強直性脊椎炎

Psoriasis is a chronic inflammatory seronegative disease closely associated with ankylosing spondylitis and inflammatory bowel disease. This study aimed to investigate the anti-inflammatory effects of candidate metabolites, such as D-proline, L-iditol, and propionylcarnitine, identified in Clonorchis sinensis preparations, in in vitro and in vivo models. None of the 3 metabolites exhibited cytotoxicity within the tested concentration range. In LPS-stimulated RAW 264.7 cells, D-proline and L-iditol significantly reduced the expression of pro-inflammatory cytokines, and in an imiquimod-induced psoriasis-like mouse model, L-iditol significantly reduced disease severity and histopathological scores, whereas the effects of other metabolites were inconsistent. These research results suggest that L-iditol, a candidate metabolite identified in Clonorchis sinensis formulations, exhibits anti-inflammatory effects in both in vitro and in vivo environments and may have therapeutic potential for inflammatory skin diseases such as psoriasis.

BACKGROUND/AIMS: Neck pain and limited neck mobility are common symptoms in patients with ankylosing spondylitis (AS). This study aimed to quantify neck muscle thickness in individuals with AS using ultrasonography and to compare these findings with measurements obtained from healthy volunteers. MATERIALS AND METHODS: A total of 30 individuals diagnosed with AS and 30 healthy participants were enrolled in this case-control study. The anteroposterior dimension, lateral dimension, cross-sectional area (CSA) of the longus colli (LC), cervical multifidus (CM), and anteroposterior dimension of the sternocleidomastoid were measured via ultrasound. Individuals diagnosed with AS were asked to complete the Neck Disability Index (NDI), the Ankylosing Spondylitis Quality of Life questionnaire (ASQoL), the Bath Ankylosing Spondylitis Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Bath Ankylosing Spondylitis Metrology Index (BASMI). RESULTS: In the AS group, the anteroposterior thickness (P = .025) and CSA (P = .021) of the right LC were markedly reduced compared with the control group. Similarly, the left LC exhibited significantly smaller anteroposterior measurements (P = .023) and CSA values (P = .012) in patients with AS. Additionally, the lateral dimension of the CM was significantly decreased on both the right (P = .001) and left (P = .002) sides relative to healthy controls. In patients with AS, LC thickness correlated negatively with NDI, ASQoL, BASDAI, BASFI, and BASMI, and positively with cervical extension and lateral flexion. In multivariate regression analyses adjusted for age and body mass index, LC thickness was independently associated with disability, functional impairment, and spinal mobility limitation. CONCLUSION: Neck muscle thickness is reduced in AS patients, and atrophy of the LC shows significant correlations with greater disability, poorer quality of life, higher disease activity, impaired functional status, and limited spinal mobility. Cite this article as: Karacif D, Karacif O, Cagliyan Turk A. Comparison of neck muscle thickness via ultrasound in patients with ankylosing spondylitis and healthy controls. ArchRheumatol. 2026;41(3):212-222.

Patients with seronegative spondyloarthropathies (SpA) have an increased risk of kidney involvement. The aim of the study was to assess early kidney injury markers (EKIMs) in SpA patients without clinically recognized kidney disease compared with control group (CG), and to analyze associations with SpA subtypes and therapy. In this cross-sectional study, 125 SpA patients (ankylosing spondylitis, psoriatic arthritis, non-radiographic axial SpA) and 53 GC were included. Serum and urinary NGAL, KIM-1, RBP4, FGF23, NAG, and IL-18 were measured. Our findings indicate subclinical kidney involvement in SpA. Serum and urinary KIM-1 levels were elevated in SpA patients compared to CG (serum: p = 0.039; urine: p = 0.024). Urinary RBP4 was higher in SpA patients (p = 0.005), while serum RBP4 was lower (p < 0.001) compared to CG. Urinary FGF23 concentrations were higher in SpA patients than in CG (p < 0.001). Serum NAG levels differed between SpA and CG (p = 0.018). While no overall differences were observed for urinary NGAL or IL-18 between the SpA group and CG, subgroup analyses revealed specific differences. Psoriatic arthritis patients showed distinct profiles, including lower serum FGF23 (p = 0.028 vs. nr-axSpA and CG), lower serum NAG (p = 0.013 vs. CG), and higher urinary IL-18 (p = 0.012 vs. CG) compared to CG. Levels of most EKIMs did not significantly differ between patients on first-line versus second-line therapies, except for serum FGF23, which was lower in patients receiving bDMARDs/tsDMARDs (p = 0.018). SpA patients without overt kidney disease demonstrate subclinical tubular injury and altered biomarker profiles, supporting the potential role of EKIMs in early renal assessment.

Ankylosing spondylitis (AS) is a chronic immune-mediated disease involving persistent inflammation of the axial skeleton and peripheral joints, often progressing to spinal deformity and irreversible ankylosis. Current therapeutic strategies, primarily non-steroidal anti-inflammatory drugs and biologic agents, focus on symptomatic relief and inflammation suppression. However, these treatments fail to halt long-term structural progression or prevent bone fusion. Recently, advanced immunotherapies, including mesenchymal stem cell (MSC) transplantation and chimeric antigen receptor (CAR)-based therapies, have been proposed as emerging exploratory strategies. While these modalities offer the theoretical potential for deep immune remodeling and might influence pathological ossification, their application in AS remains largely extrapolated from other autoimmune diseases. It is crucial to note that while traditional therapies are supported by robust clinical evidence, advanced targeted cellular immunotherapies in AS are currently in preclinical or early exploratory stages with limited direct clinical data. Globally, AS exerts a substantial socioeconomic burden, affecting young adults and requiring more effective disease-modifying interventions. Unlike existing reviews focused primarily on standard pharmaceutical updates, this article provides a novel synthesis by connecting AS immunopathogenesis with the translational potential of precision cellular engineering, offering a roadmap for future clinical research.

BACKGROUND: According to the modified New York criteria (mNYc), moderate-severe sacroiliac joint (SIJ) structural damage on radiography is necessary for classifying radiographic axial spondyloarthritis (r-axSpA). In contrast to radiography, MRI provides no ionizing radiation, higher sensitivity for structural damage, better inter-reader reliability, and is gradually replacing radiography. Therefore, we aimed to develop and validate a high specificity MRI cut-off to the radiographic component of the mNYc (rad-mNYc), defined as MRI findings that correspond to an mNY-positive radiograph. METHODS: Patients diagnosed with axSpA with available SIJ MRI and radiograph from five European clinical registries in the EuroSpA Collaboration were included. MRIs were read according to the SPARCC structural score (based on 5 predefined or all slices) and radiographs the rad-mNYc. Cut-offs with 95% specificity for rad-mNYc-positivity for MRI sum scores for individual lesions and for an MRI SIJ hierarchical Composite Structural Damage Score (CSDS5/CSDSall based on erosion, backfill and ankylosis in 5/all slices) and ROC curves were calculated. Internal validation by bootstrapping was performed. RESULTS: Overall, 640 patients were included; 296 (46%) were rad-mNYc positive. The 95%-specificity cut-off was ≥ 30 for the composite score CSDS5 predicting rad-mNYc (specificity 0.95, sensitivity 0.39, area-under-curve 0.83, accuracy with mNYc 69.2%. Internal validation showed moderate accuracy and high positive predictive value. Cut-offs for sclerosis, erosion, backfill and ankylosis were ≥ 9, ≥12, ≥ 5, and ≥ 1, respectively, with sensitivities all ≤ 0.21 except ankylosis 0.34 and accuracy ~ 60%, except ankylosis 67%. Cut-offs using all MRI-slices performed slightly worse or similarly. CONCLUSIONS: A composite MRI-score based on assessing erosion, backfill and ankylosis for five predefined semicoronal SIJ slices (CSDS5) was the optimal high specificity MRI cut-off to rad-mNYc positivity, being potentially usable in both research and clinical settings, with different thresholds depending on whether sensitivity or specificity is prioritized.