Association between serum dickkopf-1 levels and disease duration in axial spondyloarthritis.
BACKGROUND
Axial spondyloarthritis (axSpA) is characterized by new bone formation. The complex systems underlying this process involve Wnt-signaling pathway. It has been observed that serum levels of dickkopf-1 (DKK-1), an important inhibitor of Wnt-signaling, are decreased in patients with axSpA. However, these data are from studies including only patients with long-standing disease. The aim of this study is to investigate if symptom duration influences on serum DKK-1 levels in patients with axSpA.


METHODS
A cross-sectional study including consecutive patients with axSpA (ASAS criteria) naïve for anti-TNF therapy. Collected data included demographic and disease characteristics, time since first symptom onset, assessment of disease activity and function, and determination of DKK-1 serum levels. Patients were classified as early axSpA (symptom duration ≤5 years) and established axSpA (>5 years). Linear regression models were employed to investigate the variables related to DKK-1 serum levels.


RESULTS
In total, 90 patients were included. Sixty-eight patients had early axSpA and 22 had established disease. Serum levels of DKK-1 were significantly higher in patients with early axSpA compared with established axSpA (22.1±12.6 vs 16.4±10.7pM; p=0.04). Among all tested variables, only symptom duration was significantly and inversely correlated with DKK-1 serum levels (beta: -0.041; p=0.01).


CONCLUSIONS
Serum DKK-1 levels in axSpA depend on disease duration. As disease duration increases, DKK-1 serum levels decrease. Based on this, an intensive treatment at early stages of the disease could have a better outcome on inhibiting/slowing radiographic progression in patients with axSpA.
Department of Rheumatology, University Hospital Virgen Macarena, Seville, Spain. Electronic address: roxanarubio27@gmail.com.
Roxana
R
Rubio Vargas
Biochemistry Department, University Hospital Virgen Macarena, Seville, Spain.
Enrique
E
Melguizo Madrid
Biochemistry Department, University Hospital Virgen Macarena, Seville, Spain.
Concepción
C
González Rodríguez
Department of Rheumatology, University Hospital Virgen Macarena, Seville, Spain.
Federico
F
Navarro Sarabia
Department of Rheumatology, University Hospital Virgen Macarena, Seville, Spain.
Carmen
C
Dominguez Quesada
Department of Rheumatology, University Hospital Virgen Macarena, Seville, Spain.
Rafael
R
Ariza Ariza
Department of Rheumatology, IdiPaz, University Hospital La Paz, Madrid, Spain.
Victoria
V
Navarro Compán
D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors
D015415:Biomarkers; C501126:DKK1 protein, human; D036341:Intercellular Signaling Peptides and Proteins
Axial spondyloarthritis; DKK-1; Disease duration; Duración de la enfermedad; Espondiloartritis axial