Clinical Rheumatology

, Volume 27, Issue 11, pp 1429–1435 | Cite as

Identification of acute phase reactants and cytokines useful for monitoring infliximab therapy in ankylosing spondylitis

  • Consuelo Romero-Sánchez
  • William H. Robinson
  • Beren H. Tomooka
  • John Londoño
  • Rafael Valle-Oñate
  • Feng HuangEmail author
  • Xiaohu Deng
  • Liyun Zhang
  • Chunhua Yang
  • David Tak Yan Yu
Original Article


Although most ankylosing spondylitis patients show an apparent clinical response to infliximab therapy, there is considerable individual variation. Because current clinical assessment relies heavily on subjective patient self-evaluation, biomarkers of high sensitivity and specificity are much needed. Here, we assessed potential biomarkers in 47 ankylosing spondylitis patients who received three standard pulses of infliximab. Before each infusion and at week 10, the following were measured: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet count, serum levels of metalloproteinase-3 (MMP-3), and 22 different cytokines. We discovered that, 2 weeks after the first infusion, the combination of ESR, CRP, and platelet count distinguished responders from non-responders with 81.3% sensitivity and 72.7% specificity. The distinguishing power was much less when each acute phase reactant was used alone. Among the 22 cytokines, serum IL-1α was able to distinguish responders from non-responders at week 6, with sensitivity of 84.9% and specificity of 53.8%. Serum IL-1α was probably generated from the joint compartments, as synovial fluid levels were much higher than corresponding serum levels. Although infliximab infusions led to rapid and significant suppression of serum MMP-3 levels, serum MMP-3 levels did not distinguish responders from non-responders. Besides identifying potential biomarkers, our results also demonstrate the usefulness of using sensitivity and specificity to assess usefulness of potential biomarkers.


Ankylosing spondylitis Biomarkers Infliximab 



This project was supported by the Nora Eccles Treadwell Foundation and the National Science Foundation of China Grants # 351726 and 3771983.




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Copyright information

© Clinical Rheumatology 2008

Authors and Affiliations

  • Consuelo Romero-Sánchez
    • 1
  • William H. Robinson
    • 2
  • Beren H. Tomooka
    • 2
  • John Londoño
    • 1
  • Rafael Valle-Oñate
    • 1
  • Feng Huang
    • 3
    Email author
  • Xiaohu Deng
    • 3
  • Liyun Zhang
    • 3
  • Chunhua Yang
    • 3
  • David Tak Yan Yu
    • 4
  1. 1.Spondyloarthropathy Group-Division of RheumatologyHospital Militar/Universidad de la SabanaBogotáColombia
  2. 2.Division of Immunology and Rheumatology, Department of MedicineStanford University School of MedicineStanfordUSA
  3. 3.Department of RheumatologyThe Chinese PLA General HospitalBeijingChina
  4. 4.Division of Rheumatology, Department of MedicineUniversity of CaliforniaLos AngelesUSA

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