Metabolites of type I, II, III, and IV collagen may serve as markers of disease activity in axial spondyloarthritis

Sci Rep. 2019 Aug 2;9(1):11218. doi: 10.1038/s41598-019-47502-z.

Abstract

Local inflammation in axial spondyloarthritis (axSpA) leads to the release of collagen metabolites from the disease-affected tissue. We investigated whether collagen metabolites were associated with disease activity and could distinguish non-radiographic(nr)-axSpA from ankylosing spondylitis (AS). A total of 193 axSpA patients (nr-axSpA, n = 121 and AS, n = 72) and asymptomatic controls (n = 100) were included. Serum levels of metalloproteinase (MMP)-degraded collagen type I (C1M), type II (C2M), type III (C3M) and type IV (C4M2) were quantified by enzyme-linked immunosorbent assay (ELISA). All metabolites were higher in axSpA than in controls (all p < 0.001). Serum levels of C1M, C3M, and C4M2 were increased in AS compared to nr-axSpA (43.4 ng/mL vs. 34.6; p < 0.001, 15.4 vs. 12.8; p = 0.001, and 27.8 vs. 22.4; p < 0.001). The best metabolite to differentiate between axSpA and controls was C3M (AUC 0.95; specificity 92.0, sensitivity 83.4). C1M correlated with ASDAS-CRP in nr-axSpA (ρ = 0.37; p < 0.001) and AS (ρ = 0.57; p < 0.001). C1M, C3M, and C4M2 were associated with ASDAS-CRP in AS and nr-axSpA after adjustment for age, gender, and disease duration. Serum levels of collagen metabolites were significantly higher in AS and nr-axSpA than in controls. Moreover, the present study indicates that collagen metabolites reflect disease activity and are useful biomarkers of axSpA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Collagen Type I / metabolism
  • Collagen Type II / metabolism
  • Collagen Type III / metabolism
  • Collagen Type IV / metabolism
  • Diagnosis, Differential
  • Female
  • Fibrillar Collagens / metabolism*
  • Humans
  • Male
  • Spondylarthritis / blood
  • Spondylarthritis / diagnosis*
  • Spondylitis, Ankylosing / blood
  • Spondylitis, Ankylosing / diagnosis

Substances

  • Biomarkers
  • Collagen Type I
  • Collagen Type II
  • Collagen Type III
  • Collagen Type IV
  • Fibrillar Collagens