title: Elevated Serum Levels of Sclerostin are Associated with High Disease Activity and Functional Impairment in Patients with Axial Spondyloarthritis.
abstract: BACKGROUND
  Recent research suggests that biomarkers may be useful in assessing disease activity, structural damage, and response to therapy in axial spondyloarthritis (axSpA). Our study aims at evaluating the relationship between inflammation and bone remodeling markers and variables assessing disease activity and functional disability in patients with axSpA.
  
  
  METHODS
  Serum levels of sclerostin, matrix metalloproteinase-3 (MMP-3), interleukin-17 (IL-17), and IL-23 were measured in 60 patients with axSpA and 20 healthy controls. Disease activity was evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Functional status was assessed by Bath Ankylosing Spondylitis Function Index (BASFI) and measures of spinal mobility.
  
  
  RESULTS
  Sclerostin levels were more elevated in axSpA patients with high disease activity than in those with low disease activity and in controls. They were significantly correlated with BASFI values (r = 0.29, p = 0.03) and measures of spinal mobility, but not with the classical markers of disease activity (BASDAI, ASDAS, CRP, and ESR). Although both MMP-3 and IL-17 levels were elevated in patients with active disease, they were not correlated with markers of disease activity or with functional disability. The levels of sclerostin, MMP-3, IL-17, and IL-23 were similar in axSpA patients and healthy controls.
  
  
  CONCLUSIONS
  Elevated levels of sclerostin, MMP-3, and IL-17 were observed in axSpA patients with active disease, suggesting their potential role in assessing disease activity. In axSpA patients, sclerostin levels might be equally influenced by inflammation and level of physical activity. Further studies are required to confirm our findings in order to understand their clinical value.
authors.forename: Laura
authors.initials: L
authors.lastname: Muntean
authors.forename: Andreea
authors.initials: A
authors.lastname: Lungu
authors.forename: Simona R
authors.initials: SR
authors.lastname: Gheorghe
authors.forename: Madalina
authors.initials: M
authors.lastname: Valeanu
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Craciun
authors.forename: Ioana
authors.initials: I
authors.lastname: Felea
authors.forename: Ana
authors.initials: A
authors.lastname: Petcu
authors.forename: Ileana
authors.initials: I
authors.lastname: Filipescu
authors.forename: Siao-Pin
authors.initials: SP
authors.lastname: Simon
authors.forename: Simona
authors.initials: S
authors.lastname: Rednic
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000097:blood; D053759:Interleukin-23 / Q000097:blood; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000097:blood; D008875:Middle Aged; D011506:Proteins / Q000032:analysis*; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000097:blood*
chemical_list: D020381:Interleukin-17; D053759:Interleukin-23; D011506:Proteins; C013247:sclerotin; D019278:Matrix Metalloproteinase 3