Investigation of serum progranulin levels and its relationship with disease activity in patients with axial spondyloarthritis

Axial Spondyloarthritis are a group of chronic systemic diseases of unknown etiology, affecting mostly young men, with common features such as inflammatory low back pain, axial skeletal involvement, sacroiliitis, association with HLA-B27 and genetic predisposition. Inflammatory cytokines, mainly TNF-α, play a role in its etiopathogenesis. Progranulin (PGRN) is thought to be an anti-inflammatory molecule that acts through the TNF-α pathway. In our study, we aimed to investigate the relationship between serum PGRN level and disease activity in patients with axial SpA. 45 patients between the ages of 18-65 who were diagnosed with axial SpA according to Assessment of SpondyloArthritis İnternational Society (ASAS) classification criteria were included in our study. Patients with peripheral SpA, with signs of acute infection, inflammatory bowel disease, diabetes mellitus (DM) and thyroid dysfunction disease, history of malignancy, concomitant autoimmune or autoinflammatory secondary disease other than axial SpA, and corticosteroid treatment more than 7.5 mg / day and patients receiving biological agent therapy were excluded. 45 individuals between the ages of 18-65 who did not have pregnancy or lactation status, no acute or chronic infection, and no malignancy or rheumatic disease were included as the healthy control group. In addition, BASDAI, BASFI, BASMI, ASDAS-CRP, ESR, CRP levels were recorded in the patient group to determine the severity of axial SpA clinically. Serum PGRN levels were measured by ELISA method in each of the participants in the patient and control groups. Progranulin levels of male patients were statistically significantly higher than female patients (p=0.004). There was no significant difference in serum progranulin levels between male and female participants in the control group (p=0.712). Although the mean serum progranulin levels were higher in axial SpA patients than in the control group, this elevation was not statistically significant (p=0.275) . There was no significant difference in serum progranulin levels between individuals with active and inactive disease (p=0.990). When we look at the correlations of serum progranulin levels with ESH, CRP, BASDAI, BASFI, BASMI, ASDAS-CRP and BMI in the axial SpA group, progranulin levels were negatively correlated with ESR (r= -0.330, p= 0.031) and positively correlated with BMI (r= 0.343, p=0.024). No correlation was found between serum progranulin levels and CRP, BASDAI, BASFI, BASMI and ASDAS-CRP. The role of Progranulin in the Axial Spondyloarthritis needs to be clarified with more extensive and comprehensive studies.