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Serum PCSK9 is positively correlated with disease activity and Th17 cells, while its short-term decline during treatment reflects desirable outcomes in ankylosing spondylitis patients

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Abstract

Objective

Proprotein convertase subtilisin/kexin type 9 (PCSK9) participates in the autoimmune disease pathology by regulating T helper (Th) cell differentiation, NF-κB pathway, toll-like receptor 4, etc. This study intended to investigate the association of serum PCSK9 with disease activity, Th cells, and treatment response in ankylosing spondylitis (AS) patients.

Methods

Eighty-nine active AS patients were enrolled in this multicenter, prospective study. Serum was collected from AS patients at week (W)0, W4, W8, and W12, as well as from 20 osteoarthritis patients and 20 healthy controls after enrollment to detect PCSK9 by ELISA. Based on the ASAS40 response at W12, AS patients were classified as responders and non-responders.

Results

PCSK9 was increased in AS patients versus healthy controls (P < 0.001) and osteoarthritis patients (P = 0.006). In AS patients, PCSK9 was positively linked with C-reactive protein (CRP) (P = 0.003) and ASDAS-CRP (P = 0.017), but not with other clinical properties (P > 0.05). Besides, PCSK9 was negatively correlated with interleukin-4 (P = 0.034), positively associated with Th17 cells (P = 0.005) and interleukin-17A (P = 0.014), but did not relate to Th1 cells, interferon-γ, or Th2 cells (all P > 0.05). Additionally, PCSK9 was decreased from W0 to W12 in general AS patients (P < 0.001) and responders (P < 0.001) but remained unchanged in non-responders (P = 0.129). Moreover, PCSK9 was lower at W4 (P = 0.045), W8 (P = 0.008), and W12 (P = 0.004) in responders versus non-responders. Furthermore, the treatment options did not affect the PCSK9 level (P > 0.05).

Conclusion

Serum PCSK9 is positively associated with disease activity and Th17 cells, while its short-term decline reflects desirable treatment response in AS patients.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study was supported by Huadong Hospital Young Rheumatologists Training Program (2019JC030).

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Author notes

  1. Jianfei Cai and Yinghui Jiang contributed equally to this work.

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Huadong Hospital Affiliated With Fudan University, Shanghai, China

    Jianfei Cai

  2. Department of Traditional Chinese Medicine and Pharmacy, China Pharmaceutical University, Nanjing, China

    Yinghui Jiang

  3. Department of Rheumatology and Immunology, Shanghai Qiangzhi Hospital, No. 2728 Wuzhong Road, 201100, Shanghai, China

    Fucai Chen, Shubin Wu, Hongjun Ren, Pingping Wang, Jiayong Wang & Wei Liu

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Correspondence to Wei Liu.

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Cai, J., Jiang, Y., Chen, F. et al. Serum PCSK9 is positively correlated with disease activity and Th17 cells, while its short-term decline during treatment reflects desirable outcomes in ankylosing spondylitis patients. Ir J Med Sci 192, 1785–1791 (2023). https://doi.org/10.1007/s11845-022-03204-6

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