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Anti-Saccharomyces cerevisiae antibodies and its relationship with radiological damage in ankylosing spondylitis

Abstract

Aim

The presence of anti-Saccharomyces cerevisiae antibodies (ASCA) is controversial in ankylosing spondylitis (AS). In this study, we aimed to investigate the prevalence of ASCA in AS and its relationship with disease activity and radiological damage in patients attending Sharkia governorate hospitals.

Patients and methods

Thirty AS patients and 30 apparently healthy volunteers were included in the present study. All patients were questioned for Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis metrology Index and Bath Ankylosing Functional Index (BASFI). Total Bath Ankylosing Spondylitis Radiology Index (BASRI-T) and ASCA levels were measured.

Results

ASCA IgA level was significantly higher in AS patients than in healthy controls (P < 0.001). The ASCA-positive group, although not significant, tended to have higher BASFI scores. ASCA IgA-positive patients had higher BASRI-T levels (P = 0.037). In AS patients, significant positive correlation was found between ASCA IgA level and BASRI-T and BASFI (r = 0.19 and 0.31, respectively, P < 0.05). Bath Ankylosing Spondylitis Disease Activity Index scores, BASFI and ASCA IgA positivity were significantly associated with increased BASRI-T (P= 0.01, 0.03 and 0.04, respectively). The most significant risk factor for increased BASRI-T is ASCA IgA positivity (P < 0.001).

Conclusion

ASCA IgA was detected more frequently in AS patients than in healthy controls. ASCA IgA could be considered a marker of severe radiological damage. Further studies are recommended to investigate ASCA level versus radiological damage and intestinal involvement in AS patients.

References

  1. Khan MA. Updates on spondyloarthropathies. Ann Intern Med 2002; 136:896–907.

    Article  Google Scholar 

  2. Francois RJ, Braun J, Khan MA. Entheses and enthesitis: a histopathologic review and relevance to spondyloarthropathies. Curr Opin Rheumatol 2001; 13:255–264.

    Article  CAS  Google Scholar 

  3. Baeten D, De Keyser F, Mielants H, Veys EM. Immune linkages between inflammatory bowel disease and spondyloarthropathies. Curr Opin Rheumatol 2002; 14:342–347.

    Article  Google Scholar 

  4. Baeten D, de Keyser F, Mielants H, Veys EM. Ankylosing spondylitis and bowel disease. Best Pract Res Clin Rheumatol 2002; 16:537–549.

    Article  Google Scholar 

  5. Palm O, Moum B, Ongre A, Gran JT. Prevalence of ankylosing spondylitis and other spondyloarthropathies among patients with inflammatory bowel disease: a population study (the IBSEN study). J Rheumatol 2002; 29:511–515.

    PubMed  Google Scholar 

  6. Palm O, Moum B, Jahnsen J, Gran JT. The prevalence and incidence of peripheral arthritis in patients with inflammatory bowel disease, a prospective population-based study (the IBSEN study). Rheumatology 2001; 40:1256–1261.

    Article  CAS  Google Scholar 

  7. Demetter P, Vanhuysse JA, De Keyser F, Van Damme N, Verbruggen G, Mielants H, et al. Increase in lymphoid follicles and leukocyte adhesion molecules emphasizes a role for the gut in spondyloarthopathy pathogenesis. J Pathol 2002; 198:517–522.

    Article  CAS  Google Scholar 

  8. Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, et al. The European Spondyloarthritis Study Group preliminary criteria for the classification of spondyloarthritis. Arthritis Rheum 1991; 34:1218–1227.

    Article  CAS  Google Scholar 

  9. Collantes E, Veroz R, Escudero A, Munoz E, Munoz MC, Cisnal A, et al. Can some cases of ‘possible’ spondyloarthritis be classified as definite’ or ‘undifferentiated’ spondyloarthritis? Value of criteria for spondyloarthropathies. Joint Bone Spine 2000; 67:516–520.

    Article  CAS  Google Scholar 

  10. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54:2665–2673.

    Article  Google Scholar 

  11. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath ankylosing spondylitis disease activity index. J Rheumatol 1994; 21:2286–2291.

    PubMed  CAS  Google Scholar 

  12. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS metrology index. J Rheumatol 1994; 21:1694–1698.

    CAS  Google Scholar 

  13. Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 1994; 21:2281–2285.

    PubMed  CAS  Google Scholar 

  14. Braun J, Golder W, Bollow M, Sieper J, van der Heijde D. Imaging and scoring in ankylosing spondylitis. Clin Exp Rheumatol 2002; 20:S178–S184.

    PubMed  CAS  Google Scholar 

  15. Hajeer AH, Dababneh A, Makki RF, Thomson W, Poulton K, Gonzalez-Gay MA, et al. Different gene loci within the HLA-DR and TNF regions are independently associated with susceptibility and severity in Spanish rheumatoid arthritis patients. Tissue Antigens 2000; 55:319–325.

    Article  CAS  Google Scholar 

  16. Rudwaleit M, Baeten D. Ankylosing spondylitis and bowel disease. Best Pract Res Clin Rheumatol 2006; 20:451–471.

    Article  Google Scholar 

  17. Hoffman IE, Demetter P, Peeters M, De Vos M, Mielants H, Veys EM, et al. Anti-Saccharomyces cerevisiae IgA antibodies are raised in ankylosing spondylitis and undifferentiated spondyloarthropathy. Ann Rheum Dis 2003; 62:455–459.

    Article  CAS  Google Scholar 

  18. Török HP, Glas J, Gruber R, Brumberger V, Strasser C, Kellner H, et al. Inflammatory bowel disease-specific autoantibodies in HLA-B27-associated spondyloarthropathies: increased prevalence of ASCA and pANCA. Digestion 2004; 70:49–54.

    Article  Google Scholar 

  19. Riente L, Chimenti D, Pratesi F, Delle Sedie A, Tommasi S, Tommasi C, et al. Antibodies to tissue transglutaminase and Saccharomyces cerevisiae in ankylosing spondylitis and psoriatic arthritis. J Rheumatol 2004; 31:920–924.

    PubMed  CAS  Google Scholar 

  20. Aydin SZ, Atagunduz P, Temel M, Bicakcigil M, Tasan D, Direskeneli H. Anti-Saccharomyces cerevisiae antibodies (ASCA) in spondyloarthropathies: a reassessment. Rheumatology 2008; 47:142–144.

    Article  CAS  Google Scholar 

  21. Matzkies FG, Targan SR, Berel D, Landers CJ, Reveille JD, Dermot PB, et al. Markers of intestinal inflammation in patients with ankylosing spondylitis: a pilot study. Arthritis Res Ther 2012; 14:R261.

    Article  CAS  Google Scholar 

  22. Andretta MA, Vieira TD, Nishiara R, Skare TL. Anti-Saccharomyces cerevisiae (ASCA) and anti-endomysial antibodies in spondyloarthritis. Rheumatol Int 2012; 32:551–554.

    Article  CAS  Google Scholar 

  23. Fantini M, Pallone F, Monteleone G. Common immunologic mechanisms in inflammatory bowel disease and spondyloarthropathies. World J Gastroenterol 2009; 15:2472–2478.

    Article  CAS  Google Scholar 

  24. Schatteman L, Mielants H, Veys EM, Cuvelier C, De Vos M, Gyselbrecht L, et al. Gut inflammation in psoriatic arthritis: a prospective ileocolonoscopic study. J Rheumatol 1995; 22:680–683.

    PubMed  CAS  Google Scholar 

  25. Cansu DÜ, Çalışır C, Yavaş US, Kaşifoğlu T, Korkmaz C. Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clin Rheumatol 2011; 30:557–562.

    Article  Google Scholar 

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Correspondence to Ghada S. Nageeb MD.

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El-Shahawy, E.ED., Fahmy, D.S., Nageeb, G.S. et al. Anti-Saccharomyces cerevisiae antibodies and its relationship with radiological damage in ankylosing spondylitis. Egypt Rheumatol Rehabil 41, 45–50 (2014). https://doi.org/10.4103/1110-161X.132456

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  • DOI: https://doi.org/10.4103/1110-161X.132456

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