Dynamic thiol and disulfide levels in ankylosing spondilitis and undifferentiated spondyloarthritis patients and relationship between dynamic thiol&disulfide levels and disease activity markers

Aim: Spondyloartropaties are defined as the diseases which spare common clinical findings and genetic basements each other. They are gradually being wellknown and we have increased concious about them. In this article, our goal is to define the sociodemographical signs of the spondyloartropaties in Turkish society and to clear if there is a correlation between the disease activity markers and thiol/disulfide levels. There are limited studies about the correlation between disease activity markers and thiol/disulfide levels. Materials and Methods: 147 patients which above 18 years old whom diagnosed with Modified New York Criterias along with 80 healthy controls referred to Yıldırım Beyazıt University Faculty of Medicine, Rheumotology outpatient clinic from January 2017 to February 2017 are included retrospectively in this study . The patients are excluded which has overlapping syndromes, pregnancy, malignancy and acute infectious diseases. Every patient has examined and questioned about recent medical history and diagnostic precedures as complete blood count, ESR, CRP, biochemistrical analysis, HLA-B27, sacroiliak joint plain radiography, and serum thiol and disulfide levels are performed. BASDAI scores, ESR and CRP levels are used to determine disease activity levels. Demographic signs and serum thiol and disulfide levels are used in healthy control group. Serum thiol and disulfide levels are compared between healty control group and patient groups. Results: There are 227 subjects of whom %68,3 (n=155) female, %31,7 (n=72) male in this study. The study group consist of 147 patients and the control group consists of 80 healthy people. The patient and control groups were similar given the sex (p > 0.05). The median age of patients was 46,4 (IQR=15.0) and the median age of healthy people was 49 (IQR=13.0). There is no statisitical difference between two groups about median age (p=0.086). There is significant difference between two patient groups about age at diagnosis. (p=0.01) The median age at diagnosis in AS group is 37,5 (IQR=14.0), and in USpA group is 44,5 (IQR=13.0) and there is statistically significant difference between two groups (p=0.01). HLA-B27 positivity was dedected %52 (n=9) in AS group and %30 (n=15) in USpA group. There is no statistically significant difference between two group about HLA-B27 positivity (p=0.099). While there were no differences in total thiol levels between the SpA patients and the control group ( p = 0.068), native thiol levels were significantly lower in the SpA patients group compared to the control group (p < 0.001) In addition, there were significant differ¬ences between the SpA patients and the control group regard¬ing plasma disulfide levels (p<0.001). Ratios obtained using plasma native thiol, total thiol, and disulfide levels differed significantly between the SpA patients and the control group (p<0,05). Native thiol and total thiol levels were significantly lower in Classic DMARD therapy arm compared to the Anti-TNF agent arm (p=0,03). Conclusion: Native Thiol levels are significantly higher in SPA group. There was a negative correlation between the plasma native thiol and CRP&ESR.levels. Native Thiol levels can be use as a marker of disease activity. Native thiol and total thiol levels were significantly lower in Classic DMARD therapy arm compared to the Anti-TNF agent arm. Biologic DMARDS is an effective therapy in SpA patients whish has higher oxidative stress levels. Randomized controlled trials with large patient populations are necessary to continue the research in this field. Key Words: Ankylosing Spndylitis, Undifferendiated Spondylitis, Thiol, Disulfide