The Relationship Between Serum IL-17 and TNF-Alpha Levels and Disease Activity in Patients with Ankylosing Spondylitis

Abstract

Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting the spine and sacroiliac joints. This study aimed to investigate the effects of IL-17 and TNF-α on the pathogenesis of AS as well as their association with disease activity and duration, treatment type, and initiation time. Methods: The study included 91 patients diagnosed with AS, 29 patients diagnosed with RA and 31 healthy volunteers. The serum levels of TNF-alpha and IL-17 were measured using an ELISA kit, while the patient files concurrently recorded levels of C- reactive protein (CRP), erythrocyte sedimentation rate (ESR), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores. Results: 31.9% of AS patients received conventional treatment, while 68.1% received anti-TNF treatment. Significant differences were detected in interleukin-17 (IL-17) and tumor necrosis factor-alpha (TNF-α) levels among groups. RA patients had lower IL-17 levels compared to other groups (p: 0.012), and conventional treatment-receiving AS and RA patients had lower TNF-α levels compared to anti-TNF-receiving AS patients and healthy volunteers (p: 0.009). Significant differences were found in IL-17 and TNF- α levels between conventionally treated AS patients and healthy volunteers. No significant differences were found in IL-17 and TNF-α levels between anti-TNF treated AS patients and healthy volunteers. While there was no statistical difference in BASFI, 12 ESR, CRP, IL-17, and TNF-α levels between anti-TNF treated and conventionally treated AS patients, patients receiving anti-TNF treatment had lower BASDAI scores (p: 0.036). Conclusion: Biomarkers such as IL-17 and TNF-alpha facilitate monitoring treatment efficacy and determining patient-specific treatment options.

Keywords

• Ankylosing spondylitis
• Interleukin-17
• Tumor Necrosis Factor-alpha

Ankilozan Spondilit Hastalarında Serum IL-17 ve TNF-Alfa Düzeyi ile Hastalık Aktivitesi Arasındaki İlişki

Öz

Amaç: Ankilozan spondilit (AS), omurga ve sakroiliak eklemleri etkileyen kronik inflamatuar bir hastalıktır. Bu çalışma, IL-17 ve TNF-alfa'nın AS patogenezindeki etkisi, hastalık aktivitesi ve süresi, tedavi şekli ve başlama süresiyle ilişkisini incelemeyi amaçlamaktadır. Yöntemler: Bu çalışmaya AS tanısı alan 91 hasta, romatoid artrit (RA) tanısı alan 29 hasta ile 31 sağlıklı gönüllü dâhil edildi. Serum TNF-alfa ve IL-17 düzeyi elisa kiti kullanılarak ölçüldü eş zamanlı olarak hasta dosyalarında c-reaktif protein (CRP), sedimentasyon düzeyi ve Bath Ankilozan Spondilit Fonksiyonel İndeksi (BASFİ) - Bath ankilozan spondilit hastalık aktivite indeksi (BASDAI) skorları kaydedildi. Bulgular: AS hastalarının %31,9'u konvansiyonel tedavi alırken, %68,1'i anti-TNF tedavisi almıştır. İnterlökin-17 (IL-17) ve tümör nekroz faktör-alfa (TNF-α) düzeylerinde gruplar arasında anlamlı farklar tespit edilmiştir. RA hastalarında IL-17 düzeyleri diğer gruplardan daha düşük bulunurken (p= 0,012), konvansiyonel tedavi alan AS hastaları ve RA hastalarının TNF-α düzeyleri, anti-TNF alan AS hastaları ve sağlıklı gönüllülere göre daha düşük bulunmuştur (p: 0,009). Konvansiyonel tedavi alan AS hastaları ve sağlıklı gönüllüler arasında IL-17 ve TNF-α düzeylerinde anlamlı farklar bulunmuştur. Anti-TNF tedavi alan AS hastaları ve sağlıklı gönüllüler arasında ise IL-17 ve TNF-α düzeylerinde anlamlı fark bulunmamıştır. Anti-TNF tedavisi alan AS hastaları ile konvansiyonel tedavi alan AS hastaları arasında BASFI, ESR, CRP, IL- 12 17 ve TNF-α düzeylerinde istatistiksel fark bulunmazken, anti-TNF tedavisi alan hastaların BASDAI puanları daha düşük bulunmuştur (p: 0,036). Sonuç: IL-17 ve TNF-alfa gibi biyobelirteçler, tedavi etkinliğini izlemek için ve hastaya özgü tedavi seçeneklerini belirlemek için kolaylaştırıcı faktörlerdir.

Anahtar Kelimeler

• Ankilozan spondilit
• İnterlökin-17
• Tümör Nekrozis Faktör alfa

Kaynakça

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