The Comparison of Leptin, Proinflammatory Cytokines Levels and the Disease Activity Index Before and After Anti-TNF Treatment in Ankylosing Spondylitis

Abstract

Aim: Ankylosing spondylitis (AS) is the major member of the spondyloarthropathies (SpAs), a group of diseases that mainly affect the spine in association with the inflammation of enthuses. Leptin is mainly synthesized by adipose tissue and shows several biological activities such as energy expenditure, nutrition, immunity, and metabolism. Tumor necrosis factor-alpha (TNF- α) is a potential modulator of adipocytokines. The aim of this study was to evaluate the effect of anti-TNF medicine such as infliximab and etanercept on leptin plasma levels in patients with AS. Methods: Seventy patients with ankylosing spondylitis were included in the study. Fourteen patients received infliximab IV at a dose of 3mg/kg at weeks 0, 2, 6 and thereafter every 8 weeks. Sixteen patients received 25 mg etanercept subcutaneously twice weekly. Forty AS patients were included in the control group. Their body mass index (BMI) and acute phase reactants such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and serum cytokine profiles, including TNF-α, interleukin 1 beta (IL-1β) and interleukin 6 (IL-6) were assessed. Serum levels of leptin and cytokines were measured using enzyme-linked immunosorbent assay (ELISA) methods, before and after 3-months treatment with infliximab or etanercept. Results: When compared to inactive AS patients, the leptin levels were significantly higher in active AS patients (p0.05). Serum TNF-α levels were increased after treatment with infliximab. Serum leptin levels were also increased after infliximab treatment (p

Keywords

• Ankylosing spondylitis
• leptin
• BASDAI
• proinflammatory cytokine
• anti TNF therapy