Abstract
IL-23 is the main inductor in Th17 polarization of naive T cells, inducing IL-17 production. IL-17 has been demonstrated to be elevated in ankylosing spondylitis (AS). The p40 subunit is common to IL-12 and IL-23. We assessed serum and synovial levels of p40 IL12/23 in spondyloarthropathy (SpA) patients and the evolution under anti-TNF. SpA patients fulfilling ESSG criteria were included. Healthy volunteers served as controls. P40 IL12/23 was assessed using Human Quantikine ELISA (R&D Systems), and at the same time, BASDAI, ESR, CRP, IL-17, MMP-3. Patients treated with anti-TNF were evaluated again after 10 weeks of treatment. Statistical analysis used Mann Whitney and correlation tests. Twenty-seven SpA outpatients (20 men), mean age 40.3 years, mean disease duration 10.5 years, HLA B27 positive n = 21, peripheral arthritis n = 8, mean BASDAI 45.7, mean CRP 30.7 mg/l, and 24 controls (12 men), mean age 50.4 years, were included. There is no statistical difference in serum levels of p40IL12/23 between patients (mean 77.8 pg/ml) and controls (103 pg/ml) and between patients with axial and peripheral involvement. Levels were higher in HLA B-27 negative patients (p = 0.02). No statistical correlation was found between p40 IL12/40 serum levels and each of BASDAI, ESR, CRP, serum levels of IL 17, MMP 3. Fourteen AS patients were treated with TNF blockers. Whereas significant reduction in BASDAI, ESR, and CRP were obvious after treatment, there was no significant change in serum level of p40 IL12/23. Mean levels of synovial p40 IL12/23 were higher in SpA patients (n = 6; mean 536 pg/ml) compared to osteoarthritis patients (n = 3; 133 pg/ml) and compared with paired serum SpA levels. These results suggest that serum levels of p40 IL-12/23 may not be considered as a biologic tool of disease activity assessment in SpA patients.
Similar content being viewed by others
References
Fitch E, Harper E, Skorcheva I et al (2007) Pathophysiology of psoriasis: recent advances on IL-23 and Th17 cytokines. Curr Rheumatol Rep 9:461–467
Mc Kenzie BS, Kastelein RA, Cua DJ (2006) Understanding the IL-23-IL-17 immune pathway. Trends Immunol 27:17–23
Iwakura Y, Ishigame H (2006) The IL-23/IL-17 axis in inflammation. J Clin Invest 116:1218–1222
Wendling D, Racadot E, Cedoz JP et al (2007) Serum levels of IL-17, BMP-7 and biologic bone remodelling markers in ankylosing spondylitis. Joint Bone Spine 74:304–305
Rahman P, Inman RD, Gladman DD et al (2008) Association of interleukin-23 receptor variants with ankylosing spondylitis. Arthritis Rheum 58:1020–1025
Rueda B, Orozco G, Raya E et al (2008) The IL23 Arg381Gln non-synonymous polymorphism confers susceptibility to ankylosing spondylitis. Ann Rheum Dis 67:1451–1454
Rahman P, Inman RD, Maksymowych WP et al (2007) Association of interleukin-23 variants with psoriatic arthritis. Arthritis Rheum 56(suppl):S255
Gottlieb AB, Menter A, Mendelsohn A et al (2007) Phase II, randomized, placebo-controlled study of CNTO 1275, a human interleukin-12/23 monoclonal antibody, in psoriatic arthritis. Arthritis Rheum 56:4310
Dougados M, van der Linden S, Juhlin R et al (1991) The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 34:1218–1227
Maksymowych W, Landewé R, Conner-Spady B et al (2007) Serum matrix metalloproteinase 3 is an independant predictor of structural damage progression in patients with ankylosing spondylitis. Arthritis Rheum 56:1846–1853
Kim HR, Kim HS, Park MK et al (2007) The clinical role of IL-23p19 in patients with rheumatoid arthritis. Scand J Rheumatol 36:259–264
Kageyama Y, Ichikawa T, Nagafusa T et al (2007) Etanercept reduces the serum levels of interleukin-23 and macrophage inflammatory protein-3 alpha in patients with rheumatoid arthritis. Rheumatol Int 28:137–143
Singh R, Aggarwal A, Misra R (2007) Th1/Th17 cytokine profiles in patients with reactive arthritis/undifferentiated spondyloarthropathy. J Rheumatol 34:2285–2290
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Financial support: Association Franc-Comtoise pour la Formation, la Recherche et l’Enseignement en Rhumatologie.
Contributions: DW: design of the study, recruitment and follow up of the patients, analysis of the results, preparation of the manuscript; JPC: statistical analysis; ER: biologic evaluation (ELISA).
Rights and permissions
About this article
Cite this article
Wendling, D., Cedoz, JP. & Racadot, E. Serum and synovial fluid levels of p40 IL12/23 in spondyloarthropathy patients. Clin Rheumatol 28, 187–190 (2009). https://doi.org/10.1007/s10067-008-1011-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-008-1011-0