Pro-inflammatory cytokines in spondyloarthritis: a case-control study

ABSTRACT

Objectives

We aimed to determine the discriminative values of pro-inflammatory cytokines to distinguish spondyloarthritis patients from healthy subjects and to assess the association between these cytokines and spondyloarthritis characteristics.

Methods

We conducted a case-control study, including 144 subjects matched for age and sex: 72 spondyloarthritis patients(G1) and 72 controls (G2). The disease activity was assessed using ASDAS-CRP and BASDAI. Structural damage was assessed using BASRI. The levels of interleukin (IL) IL-1, IL-6, IL-8, IL-17, IL-23, and tumor necrosis factor α(TNFα) were measured.

Results

Each group included 57 men. The mean age was 44.84 ± 13.42 years. Except for IL-8, all cytokine levels were significantly higher in patients compared to controls (IL-1: p = 0.05, IL-6: p = 0.021, TNFα: p = 0.039, IL-17 and IL-23: p < 0.001). Cutoff values of IL-17 and IL-23 distinguishing patients in G1 from those in G2 were 17.6 and 7.96 pg/mL, respectively. TNFα level correlated to BASDAI (p = 0.029) and BASRI (p = 0.002). Multivariate analysis showed that structural damage was associated with the male gender (p = 0.017), longer disease duration (p = 0.038), and high disease activity (p = 0.044). Disease activity was associated with longer disease duration (p = 0.012) and increased IL-6 levels (p = 0.05).

Conclusion

Our study showed that IL-17 was the ablest to distinguish between spondyloarthritis patients and controls, suggesting that IL-17 may be helpful for the diagnosis of spondyloarthritis.

KEYWORDS:

• Ankylosing spondylitis
• cytokines
• interleukin 17
• interleukin 23
• spondyloarthritis

Article highlights

• IL-17, IL-23, IL-6, TNFα, and IL-1 levels were significantly higher in patients with spondyloarthritis compared to healthy controls.

• IL-17 was the ablest to discriminate between spondyloarthritis patients and healthy controls, suggesting that this cytokine can be helpful for the diagnosis of this disease.

• Disease activity was associated with longer disease duration and higher IL-6 levels.

• Structural damage is associated with TNFα and was associated with the male gender, longer disease duration, and increased disease activity.

Declaration of interest

All authors have no financial involvement with any organization or entity with a financial interest or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors’ contributions

- Dr. Maroua SLOUMA: Methodology and Writing – review & editing

- Dr. Lobna KHARRAT: Roles/Writing – original draft and data curation

- Dr. Rim DHAHRI: formal analysis

- Dr. Aymen TEZEGDENTI: data analysis

- Dr. Ezzeddine GHAZOUANI: conceptualization and supervision

- Dr. Imen GHARSALLAH: visualization and validation

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics statement

This study was conducted according to the Helsinki Declaration. The ethics committee of the hospital has approved the study (Approval number: 28/2019/CLPP). Each participant has read and signed an informed consent form explaining the aim and participation terms of the study.

Additional information

Funding

This paper was not funded.