title: Patients with ankylosing spondylitis and low disease activity because of anti-TNF-alpha therapy have higher TRAIL levels than controls: a potential compensatory effect.
abstract: OBJECTIVE
  TRAIL is a potential biomarker of cardiovascular (CV) disease. Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with metabolic syndrome (MeS) and accelerated atherosclerosis. We assessed whether disease activity, systemic inflammation, and MeS features were associated with circulating TRAIL levels in AS patients undergoing TNF-α antagonist infliximab therapy and if infliximab infusion modified TRAIL levels.
  
  
  METHODS
  We measured TRAIL serum levels in 30 nondiabetic AS patients without CV disease undergoing anti-TNF-α therapy, immediately before and after an infliximab infusion, and in 48 matched controls. Correlations of TRAIL levels with disease activity, systemic inflammation and MeS features, adipokines, and biomarkers of endothelial activation were evaluated. Changes in TRAIL levels following anti-TNF-α infusion were analyzed.
  
  
  RESULTS
  TRAIL levels were higher in AS patients than controls. TRAIL levels displayed an inverse correlation with total and LDL cholesterol. We observed an inverse correlation with QUICKI and a marginal association with HOMA-IR. We also found an inverse correlation with resistin and a marginal association with apelin and OPN. Anti-TNF-α infusion did not change TRAIL levels after 120'.
  
  
  CONCLUSIONS
  Elevated TRAIL levels in AS patients may be the result of a compensatory mechanism to reduce CV risk in these patients.
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Fernanda
authors: 0000-0003-3612-1448
authors: F
authors: Genre
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Raquel
authors: R
authors: López-Mejías
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Javier
authors: J
authors: Rueda-Gotor
authors: Rheumatology Division, Hospital Lucus Augusti, 27003 Lugo, Spain.
authors: José A
authors: JA
authors: Miranda-Filloy
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Begoña
authors: B
authors: Ubilla
authors: Oncology Division, Hospital Del Bierzo, Ponferrada, 24411 León, Spain.
authors: Beatriz
authors: B
authors: Carnero-López
authors: Rheumatology Division, Hospital General de Almansa, 02640 Albacete, Spain.
authors: Natalia
authors: N
authors: Palmou-Fontana
authors: Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IDIVAL, and CIBER Epidemiología y Salud Pública (CIBERESP), 39011 Santander, Spain.
authors: Inés
authors: I
authors: Gómez-Acebo
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Ricardo
authors: R
authors: Blanco
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Trinitario
authors: T
authors: Pina
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Rodrigo
authors: R
authors: Ochoa
authors: Cardiology Division, Hospital Lucus Augusti, 27003 Lugo, Spain.
authors: Carlos
authors: C
authors: González-Juanatey
authors: Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IDIVAL, and CIBER Epidemiología y Salud Pública (CIBERESP), 39011 Santander, Spain.
authors: Javier
authors: 0000-0002-9400-0989
authors: J
authors: Llorca
authors: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain.
authors: Miguel A
authors: MA
authors: González-Gay
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000097:blood*; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D053221:TNF-Related Apoptosis-Inducing Ligand; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab