Vasoactive intestinal peptide in early spondyloarthritis: low serum levels as a potential biomarker for disease severity

Research Projects
Organizational Units
Journal Issue
Spondyloarthritis (SpA) is a family of inflammatory diseases sharing clinical, genetic, and radiological features. While crucial for tailoring early interventions, validated prognostic biomarkers are scarce in SpA. We analyze the correlation between serum levels of vasoactive intestinal peptide (VIP) and disease activity/severity in patients with early chronic inflammatory back pain. The study population comprised 54 patients enrolled in our early chronic inflammatory back pain register. We collected demographic information, clinical data, laboratory data, and imaging findings. VIP levels were measured by enzyme immunoassay in serum samples from 162 visits. The association between independent variables and VIP levels was analyzed using longitudinal multivariate analysis nested by patient and visit. No significant differences were observed in VIP levels between these two groups. Lower levels of VIP were significantly associated with a higher Bath Ankylosing Spondylitis Disease Activity Index (BASFI) score, presence of bone edema in magnetic resonance imaging (MRI) scan, and lower hemoglobin levels. Coexistence of cutaneous psoriasis was independently associated with lower VIP levels, and similar trend was observed for enthesitis.We conclude that SpA patients with low serum VIP levels had worse 2-year disease outcome, suggesting that
Marzo-Ortega H, Emery P, McGonagle D (2002) The concept of disease modification in spondyloarthropathy. J Rheumatol 29:1583–1585. Marzo-Ortega H,McGonagle D, O’Connor P et al (2009) Baseline and 1-year magnetic resonance imaging of the sacroiliac joint and lumbar spine in very early inflammatory back pain. Relationship between symptoms, HLA-B27 and disease extent and persistence. Ann Rheum Dis 68:1721–1727. McGonagle D, Thomas RC, Schett G (2014) Spondyloarthritis: may the force be with you? Ann Rheum Dis 73:321–323. Nalbant S, Cagiltay E, Sahan B, Terekeci HM, Oktenli C (2011) The vasoactive intestinal polypeptide (VIP) levels at the patients with ankylosing spondylitis and its association with inflammation markers. Rheumatol Int 31:1143–1146. Niccoli L, Nannini C, Cassara E, Kaloudi O, Cantini F (2012) Frequency of anemia of inflammation in patients with ankylosing spondylitis requiring anti-TNFalpha drugs and therapy-induced changes. Int J Rheum Dis 15:56–61. Pan W (2001) Model selection in estimating equations. Biometrics 57:529–534. Poddubnyy D, Haibel H, Listing J et al (2012) Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum 64:1388–1398. Rudwaleit M, Jurik AG, Hermann KG et al (2009a) Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis 68:1520–1527. Rudwaleit M, Khan MA, Sieper J (2005) The challenge of diagnosis and classification in early ankylosing spondylitis: do we need new criteria? Arthritis Rheum 52:1000–1008. Rudwaleit M, van der Heijde D, Landewe R et al (2009b) The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783. van der Heijde D, Sieper J, MaksymowychWP et al (2011) 2010 Update of the international ASAS recommendations for the use of anti-TNF agents in patients with axial spondyloarthritis. Ann Rheum Dis 70:905–908. van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal formodification of the New York criteria. Arthritis Rheum 27:361–368. Vastesaeger N, van der Heijde D, Inman RD et al (2011) Predicting the outcome of ankylosing spondylitis therapy. Ann Rheum Dis 70:973–981. Ward MM, Learch TJ, Gensler LS, Davis JC Jr, Reveille JD, Weisman MH (2013) Regional radiographic damage and functional limitations in patients with ankylosing spondylitis: differences in early and late disease. Arthritis Care Res (Hoboken) 65:257–265.