Increasing of SIgA serum levels may reflect subclinical intestinal involvement in non-radiographic axial and peripheral
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ORIGINAL ARTICLE
Increasing of SIgA serum levels may reflect subclinical intestinal involvement in non-radiographic axial and peripheral spondyloarthritis Ivonne Arias 1 & Daniel Herrera 1 & Wilson Bautista-Molano 2,3 & Juan Manuel Bello-Gualtero 2,3 Juliette De Avila 3 & Fabián Salas-Cuestas 2,3 & Consuelo Romero-Sánchez 2,3
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Received: 29 April 2020 / Revised: 23 July 2020 / Accepted: 24 August 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objective The evidence shows that previous infection with enteric pathogens is a requirement to develop pSpA. Based on our previous results, variances on regulation of SIgA might influence SpA activity; thus, the aim of this study was to correlate the levels of SIgA, IgA against some enteric bacteria, and IL-17, IL-21, and IL-6 with clinical features in a group of SpA patients. Methods Twenty-six pSpA, 20 nr-axSpA, 60 healthy volunteers (HV), and 34 patients with inflammatory bowel diseases (IBD) were included. All subjects were assessed to measure SIgA, total and specific IgA for enteric bacteria, and IL-17, IL-21, and IL-6 levels and clinical variables. For SpA patients, the diagnosis was verified 5 years after first evaluation to assess the risk of developing r-axSpA. Results SIgA levels were significantly higher in SpA patients than in HV and IBD (p < 0.0001 and p = 0.047, respectively). However, no differences for SIgA neither total IgA were found among the SpA subtypes (p = 0.624). Only IL-6 was higher in SpA than HV (p = 0.013). An inverse correlation was demonstrated for SIgA and BASFI (r: − 0.45; p = 0.003), BASDAI (r: − 0.39; p = 0.0123), ASDAS-CRP (r: − 0.37; p = 0.014), and ASDAS-ESR (r: − 0.45; p = 0.0021). There was no evidence of risk of developing r-axSpA in patients who previously showed high levels of serum antibodies. Conclusion The results show that pSpA as well as nr-axSpA share a similar SIgA-intestinal involvement independently of a previous infection. This suggests that serum SIgA increases are evidence of subclinical intestinal compromise which could have influence on disease activity but not in this progression. Key Point • The levels of SIgA, IgA against some enteric bacteria, and IL-17, IL-21, and IL-6 are correlated with clinical features in a group of SpA patients.
Keywords ASDAS . BASDAI . Intestinal disease . Secretory immunoglobulin A (SIgA) . Spondyloarthritis
Introduction
* Consuelo Romero-Sánchez [email protected] 1
Instituto de Genética Humana, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
2
Rheumatology and Immunology Department / Clinical Immunology Group School of Medicine, Hospital Militar Central, Transversal 3ª # 49-00, Bogotá 110231, Colombia
3
Cellular and Molecular Immunology Group/InmuBo, Universidad El Bosque, Bogotá, Colombia
Spondyloarthritis (SpA) has been described as a group of chronic autoinflammatory diseases with a common clinical, radiological, and immunogenetic pattern [1, 2]. These diseases mainly affect young adult men who develop a joi
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