Serial Lipocalin 2 and Oncostatin M levels reflect inflammation status and treatment response in axial spondyloarthritis

Arthritis Research & Therapy

Florence W. L. Tsui¹  Robert D. Inman²  Aifeng Lin³  Hing Wo Tsui⁴  Zhenbo Zhang⁵  Ismail Sari⁶ 

[1] Department of Immunology, University of Toronto, Toronto, Ontario, Canada;KeyIntel Medical Inc, Toronto, Ontario, Canada;Department of Immunology, University of Toronto, Toronto, Ontario, Canada;Krembil Research Institute, University Health Network, Toronto, Ontario, Canada;Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada;Department of Medicine and Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada;KeyIntel Medical Inc, Toronto, Ontario, Canada;Krembil Research Institute, University Health Network, Toronto, Ontario, Canada;Krembil Research Institute, University Health Network, Toronto, Ontario, Canada;Krembil Research Institute, University Health Network, Toronto, Ontario, Canada;Department of Biomedical and Molecular Science, Queen’s University, Kingston, Ontario, Canada;Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada;Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey;

关键词: Axial spondyloarthritis;    Lipocalin 2;    Oncostatin M;    MRI;    Joint inflammation;    Treatment response;   

DOI  :  10.1186/s13075-021-02521-y

来源: Springer

【 摘 要 】

BackgroundInformative serum biomarkers for monitoring inflammatory activity and treatment responses in axial spondyloarthritis (axSpA) are lacking. We assessed whether Lipocalin 2 (LCN2) and Oncostatin M (OSM), both having roles in inflammation and bone remodeling, may accurately reflect chronic joint inflammation and treatment response in axSpA. Previous reports in animal models showed involvement of LCN2 and OSM in joint/gut inflammation. We asked whether they also play a role in human axSpA.MethodsWe analyzed a longitudinal observational axSpA cohort (286 patients) with yearly clinical assessments and concurrent measurements of serum LCN2 and OSM (1204 serum samples) for a mean of 4 years. Biomarker levels were correlated with MRI scoring and treatment response.ResultsPersistent and transient elevation of LCN2 and OSM were observed in axSpA patients. Persistent elevation of LCN2 or OSM, but not CRP, correlated with sacroiliac joint (SIJ) MRI SPARCC scores (Pearson’s correlation p = 0.0005 and 0.005 for LCN2 and OSM respectively), suggesting that LCN2/OSM outperforms CRP as reflective of SIJ inflammation. We observed both concordant and discordant patterns of LCN2 and OSM in relationship to back pain, the cardinal clinical symptom in axSpA. Twenty-six percent (73/286) of the patients remained both clinically and serologically active (CASA). Sixty percent (173/286) of the patients became clinically quiescent, with back pain resolved, but 53% (92/173) of them were serologically active (CQSA), indicating that pain control may not indicate control of joint inflammation, as reflected by positive MRI imaging of SIJ. With respect to treatment responses, transient elevation of LCN2 or OSM over time was predictive of better response to all treatments.ConclusionIn axSpA, persistent LCN2 and/or OSM elevation reflects chronic SIJ inflammation and suboptimal treatment response. In our cohort, half of the currently deemed clinically quiescent patients with back pain resolved continued to demonstrate chronic joint inflammation. LCN2 and OSM profiling outperforms CRP as a predictive measure and provides an objective assessment of chronic local inflammation in axSpA patients.

【 授权许可】

CC BY