Comparison of microRNA-210 and microRNA-214 levels in patients with ankylosing spondylitis treated with Anti-TNF and IL-17a inhibitors

This study investigated the association between serum microRNA-210 (miR-210) and microRNA-214 (miR-214) levels and Anti-Tumor Necrosis Factor (Anti-TNF) or Interleukin-17A inhibitor Secukinumab therapies in patients with Ankylosing Spondylitis (AS). A total of 50 individuals were included: 34 AS patients (17 receiving Anti-TNF and 17 receiving Secukinumab) who met the ASAS 2009 criteria and had been diagnosed for at least two years, and 16 age- and sex-matched healthy controls. Clinical evaluations were performed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Visual Analogue Scale (VAS). Serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and bone metabolism biomarkers [Tartrate-resistant acid phosphatase 5b (TRAP5b), Type I collagen C-terminal telopeptide (CTX-I), and Procollagen I N-terminal propeptide (PINP)] were measured. miR-210 and miR-214 expression levels were analyzed in whole blood using qPCR. Results showed significantly higher CRP levels (p=0.028) and lower CTX-I (p<0.001) and TRAP5b (p=0.003) levels in AS patients compared to controls. Moreover, miR-214 levels differed significantly between patients and healthy controls (p=0.014). ROC analysis demonstrated that miR-214 possesses a distinctive diagnostic potential (AUC > 0.7). When treatment groups were compared, CRP was higher in the Anti-TNF group, while CTX-I and TRAP5b were lower in the Secukinumab group. Correlation analyses revealed a positive association between BASDAI and CRP in the Anti-TNF group, whereas BASDAI was more strongly correlated with BASFI and VAS in the Secukinumab group. In conclusion, AS is characterized by inflammation and alterations in bone metabolism, with biological therapies exerting distinct effects on these processes. The marked influence of Secukinumab on bone metabolism and the diagnostic potential of miR-214 may provide promising insights for novel approaches in the management of Ankylosing Spondylitis.