ABSTRACT

Endothelial dysfunction (ED), which plays a key role in development of atherosclerosis, may be present in ankylosing spondylitis (AS). Some studies reported a beneficial effect of biotherapies on vascular function in AS. However, the effects of conventional treatment on ED is unknown. The aim of this study was to investigate the effect of conventional treatment on the levels of asymmetric dimethylarginine (ADMA) and endothelin-1 (ET-1), novel biomarkers related with vascular injury in patient with AS.

Twenty patients (mean age 37±11 years; male/female: 11/9) who met modified New York criteria for AS were studied. The serum level of ADMA, the plasma level of ET-1 and acute phase reactants (C-reactive protein-CRP, erythrocyte sedimentation rate- ESR) were measured before treatment and after 2 months of treatment. AS disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional status of patients was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI). Spinal mobility was measured with Bath Ankylosing Spondylitis Metrology Index (BASMI). Sulphasalazine (SSZ) 2 g/day, diclofenac 75-150 mg/day and home exercise programme were given as treatment.

Two months of conventional treatment resulted in significant decrease on acute phase reactants (CRP and ESR) and BASDAI (p<0.05). However, ADMA and ET-1 concentrations, BASFI and BASMI did not show any significant change compared to baseline measurements (p>0.05).

Biomarkers related with vascular injury seemed not affected by the conventional therapy of 2 months' duration. On the other hand BASDAI and acute phase reactans showed significant decrease during this period.