Stable high interleukin-17A concentration in patients with ankylosing spondylitis treated with tumor necrosis factor-α inhibitors during a year


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Abstract

Aim. To assess changes in the concentration of interleukin-17A (IL-17A) in patients with ankylosing spondylitis (AS) treated with tumor necrosis factor-α (TNFα) inhibitors during a year. Subjects and methods. Examinations were made in 30 patients (22 (73.3%) men) aged 38.35±9.19 years with AS (modified New-York criteria, BASDAI ≥4.0; AS duration, 11.4±9.6 years) and in 20 healthy individuals (12 (60%) men) aged 40.1±7.7 years) (a control group). All the patients were treated with infliximab (remicade, MSD) 5 mg/kg body weight during a year according to the recommended regimen. BASDAI and ASDAS were calculated; C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and TNFα and IL-17A concentrations were measured before and 52±2 weeks after TNFα inhibitors treatment. BASDAI/ASDAS improvement, ESR and CRP decreases; ASAS20/40 responses, ASAS partial remission, and an ASDAS improvement were estimated. Results. In the patients with AS, the concentrations of TNFα and IL-17A were higher than those in the healthy individuals (p < 0.000). Twelve (40%) AS patients treated with TNFα inhibitors achieved ASAS partial remission. The average estimated back pain, ASDAS and BASDAI scores, and CRP and ESR substantially reduced (p<0.000 for all). The concentration of TNFα decreased from 17.8±7.6 to 7.3±3.2 pg/ml (p<0.000). The IL-17A level was 28.4±14.4 and 32.1±12.2 pg/ml before and after the treatment, respectively. The baseline level of IL-17A was lower in the patients with AS who had achieved remission than that in those who had not (p=0.01). Conclusion. The improvement due to one-year AS treatment with TNFα inhibitors is not associated with the reduction of IL-17A concentrations. In the patients who failed to achieve ASAS partial remission, the baseline and final serum concentrations of IL-17A were higher than in those who achieved the remission.

About the authors

I Z Gaydukova

ФГБОУ ВО «Саратовский ГМУ им. В.И. Разумовского» Минздрава России

Саратов, Россия

A P Rebrov

ФГБОУ ВО «Саратовский ГМУ им. В.И. Разумовского» Минздрава России

Саратов, Россия

A V Aparkina

ФГБОУ ВО «Саратовский ГМУ им. В.И. Разумовского» Минздрава России

Саратов, Россия

E V Khondkaryan

ФГБОУ ВО «Саратовский ГМУ им. В.И. Разумовского» Минздрава России

Саратов, Россия

References

  1. Эрдес Ш.Ф., Бадокин В.В., Бочкова А.Г., Бугрова О.В., Гайдукова И.З., Годзенко А.А., Дубиков А.А., Дубинина Т.В., Иванова О.Н., Коротаева Т.В., Лапшина С.А., Несмеянова О.Б., Никишина И.П., Оттева Э.Н., Раскина Т.А., Ребров А.П., Румянцева О.А., Ситало А.В., Смирнов А.В. О терминологии спондилоартритов. Научно-практическая ревматология. 2015;53(6):657-660. doi: 10.14412/1995-4484-2015-657-660
  2. Heijde D, Ramiro S, Landewé R, Baraliakos X, Van den Bosch F, Sepriano A, Regel A, Ciurea A, Dagfinrud H, Dougados M, van Gaalen F, Géher P, van der Horst-Bruinsma I, Inman RD, Jongkees M, Kiltz U, Kvien TK, Machado PM, Marzo-Ortega H, Molto A, Navarro-Compàn V, Ozgocmen S, Pimentel-Santos FM, Reveille J, Rudwaleit M, Sieper J, Sampaio-Barros P, Wiek D, Braun J. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. van der Ann Rheum Dis. 2017. doi: 10.1136/annrheumdis-2016-210770
  3. Schoels MM, Braun J, Dougados M, Emery P, Fitzgerald O, Kavanaugh A, Kvien TK, Landewé R, Luger T, Mease P, Olivieri I, Reveille J, Ritchlin C, Rudwaleit M, Sieper J, Smolen JS, Wit Md, van der Heijde D. Treating axial and peripheral spondyloarthritis, including psoriatic arthritis, to target: results of a systematic literature search to support an international treat-to-target recommendation in spondyloarthritis. Ann Rheum Dis. 2014;73(1):238-242. doi: 10.1136/annrheumdis-2013-203860
  4. Wendling D. Treating to target in axial spondyloarthritis: defining the target and the arrow. Expert Rev Clin Immunol. 2015;11(6): 691-693. doi: 10.1586/1744666X.2015.1039514
  5. Baraliakos X, Listing J, Brandt J, Haibel H, Rudwaleit M, Sieper J, Braun J. Radiographic progression in patients with ankylosing spondylitis after 4 yrs of treatment with the anti-TNF-alpha antibody infliximab. Rheumatology(Oxford). 2007;46(9):1450-1453.
  6. Braun J, Deodhar A, Dijkmans B, Geusens P, Sieper J, Williamson P, Xu W, Visvanathan S, Baker D, Goldstein N, van der Heijde D; Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy Study Group. Efficacy and safety of infliximab in patients with ankylosing spondylitis over a two-year period. Arthritis Rheum. 2008;59(9):1270-1278. doi: 10.1002/art.24001
  7. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361-368.
  8. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286-2291.
  9. Brandt J, Listing J, Sieper J, Rudwaleit M, van der Heijde D, Braun J. Development and preselection of criteria for short term improvement after anti-TNF alpha treatment in ankylosing spondylitis. Ann Rheum Dis. 2004;63(11):1438-1444. doi: 10.1136/ard.2003.016717
  10. van der Heijde D, Lie E, Kvien TK, Sieper J, Van den Bosch F, Listing J, Braun J, Landewé R. ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis. 2009;68(12):1811-1818. doi: 10.1136/ard.2008.100826
  11. Machado P, Landewé R, Lie E, Kvien TK, Braun J, Baker D, van der Heijde D; Assessment of SpondyloArthritis international Society. Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activitystates and improvement scores. Ann Rheum Dis. 2011;70(1):47-53. doi: 10.1136/ard.2010.138594
  12. Calin A, Garrett S, Whitelock H, Kennedy LG, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol. 1994;21(12):2281-2285.
  13. Heuft-Dorenbosch L, Spoorenberg A, van Tubergen A, et al. Assessment of enthesitis in ankylosing spondylitis. AnnRheumDis. 2003;62(2):127-132.
  14. Реброва О.Ю., ред. В кн: Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. М.: Медиа-Сфера; 2002.
  15. Der-Yuan Chen, Yi-Ming Chen, Hsin-Hua Chen, Chia-Wei Hsieh, Chi-Chen Lin, Joung-Liang Lan. Increasing levels of circulating Th17 cells and interleukin-17 in rheumatoid arthritis patients with an inadequate response to anti-TNF-α therapy. Arthritis Res Ther. 2011;13(4):R126. doi: 10.1186/ar3431
  16. Fernanda Manente Milanez, Carla GS Saad, Vilma T Viana, Júlio C B Moraes, Grégory Vinícius Périco, Percival Degrava Sampaio-Barros, Célio R Goncalves, Eloísa Bonfá. IL-23/Th17 axis is not influenced by TNF-blocking agents in ankylosing spondylitis patients. Arthritis Res Ther. 2016;18:52. doi: 10.1186/s13075-016-0949-6
  17. C Henrique Alves, Eric Farrell, Marijn Vis, Edgar M. Colin, Erik Lubberts. Animal Models of Bone Loss in Inflammatory Arthritis: from Cytokines in the Bench to Novel Treatments for Bone Loss in the Bedside — a Comprehensive Review. Clin Rev Allergy Immunol. 2016;51:27-47. doi: 10.1007/s12016-015-8522-7
  18. Hideki Okazaki, Qingshun Lin, Keiko Nishikawa, Naomi Ohtsuji, Hiromichi Tsurui, Mareki Ohtsuji, Hirofumi Amano, Norihiro Tada, Katsuko Sudo, Hiroyuki Nishimura, Toshikazu Shirai, and Sachiko Hirose. Modern TNFα but not IL-17 is critical in the pathogenesis of rheumatoid arthritis spontaneously occurring in a unique FcγRIIB-deficient mouse model. Rheumatology. 2014;24(6):2014. doi: 10.3109/14397595.2014.886351
  19. Wendling D. Interleukin-17 targeted therapies in axial spondyloarthritis. Immunotherapy. 2015;7(11):1125-1128. doi: 10.2217/imt.15.85
  20. Jethwa H, Bowness P. The interleukin (IL)-23/IL-17 axis in ankylosing spondylitis: new advances and potentials for treatment. Clin Exp Immunol. 2016;183(1):30-36. doi: 10.1111/cei.12670
  21. Koenders MI, van den Berg WB. Secukinumab for rheumatology: development and its potential place in therapy. Drug Des Devel Ther. 2016;10:2069-2080. doi: 10.2147/DDDT.S105263
  22. Maldonado-Ficco H, Perez-Alamino R, Maldonado-Cocco JA. Secukinumab: a promising therapeutic option in spondyloarthritis. Clin Rheumatol. 2016;35(9):2151-2161. doi: 10.1007/s10067-016-3350-6
  23. Milanez FM, Saad CG, Viana VT, Moraes JC, Périco GV, Sampaio-Barros PD, Goncalves CR, Bonfá E. IL-23/Th17 axis is not influenced by TNF-blocking agents in ankylosing spondylitis patients. Arthritis Res Ther. 2016;18:52. doi: 10.1186/s13075-016-0949-6
  24. Braun J, Baraliakos X, Deodhar A, Baeten D, Sieper J, Emery P, Readie A, Martin R, Mpofu S, Richards HB; MEASURE 1 study group. Effect of secukinumab on clinical and radiographic outcomes in ankylosing spondylitis: 2-year results from the randomised phase III MEASURE 1 study. Ann Rheum Dis. 2016. pii: annrheumdis-2016-209730. doi: 10.1136/annrheumdis-2016-209730
  25. Sieper J, Deodhar A, Marzo-Ortega H, Aelion JA, Blanco R, Jui-Cheng T, Andersson M, Porter B, Richards HB; MEASURE 2 Study Group. Secukinumab efficacy in anti-TNF-naive and anti-TNF-experienced subjects with active ankylosing spondylitis: results from the MEASURE 2 Study.Ann Rheum Dis. 2016. pii: annrheumdis-2016-210023. doi: 10.1136/annrheumdis-2016-210023
  26. Baraliakos X, Borah B, Braun J, Baeten D, Laurent D, Sieper J, Emery P, McInnes IB, van Laar JM, Wordsworth P, Wollenhaupt J, Kellner H, Colin L, Vandenhende F, Radford K, Hueber W. Long-term effects of secukinumab on MRI findings in relation to clinical efficacy in subjects with active ankylosing spondylitis: an observational study. Ann Rheum Dis. 2016;75(2):408-412. doi: 10.1136/annrheumdis-2015-207544
  27. Braun J, Baraliakos X, Deodhar A, Baeten D, Sieper J, Emery P, Readie A, Martin R, Mpofu S, Richards HB; MEASURE 1 study group. Effect of secukinumab on clinical and radiographic outcomes in ankylosing spondylitis: 2-year results from the randomised phase III MEASURE 1 study. Ann Rheum Dis. 2016. pii: annrheumdis-2016-209730. doi: 10.1136/annrheumdis-2016-209730

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