Faculty Collaboration Database

Novel Biomarker of Collagen Degradation Can Identify Patients Affected With Both Axial Spondyloarthritis and Crohn Disease. J Rheumatol 2022 Dec;49(12):1335-1340

Date

06/16/2022

Pubmed ID

35705233

DOI

10.3899/jrheum.220142

Scopus ID

2-s2.0-85143200792 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

OBJECTIVE: Chronic inflammatory arthritis is a hallmark of axial spondyloarthritis (axSpA), where coexistence of Crohn disease (CD) is prominent. We investigated the association between biomarkers of collagen degradation in healthy controls (HCs) and in patients with axSpA, CD, and CD and axSpA overlap (CD-axSpA), with the aim to investigate the ability of the biomarkers to identify patients with CD-axSpA.

METHODS: Patients with axSpA who fulfilled Assessment of Spondyloarthritis international Society criteria (n = 13), had biopsy-proven CD (n = 14), had CD-axSpA (n = 10), and HCs (n = 11) undergoing standard-of-care colonoscopies were included in the study. The collagen biomarkers measuring type III, IV, VI and X collagen (C3M, C4M, C6M, and C10C, respectively) were measured in plasma samples from all subject groups. Statistical analysis was performed using an ANCOVA adjusted for age, an area under the receiver-operating characteristic (AUROC) curve analysis, and Spearman correlation.

RESULTS: C4M was significantly higher in patients with CD-axSpA overlap compared to axSpA, CD, and HCs (all P < 0.001). In an AUROC analysis, C4M showed a complete separation between the patients with CD-axSpA overlap compared to HC, axSpA and CD with an area under the curve (AUC) = 1.00 (P < 0.001). No differences were found between the patient groups for C3M, C6M, and C10C. No correlations were found between the collagen biomarkers and C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Simple Clinical Colitis Activity Index, or Harvey-Bradshaw Index scores.

CONCLUSION: Degradation of type IV collagen quantified by C4M showed a complete separation of patients with CD-axSpA overlap, compared to axSpA, CD, and HCs, and indicates excessive collagen degradation and epithelial turnover. This biomarker could potentially be used to identify patients affected by both manifestations and to guide treatment decisions.

Author List

Nielsen SH, Stahly A, Regner EH, Bay-Jensen AC, Karsdal MA, Kuhn KA

Author

Emilie Regner MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Biomarkers
Collagen
Crohn Disease
Humans
Spondylarthritis
Spondylitis, Ankylosing