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Bone turnover biomarkers, disease activity, and MRI changes of sacroiliac joints in patients with spondyloarthritis

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Abstract

The lack of valid biomarkers in patients with spondyloarthritis (SpA) requires searching for additional options to increase sacroiliac joint (SIJ) evaluation effectiveness. We assessed the serum levels of bone turnover markers and their relationships with active and chronic changes in SIJs using magnetic resonance imaging (MRI), indices, and laboratory parameters of disease activity in SpA patients. 102 patients with SpA and 15 healthy subjects were included. Testing of serum levels of transforming growth factor-beta (TGF-β1), Wnt3, sclerostin, and Dickkopf-1 (Dkk-1) was conducted. Active inflammatory lesions in SIJs were evaluated using Spondyloarthritis Research Consortium of Canada (SPARCC) MRI SIJ score, and chronic changes using the Danish scoring method. Bath Ankylosing Spondylitis Disease Activity Index, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Ankylosing Spondylitis Disease Activity Scores with CRP, and ESR were used to assess disease activity. Serum levels of Dkk-1, TGF-β1, and sclerostin were significantly lower in SpA patients compared to healthy controls. The serum levels of Dkk-1 positively correlated with CRP. Dkk-1 had a significant negative correlation with Danish score. The sclerostin serum level had a weak negative correlation with the active inflammatory MRI SIJ lesions. There were positive correlations between TGF-β1 and sclerostin with Dkk-1, and negative correlation between Wnt3 and sclerostin. Dkk-1 positively correlated with CRP and negatively with chronic SIJ changes by Danish score. Sclerostin negatively correlated with the active SIJ lesions by SPARCC. This suggests that Dkk-1 and sclerostin are the most promising candidates to reveal inflammation and bone turnover in patients with SpA.

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Authors and Affiliations

  1. Department of Internal Medicine #3, Bogomolets National Medical University, T. Shevchenko Boulevard, 13, Kiev, 01601, Ukraine

    Oleg Iaremenko, Iuliia Shynkaruk, Dmytro Fedkov & Liubov Petelytska

  2. Central Laboratory Department, Olexandrivska City Hospital, Kiev, 01601, Ukraine

    Kateryna Iaremenko

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  1. Oleg Iaremenko
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Contributions

All authors participated in the analysis and interpretation of the data, reviewed and provided feedback on the draft manuscript, and made the decision to submit the manuscript for publication. All authors vouch for the completeness and accuracy of the data and analyses. Material preparation, literature search, and data analysis were performed by OI, IS, DF, and LP. Laboratory methods and specimen handling for biomarkers were performed by KI. The first draft of the manuscript was written by DF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Dmytro Fedkov.

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Conflict of interest

Oleg Iaremenko, Iuliia Shynkaruk, Dmytro Fedkov, Kateryna Iaremenko, and Liubov Petelytska declare that they have no conflict of interest.

Ethical approval

The study was conducted in accordance with the ethical principles of the Declaration of Helsinki and Good Clinical Practice guidelines, and was approved by the appropriate institutional review boards (Local Ethic Committee of Bogomolets National Medical University, protocol #58, 26 Feb 2016). Authors fulfilled the ICMJE authorship criteria.

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Written informed consent was obtained from all patients prior to study start.

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Iaremenko, O., Shynkaruk, I., Fedkov, D. et al. Bone turnover biomarkers, disease activity, and MRI changes of sacroiliac joints in patients with spondyloarthritis. Rheumatol Int 40, 2057–2063 (2020). https://doi.org/10.1007/s00296-020-04708-z

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