS and post-anti-TNF-α therapy periods. Fifty-two patients took part. Participants were on average 44.8 years old, predominately male (86.5%) and had been on anti-TNF-α therapy for 29 months; 39% were in partial remission and 75% had 50% reduction in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Responders to anti-TNF-α therapy were 10.5 years younger than non-responders (P = 0.004). Post-anti-TNF-α therapy participants gained 6.6 h/week of work (P = 0.02), and productivity improved 31% (P treatment. Physical activity participation increased from 71% to 85% (P = 0.039) and activity intensity increased by 33% (P = 0.002) post-treatment. Participants gained 1.8 h/week of sport (P = 0.001) and 2.2 h/week of recreational physical activity (P Treatment with anti-TNF-α therapy results in significant improvement in these parameters. © 2012 The Authors International Journal of Rheumatic Diseases © 2012 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  20. Treatment of kyphosis in ankylosing spondylitis by osteotomy through the gap of a pathological fracture: a retrospective study.

    Science.gov (United States)

    Zhang, Hongqi; Zhou, Zhenhai; Guo, Chaofeng; Wang, Yuxiang; Yu, Honggui; Wang, Longjie

    2016-11-08

    Surgical interventions are commonly advocated for correcting kyphotic deformities and relieving severe back pain in ankylosing spondylitis (AS) patients. The aim of this study was to evaluate the clinical outcome of osteotomy performed through the gap of a pathological fracture for the treatment of kyphosis in ankylosing spondylitis and to introduce the key points of this novel surgical approach. From January 1, 2010, to December 31, 2014, 13 consecutive AS patients who were treated with osteotomy through the fracture gap were retrospectively reviewed. Patients underwent the radiographic assessment of sagittal balance parameters. Visual analog scale (VAS) scores were used to assess improvement in back pain. The average follow-up time was 2 years and 1 month. The median operation time was 280 min (range, 220-460 min). The mean blood loss was 1100 mL (range, 820-1300 mL). No major acute complications such as death or complete paralysis occurred. There were no neurologic complications or cerebrospinal fluid leaks in any patient. One patient had postoperative wound infection, which subsided after a switch of antibiotics. The global kyphosis Cobb angle of patients decreased from the preoperative 55.8° ± 11.0° to 23.2° ± 6.7° (P < 0.001) after surgery. The C7 plumb line was used to assess global balance; its relationship with the posterosuperior corner of the sacrum decreased from 166 ± 37 mm to 111 ± 20 mm (P < 0.001). The thoracolumbar kyphosis Cobb angle decreased from 51.0° ± 9.9° to 21.6° ± 11.0° (P < 0.001). VAS scores for back pain decreased from 7.2 ± 1.2 to 2.1 ± 1.1 (P < 0.001). Lumbar lordosis increased from 5.7° ± 23.2° to 10.5° ± 29.2° (P = 0.001). Osteotomy through the pathological fracture gap is a safe and effective surgical procedure for kyphosis correction and improvement of back pain in AS patients with pathological fractures. A significant kyphosis correction and

  1. Golimumab for the treatment of ankylosing spondylitis : a NICE single technology appraisal

    NARCIS (Netherlands)

    Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

    As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing

  2. Clinical, para-clinical and subjective quality of life modifications after[224Ra] radium-chloride-therapy (224 SpondylAT) in ankylosing spondylitis (Bechterew's disease)

    International Nuclear Information System (INIS)

    Straube, F.; Sagner, K.; Mende, T.; Tutar, K.

    2002-01-01

    Aim: The ankylosing spondylitis is a painful, chronically inflammatory illness which mainly manifests itself at the spine, and in addition at the peripheral joints with a pronounced inclination to reinforcement. Over the last years we again have been having the possibility to help the patients with a [ 224 Ra]radium treatment to reduce the pain and probably stop the progress of the disease. The purpose was to examine the analgetic effect in connection with the para-clinical inflammation parameters and subjective modifications of the quality of life. Material and Methods: In our clinic, 5 patients (1 woman, 4 men) (age median 43,4 years) were treated over a period of 10 weeks with one weekly injection of 1 MBq [ 224 Ra]radium chloride ( 224 SpondylAT). Before the therapy, at the last day of treatment, and 3 and 6 month after the therapy we documented the pain score (scale 1 to 10) of patients and the laboratory-chemical data (hemoglobin, leukocytes, neutrophile leukocytes, thrombocytes, CRP, blood sedimentation). Physical operability, psychological fortunes and the social role behavior was measured with the clinical test p rofile of quality of life chronically patients . The patients were asked retrospectively (approx. 5 to 15 months) to estimate their pre- and post-therapeutic situation. Results: Before the therapy, the inflammation parameters CRP (average 24.5) and BSR (average 47) of all patients were clearly increased. After 3 months, the CRP value showed a descending tendency, after 6 months however the starting value was almost reached again. The blood sedimentation rate was lowest 3 months after therapy; at a check after 6 months it was somewhat more higher, however still under the outgoing value. After 3 months, the pain score indicated by the patients was reduced from the first value of 7 significantly to 5,3, and after 6 months to 3,7. A significant modification of the blood cell parameters did not occur during the investigation period. 4 of 5 patients

  3. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.

    Science.gov (United States)

    Ward, Michael M; Deodhar, Atul; Akl, Elie A; Lui, Andrew; Ermann, Joerg; Gensler, Lianne S; Smith, Judith A; Borenstein, David; Hiratzka, Jayme; Weiss, Pamela F; Inman, Robert D; Majithia, Vikas; Haroon, Nigil; Maksymowych, Walter P; Joyce, Janet; Clark, Bruce M; Colbert, Robert A; Figgie, Mark P; Hallegua, David S; Prete, Pamela E; Rosenbaum, James T; Stebulis, Judith A; van den Bosch, Filip; Yu, David T Y; Miller, Amy S; Reveille, John D; Caplan, Liron

    2016-02-01

    To provide evidence-based recommendations for the treatment of patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (SpA). A core group led the development of the recommendations, starting with the treatment questions. A literature review group conducted systematic literature reviews of studies that addressed 57 specific treatment questions, based on searches conducted in OVID Medline (1946-2014), PubMed (1966-2014), and the Cochrane Library. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method. A separate voting group reviewed the evidence and voted on recommendations for each question using the GRADE framework. In patients with active AS, the strong recommendations included use of nonsteroidal antiinflammatory drugs (NSAIDs), use of tumor necrosis factor inhibitors (TNFi) when activity persists despite NSAID treatment, not to use systemic glucocorticoids, use of physical therapy, and use of hip arthroplasty for patients with advanced hip arthritis. Among the conditional recommendations was that no particular TNFi was preferred except in patients with concomitant inflammatory bowel disease or recurrent iritis, in whom TNFi monoclonal antibodies should be used. In patients with active nonradiographic axial SpA despite treatment with NSAIDs, we conditionally recommend treatment with TNFi. Other recommendations for patients with nonradiographic axial SpA were based on indirect evidence and were the same as for patients with AS. These recommendations provide guidance for the management of common clinical questions in AS and nonradiographic axial SpA. Additional research on optimal medication management over time, disease monitoring, and preventive care is needed to help establish best practices in these areas. © 2015, American College of Rheumatology.

  4. Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis

    International Nuclear Information System (INIS)

    Yu, Wei; Feng Feng; Yang Hongzen; Jiang Ming; Dion, E.; Genant, H.K.

    1998-01-01

    Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with rephasing T2* images were obtained without fat saturation using a 0.3-T imager for all volunteers and patients. Postcontrast MR examination was performed using the same precontrast SE T1 sequence for patients with AS. Results and conclusions. MR imaging directly showed the normal cartilage in all 16 sacroiliac joints of the 8 volunteers. In the 24 patients with AS, cartilage abnormalities were observed in 42 sacroiliac joints. More diagnoses of sacroiliitis were made using MR and CT imaging than using radiography (P<0.001). Therefore, low-field-strength MR can be useful in detecting early sacroiliitis in patients with AS. MR imaging was able to reveal early cartilage changes and bone marrow edema, which could not be found by either CT or radiography. (orig.)

  5. IGF-1 and ADMA Levels Are Inversely Correlated in Nondiabetic Ankylosing Spondylitis Patients Undergoing Anti-TNF-Alpha Therapy

    Directory of Open Access Journals (Sweden)

    Fernanda Genre

    2014-01-01

    Full Text Available Like rheumatoid arthritis, ankylosing spondylitis (AS is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1 is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3 levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-α antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA, an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r=-0.397; P=0.04. However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-α therapy, IGF-1 and ADMA are inversely correlated.

  6. Muscle Mass, Strength, Mobility, Quality of Life, and Disease Severity in Ankylosing Spondylitis Patients: A Preliminary Study.

    Science.gov (United States)

    Kim, Seung Chan; Lee, Yeong Guk; Park, Si-Bog; Kim, Tae Hwan; Lee, Kyu Hoon

    2017-12-01

    To determine if there is muscle mass reduction in patients with ankylosing spondylitis (AS) compared to the general population and to examine the relationship between skeletal muscle mass, quality of life (QOL), strength, and mobility in patients with AS. A total of 30 AS patients were enrolled in this study. Skeletal muscle mass was measured by bioelectrical impedance analysis, and it was expressed as the skeletal muscle mass index (SMI). QOL was assessed using the EuroQOL (EQ-5D). To measure mobility, the modified Schöber test and chest expansion test were used. To measure grip strength as a measure of muscle strength, we used the hydraulic hand dynamometer. Additionally, we divided the patients into two groups according to the degree of X-ray finding and compared the differences between the two groups. There was no significant reduction in skeletal muscle mass in patients with AS compared to the general population. Also, there was no significant correlation between SMI and QOL. On the other hand, there was a significant positive correlation between SMI and mobility, and grip strength. A significant positive correlation was found between mobility and QOL. Additionally, there was a statistically significant difference in mobility between the two groups according to the degree of X-ray finding. Maintaining muscle mass in AS patients may not be helpful for improving QOL, but it may contribute to achieving adequate mobility and strength.

  7. Impact of peer-led group education on the quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Kaya, Taciser; Goksel Karatepe, Altinay; Atici Ozturk, Pinar; Gunaydin, Rezzan

    2016-02-01

    To determine the effect of peer-led group education on the quality of life and depression in patients with ankylosing spondylitis (AS). Eighty patients with definite AS were allocated randomly to either the education or control group. The education group (n = 40) was subjected to a peer-led group education program about disease and was given an educational booklet, while the control group (n = 40) was given the educational booklet only. Levels of quality of life and depression were measured at baseline, immediately after education (fourth week) and at 6 months in both groups. The results are based on 56 (n = 27, education group; n = 29, control group) patients. The level of quality of life and depressive symptoms were not changed except for a deterioration in the social functioning subgroup of Short From (SF)-36 in both groups. When the groups were compared, there were no significant differences between changes in social functioning scores. Peer-led education did not alter quality of life levels and depression scores. However, because of the maintainance of quality of life levels, this type of intervention may be considered as a supplementary intervention to the standard medical care for management of AS. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  8. Non-­‐pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-05-01

    Full Text Available This cross-sectional study aimed to describe non--‐pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  9. Criptosporidiose em paciente com espondilite anquilosante usando adalimumabe Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab

    Directory of Open Access Journals (Sweden)

    Fernando Augusto Chiuchetta

    2010-06-01

    Full Text Available A criptosporidiose é uma doença parasitária causada pelo protozoário Cryptosporidium sp. Observou-se um aumento no número de diagnósticos realizados nos últimos vinte anos, principalmente em pacientes que apresentam imunodeficiências como a síndrome da imunodeficiência humana adquirida e as imunodeficiências induzidas como em pacientes transplantados e nos que necessitam realizar hemodiálise frequentemente. Relata-se o caso de um jovem com espondilite anquilosante que, usando adalimumabe, apresentou diarreia devido à criptosporidiose.Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplant patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis

  10. Complex Segregation Analysis Provides Evidence for Autosomal Dominant Transmission in the Chinese Han Families with Ankylosing Spondylitis

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    Yutong Jiang

    2017-01-01

    Full Text Available Introduction. Familial aggregation of ankylosing spondylitis (AS has been frequently noticed. However, the mode of inheritance in AS remains poorly understood. Our aim was to determine the mode of inheritance best fitting the observed transmission pattern of AS families. Methods. Families with 5 or more AS patients diagnosed with 1984 modified New York criteria were recruited. We performed complex segregation analysis for a binary trait in regressive multivariate logistic models. The inheritance models, including sporadic, major gene, environmental, general, and other 9 models, were compared by likelihood ratio tests and Akaike’s Information Criterion. Results. This research included 9 Chinese Han AS families with a total number of 315 persons, including 74 patients. First, familial association was determined. Sporadic with familial association model was rejected when compared with either the general model or the homogeneous general model (p<0.001. The environmental model was also rejected when compared with general models (p<0.02. Mendelian dominate mode fitted best in 5 AS families, while Tau AB free model best explained the mode of inheritance in these AS families. Conclusion. This study provided evidence in support of Mendelian dominant mode and firstly discovered a non-Mendelian mode called tau AB free inheritance mode in AS.

  11. Towards an ICF-based clinical measure of functioning in people with ankylosing spondylitis: a methodological exploration.

    Science.gov (United States)

    Cieza, A; Hilfiker, R; Boonen, A; van der Heijde, D; Braun, J; Stucki, G

    2009-01-01

    To explore whether it is possible to construct clinical measures of functioning for patients with ankylosing spondylitis (AS) by integrating information obtained across categories of the International Classification of Functioning, Disability and Health (ICF). Sixty-eight ICF categories that were identified as relevant by patients with AS and that covered body functions, structures, and activity and participation were analysed based on the Rasch model for ordered response options. The following properties were studied: unidimensionality, reliability, fit of the ICF categories to the Rasch model, the appropriateness of the order of the response options of the ICF qualifier, and the targeting between the ICF categories and the person's abilities. After accounting for disordered thresholds and misfitting ICF categories, a clinical measure of functioning for AS was proposed that contained 64 ICF categories. On the basis of a transformation table, the raw scores obtained by adding the answers to the 64 ICF categories can be transformed to the Rasch logit scale and to a meaningful interval scale ranging from zero to 100. For the first time, it has been shown that clinical measures of functioning, in principle, can be constructed based on the comprehensive ICF framework covering body functions and structures and activities and participation domains. The results of this investigation are preliminary and must be validated, but they are promising and can contribute to the acceptance and usefulness of the ICF in clinical practice.

  12. Sleep quality and associated factors in ankylosing spondylitis: relationship with disease parameters, psychological status and quality of life.

    Science.gov (United States)

    Batmaz, İbrahim; Sarıyıldız, Mustafa Akif; Dilek, Banu; Bez, Yasin; Karakoç, Mehmet; Çevik, Remzi

    2013-04-01

    The aim of this study is to investigate sleep quality in patients with ankylosing spondylitis (AS) and to evaluate the relationship of the disease parameters with sleep disturbance. Eighty AS patients (60 males and 20 females) fulfilling the modified New York criteria, and 52 age- and gender-matched controls (33 males and 19 females) were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured by visual analogue scale. The disease activity and functional status were assessed by the Bath AS disease Activity Index and the Bath AS Functional Index. The Bath AS Metrology Index was used to evaluate mobility restrictions, and the Bath AS Radiology Index was employed to evaluate the radiological damage. The psychological status and quality of life were assessed with the hospital anxiety-depression scale and AS quality of life scale. The patients with AS had significantly more unfavourable scores in the subjective sleep quality, habitual sleep efficiency domains (p sleep quality (total PSQI score) was positively correlated with increased pain, poor quality of life, higher depressed mood, higher disease activity and mobility restrictions. Pain was also an independent contributor to poorer sleep quality (p = 0.002). The sleep quality is disturbed in patients with AS. The lower quality of sleep is greatly associated with the pain, disease activity, depression, quality of life and increased limitation of mobility.

  13. Enhanced jejunal production of antibodies to Klebsiella and other Enterobacteria in patients with ankylosing spondylitis and rheumatoid arthritis.

    Science.gov (United States)

    Mäki-Ikola, O; Hällgren, R; Kanerud, L; Feltelius, N; Knutsson, L; Granfors, K

    1997-07-01

    To measure gut immunity directly in jejunal fluid in patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). Antibodies against three different Enterobacterias were measured in jejunal perfusion fluids (collected by a double balloon perfusion device) of 19 patients with AS, 14 patients with RA, and 22 healthy controls using enzyme linked immunosorbent assay. The AS patients had significantly increased jejunal fluid concentrations of IgM, IgG, and IgA class antibodies against Klebsiella pneumoniae, and IgM and IgA class antibodies against Escherichia coli and Proteus mirabilis compared with healthy controls. When compared with the patients with RA, the AS patients had higher concentrations of IgA and IgG class antibodies only against K pneumoniae. The RA patients had higher IgM class antibody concentrations against all three studied Enterobacterias, when compared with the healthy controls, suggesting an enhanced mucosal immune response in these patients. A three month treatment with sulphasalazine did not decrease enterobacterial antibody concentrations in the 10 patients with AS. There is strong direct evidence for an abnormal mucosal humoral immune response particularly to K pneumoniae in patients with AS.

  14. Improved precision of syndesmophyte measurement for the evaluation of ankylosing spondy