Serum CCL11 level is associated with radiographic spinal damage in patients with ankylosing spondylitis
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The clinical significance of C–C motif chemokine11 (CCL11) in bone metabolism in ankylosing spondylitis (AS) is not clearly elucidated. Thus, this cross-sectional study aimed to compare serum levels of CCL11 between patients with AS and healthy controls and to investigate the relationship between serum levels of CCL11 and radiographic spinal damage in patients with AS. We consecutively recruited 55 male patients with AS and 26 age- and sex-matched healthy controls. Serum levels of CCL11, tumor necrosis factor-α (TNF-α), interleukin-17, and Dickkopf-1 (DKK-1) were measured with commercially available enzyme-linked immunosorbent assay kits. Radiographs were scored according to the modified Stoke ankylosing spondylitis spine score (mSASSS), and syndesmophytes were defined as mSASSS ≥ 2. The serum levels of CCL11 in AS patients with syndesmophytes were significantly higher than those in AS patients without syndesmophytes (p = 0.007) and healthy controls (p = 0.006). In AS patients, the serum levels of CCL11 were significantly and positively correlated with mSASSS (p = 0.006), number of syndesmophytes (p = 0.029). After adjusting for confounding factors, elevated serum levels of CCL11 were associated with increased mSASSS (β = 0.007, p = 0.03) and higher risk for the presence of syndesmophytes (OR 2.34 per 50 pg/ml increase, p = 0.012) in AS patients. We found that the serum level of CCL11 was associated with structural damage in patients with AS, suggesting that CCL11 may serve as a promising biomarker for new bone formation in AS.
KeywordsAnkylosing spondylitis CC chemokines Osteogenesis Biomarkers Tumor necrosis factor
We specially thank the late Professor Sung-Il Kim who devoted himself to education, research, and patient care in Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine (1963 to 2011).
DHS: research concept and study design, performance of the tests, statistical analysis, data analysis and interpretation, and drafting the article; HJ: performance of the tests and data analysis; JSR: performance of the tests and data analysis; HNL: radiographic data analysis; EK: clinical examination, sample collection and data acquisition; JHK: data interpretation; SGL: research concept and study design, study subject recruitment, statistical analysis, data analysis and interpretation, and drafting the article, manuscript editing, substantial supervision and coordination of the study. All authors approved the final version of the paper.
This work was supported by the research fund of Rheumatology Research Foundation (RRF-2017-01). Also, this research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2016R1D1A1B03934716).
Compliance with ethical standards
Conflict of interest
The authors have declared no conflict of interest.
The present study was approved by the Research and Ethical Review Board of Pusan National University Hospital (IRB No. 1603-005-039). All study participants provided written informed consent in accordance with the principles of the Declaration of Helsinki.
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