Relationship between IL-17 and IL-23 levels with disease activity, functional status and quality of life in ankylosing spondylitis patients

Introduction:In this study, we aimed to determine serum IL-17 and IL-23 levels in patients with Ankylosing Spondylitis (AS) compared to healthy controls and to determine the association of these cytokines with disease activity, functional status and quality of life. Materials and methods:This study was carried out between the dates of 01/04 / 2016-01 / 10/2016 in Recep Tayyip Erdoğan University Faculty of Medicine Training and Research Hospital FTR clinic in Rize. 86 patients who received AS diagnosis according to Modifiye New York criteria and ASAS criteria were included by the responsible investigator. For the control group, 70 healthy individuals who attended the hospital for routine checks were included according to their age and gender. Demographic data such as height, weight, age, sex, education status and profession were recorded in the patient and control group. Disease activity, functional status, quality of life, enthesitis index and general pain status were evaluated with the patient's examination. Serum IL-17 and IL-23 levels were assayed by enzyme-linked immunosorbent assay (ELISA). Results: 156 individuals who consisted of 86 AS patients (56 male, 30 female) and 70 healthy individuals (17 male, 53 female) were included in the study.Patients and healthy individuals had an average age of 40±12,05 and 41±11,77, respectively. Groups were similar in age variability. Serum IL-17 and IL-23 levels were higher in AS patients than in healthy subjects and the difference was statistically significant (p<0,001). When the patients were divided into active and inactive groups according to BASDAI score, serum IL-17 levels were not statistically different between the two groups (p>0,05). However, serum IL-23 levels were significantly higer in AS patients than that in controls.There was no difference between the two groups in terms of serum IL-17 and IL-23 levels when we divided the patients into two groups as anti-TNF and SOAI sites for treatment (p>0,05). Although there was statistically significant but low level correlation between serum IL-17 level and ASDAS-ESH and ASDAS-CRP in AS patients (p=0,024, r=0,244; p=0,017, r=0,258 respectively), there was no correlation with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life Index (ASQoL) and enthesitis index (SPARCC).Although there was a statistically significant correlation (p = 0,015, r = 0,262) between serum IL-23 level and Achilles VAS score in AS patients, there was no correlation with other clinical parameters (p>0,05). Conclusion:Serum IL-17 and IL-23 levels of AS patients were found to be higher. There was a significant positive correlation between serum levels of IL-17 and IL-23 and ASDAS reflecting disease activity. IL-17 and IL-23 are thought to be cytokines that play an important role in the pathogenesis of AS. Key words: Ankylosing spondilitis, IL-17, IL-23, disease activity