Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Evaluation of T Helper 17 Axis in Ankylosing Spondylitis.

Taylan,  Ali, Sari,  Ismail, Kozaci,  Didem, Yuksel,  Arif, Bilge,  Safak, Yildiz,  Yasar, Sop,  Gulten


Ankylosing spondylitis (AS) is a chronic inflammatory disorder which primarily affects the axial skeleton. Although the etiology of AS is unknown, available data strongly suggests the importance of genetic factors in the susceptibility to the disease. Recent studies suggest that interleukin-23 receptor (IL-23R) is one of the major generic factors involved in susceptibility to AS. In accordance with this observation, recent studies focused on the T helper 17 (Th17) axis in patients who have AS or spondylarthropathy (SpA).


To evaluate T helper 17 (Th17) axis and its relation with tumor necrosis factor (TNF) alpha blockage and disease activity in ankylosing spondylitis (AS).


127 AS patients (100M/27F) and 38 (27M/11F) controls were studied. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI). Patients were also evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Serum sample measurement of cytokines including IL-6, IL-12, IL-17A and IL-23 were performed by using commercially available ELISA kits.


Age, and sex distributions were similar between patients and controls (p>0.05). Cytokines including IL-6, IL-12, IL-17, and IL-23 were significantly higher in the AS patients than the controls (p<0.05; 3.06 [0.73–339,4] vs.1.42 [0.74–4]pg/mL, 4.65 [3,4–41,1] vs. 4.27 [3.47–57,8] pg/mL, 0.72 [0–31,6] vs. 0.15 [0–3.85]pg/mL, 98 (38–206) vs. 57 (36–160) pg/mL respectively).

Comparison of the patients who were on anti-TNF and conventional therapy revealed Th-17 related Cytokines were not different between the groups (p>0.05). Cytokines also were similar between the active vs. inactive patients' groups (p>0.05).

On correlation analysis, IL-17 was correlated with IL-23 and IL-12 (p<0.05). IL-23 showed correlations with IL-17, IL-12 and BASMI (p<0.05). Other correlations (p<0.05) were as follows:IL-6 with CRP, IL-12 with IL-17 and IL-23.

Table 1. Clinical and laboratory characteristics of the patients and controls

 AS Patients (n=127)Controls (n=38)P value
Age (years)38 (16–64)38 (23–56)0.94
Sex (M/F)100/2727/110.38
BMI (kg/m2)25.9 (16,3–36,7)25,3 (18,2–34,3)0.28
Disease duration (years)10 (1–35)  
BASFI3.6 (0–9,5)  
BASDAI4.4 (0–9,2)  
BASMI2 (1–9)  
CRP (mg/L)7.5 (0.27–119,1)1.15 (0.19–6,4)<0.001
IL-6 (pg/mL)3.06 (0.73–339,4)1.42 (0.74–4)<0.001
IL-12 (pg/mL)4.65 (3,4–41,1)4.27 (3.47–57,8)0.04
IL-17 (pg/mL)0.72 (0–31,6)0.15 (0–3.85)<0.001
IL-23 (pg/mL)98 (38–206)57 (36–160)0.001
TGF-b (pg/mL)26.4 (5.2–87)22.1 (0,4–39)0.01


In this study we found serum levels of Th-17 axis related cytokines to be significantly increased in the sera of AS patients. Disease activity, treatment type and history of peripheral arthritis(not shown) seem no effect on these cytokines. Targeting the cytokines related with the Th-17 axis may be a reasonable approach in AS patients who don't respond anti-TNF therapies.

To cite this abstract, please use the following information:
Taylan, Ali, Sari, Ismail, Kozaci, Didem, Yuksel, Arif, Bilge, Safak, Yildiz, Yasar, et al; Evaluation of T Helper 17 Axis in Ankylosing Spondylitis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1970
DOI: 10.1002/art.29735

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