Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Forsblad-d'Elia, HelenaORCID iD iconorcid.org/0000-0001-7871-5303
Alternative names
Publications (10 of 124) Show all publications
Law, L., Lindqvist, P., Liv, P., Hellman, U., Lejon, K., Geijer, M., . . . Forsblad-d'Elia, H. (2024). Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation. Clinical Rheumatology, 43(5), 1559-1570
Open this publication in new window or tab >>Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation
Show others...
2024 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 43, no 5, p. 1559-1570Article in journal (Refereed) Published
Abstract [en]

Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA.

Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations.

Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P < 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 109/L) and monocytes (0.6 ± 0.2 109/L); WBC count (unstandardized β (95% CI) 0.019 (0.0065, 0.031), P = 0.003, R2 = 0.57) and monocytes (0.13 (0.0047, 0.26), P = 0.041, R2 = 0.55), adjusted for age, smoking status, body mass index, hypertension, dyslipidemia, diabetes mellitus, ASDAS-CRP, and treatment with DMARDs and glucocorticoids. No significant association was found between cIMT and clinical disease activity assessed by ASDAS-CRP.

Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. 

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Cardiovascular disease (CVD), Carotid intima-media thickness (cIMT), Radiographic axial spondyloarthritis (r-axSpA), Ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-221778 (URN)10.1007/s10067-024-06913-8 (DOI)001176391500001 ()38443604 (PubMedID)2-s2.0-85186622797 (Scopus ID)
Funder
Swedish Research CouncilRegion VästerbottenStiftelsen Konung Gustaf V:s 80-årsfond
Available from: 2024-03-06 Created: 2024-03-06 Last updated: 2024-04-18Bibliographically approved
Lejon, K., Hellman, U., Kumar, A. & Forsblad-d'Elia, H. (2023). Decreased levels of T follicular helper (CD4+CXCR5+) cells and CD27+CD38+ and CD27+CD38− B cells in ankylosing spondylitis patients correlate with markers of inflammation. Scandinavian Journal of Immunology, 97(1), Article ID e13235.
Open this publication in new window or tab >>Decreased levels of T follicular helper (CD4+CXCR5+) cells and CD27+CD38+ and CD27+CD38− B cells in ankylosing spondylitis patients correlate with markers of inflammation
2023 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 97, no 1, article id e13235Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to study CD4+CXCR5+ T follicular helper (TFH) cells, CD27+CD38+ plasmablasts and CD27+CD38− memory B cells, as well as disease-related factors in patients with ankylosing spondylitis (AS) from northern Sweden. Peripheral blood mononuclear cells (PBMC) from 50 patients with AS (mean age 52 ± 9 years, 66% men, 100% HLA-B27 positive) and 50 pairwise matched blood donor controls (mean age 54 ± 9 years, 66% men) were stained with antibodies for CD27, CD38, CD19, CD3, CD4 and CXCR5 markers and analysed by flow cytometry. Patients with AS were examined with spinal x-ray for radiographic alterations (mSASSS), and plasma levels of C-reactive protein, erythrocyte sedimentation rate, as well as selected proinflammatory and regulatory cytokines were determined. Physical mobility, function and disease activity were registered by BASMI, BASFI and ASDAS-CRP, BASDAI, respectively. Comparing AS patients and controls pairwise, we observed a 56% reduction of TFH cells in PBMCs from AS patients (P =.000008). Furthermore, a 20%-30% reduction in plasmablasts and B memory cells (P ≤.002 and P ≤.007, respectively) was observed. In female patients, negative correlations between ESR and TFH, plasmablasts and B memory cells were observed; Rs = −0.551, P ≤.02; Rs = −0.476, P ≤.05 and Rs = −0.522, P ≤.03, respectively. In addition, positive correlations between the regulatory cytokine IL-10 and the proportion of B cells, IL-22, and the proportion of plasmablasts as well as a negative correlation between levels of the proinflammatory cytokine IL-6 and TFH were detected. Our observations indicate a role of an aberrant humoral immune response related to inflammation in AS.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
ankylosing spondylitis, memory B cells, plasmablasts, radiographic axial spondyloarthritis, TFH
National Category
Immunology in the medical area Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-201478 (URN)10.1111/sji.13235 (DOI)000889655600001 ()2-s2.0-85142643347 (Scopus ID)
Funder
Stiftelsen Konung Gustaf V:s 80-årsfond, FAI2017-0454Region Västerbotten, ALFVLL-640251Swedish Research Council, 2016-02035
Available from: 2022-12-06 Created: 2022-12-06 Last updated: 2023-03-24Bibliographically approved
Deminger, A., Klingberg, E., Lorentzon, M., Hedberg, M., Carlsten, H., Jacobsson, L. T. & Forsblad-d'Elia, H. (2022). Factors associated with changes in volumetric bone mineral density and cortical area in men with ankylosing spondylitis: a 5-year prospective study using HRpQCT. Osteoporosis International, 33(1), 205-216
Open this publication in new window or tab >>Factors associated with changes in volumetric bone mineral density and cortical area in men with ankylosing spondylitis: a 5-year prospective study using HRpQCT
Show others...
2022 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 33, no 1, p. 205-216Article in journal (Refereed) Published
Abstract [en]

Summary: Patients with ankylosing spondylitis (AS) have impaired volumetric bone mineral density (vBMD) assessed with high-resolution peripheral computed tomography (HRpQCT). This first longitudinal HRpQCT study in AS shows that cortical and trabecular vBMD decreased at tibia and that signs of inflammation were associated with cortical bone loss at tibia and radius.

Introduction: Patients with ankylosing spondylitis (AS) have reduced volumetric bone mineral density (vBMD) in the peripheral skeleton assessed with high-resolution peripheral quantitative computed tomography (HRpQCT). The aims were to investigate longitudinal changes in vBMD, cortical area, and microarchitecture and to assess factors associated with changes in vBMD and cortical area in men with AS.

Methods: HRpQCT of radius and tibia was performed in 54 men with AS at baseline and after 5 years. Univariate and multivariable linear regression analyses were used.

Results: At tibia, there were significant decreases exceeding least significant changes (LSC) in cortical and trabecular vBMD, mean (SD) percent change −1.0 (1.9) and −2.7 (5.0) respectively (p<0.001). In multivariable regression analyses, increase in disease activity measured by ASDAS_CRP from baseline to follow-up was associated with decreases in cortical vBMD (β −0.86, 95% CI −1.31 to −0.41) and cortical area (β −1.66, 95% CI −3.21 to −0.10) at tibia. At radius, no changes exceeded LSC. Nonetheless, increase in ASDAS_CRP was associated with decreases in cortical vBMD, and high time-averaged ESR was associated with decreases in cortical area. Treatment with TNF inhibitor ≥ 4 years during follow-up was associated with increases in cortical vBMD and cortical area at tibia, whereas exposure to bisphosphonates was associated with increases in cortical measurements at radius. No disease-related variables or treatments were associated with changes in trabecular vBMD.

Conclusion: The findings in this first longitudinal HRpQCT study in patients with AS strengthen the importance of controlling disease activity to maintain bone density in the peripheral skeleton.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Bone mineral density, DXA, high-resolution peripheral quantitative computed tomography, other diseases related to bone (ankylosing spondylitis), radiology
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-187329 (URN)10.1007/s00198-021-06049-4 (DOI)000673498400001 ()34263348 (PubMedID)2-s2.0-85118408575 (Scopus ID)
Funder
Swedish Research Council, 2016-02035Swedish Research Council, 2017-02229Swedish Rheumatism AssociationSwedish Society of MedicineIngaBritt and Arne Lundberg’s Research Foundation
Note

Errata: Deminger, A., Klingberg, E., Lorentzon, M. et al. Correction to: Factors associated with changes in volumetric bone mineral density and cortical area in men with ankylosing spondylitis: a 5-year prospective study using HRpQCT.. Osteoporos Int 32, 2601 (2021). DOI: 10.1007/s00198-021-06156-2

Available from: 2021-09-08 Created: 2021-09-08 Last updated: 2022-07-12Bibliographically approved
Lejon, K., Hellman, U., Do, L., Kumar, A. & Forsblad-d'Elia, H. (2022). Increased proportions of inflammatory T cells and their correlations with cytokines and clinical parameters in patients with ankylosing spondylitis from northern Sweden. Scandinavian Journal of Immunology, 96(3), Article ID e13190.
Open this publication in new window or tab >>Increased proportions of inflammatory T cells and their correlations with cytokines and clinical parameters in patients with ankylosing spondylitis from northern Sweden
Show others...
2022 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 96, no 3, article id e13190Article in journal (Refereed) Published
Abstract [en]

Ankylosing spondylitis (AS) is an autoimmune disease affecting parts of the skeletal structure in particular. Previously increased levels of the inflammatory cell types Th17, Th22, Tc17 and Tc22 cells have been shown to be associated with AS. Here, we analysed the levels of inflammatory T cell subsets, related cytokines and clinical characteristics of AS patients vs controls from northern Sweden. Peripheral blood mononuclear cells (PBMCs) obtained from 50 AS patients and 50 matched controls were short term stimulated with PMA/Ionomycin, stained and analysed by flow cytometry. Plasma levels of Interleukin (IL)-17, IL-22, IL-10 as well as clinically relevant markers were determined. Compared to male controls, male AS patients showed 1.5- to 2-fold increases of Th17 (P = .013), Th22 (P = .003) and Tc22 (P = .024) among CD45+CD3+ lymphocytes. Plasma IL-22 levels correlated with the Tc17 proportion in male patients (Rs = 0.499, P = .003) and plasma IL-10 levels were inversely correlated with Tc17 among all patients (Rs = −0.276, P = .05). Male patients with syndesmophytes showed significantly higher Th17 proportions (P = .038). In female AS patients, Tc22 was negatively correlated with C-reactive protein (high sensitivity) (hsCRP) (Rs = −0.573, P = .016). We confirmed increased proportions of inflammatory T cells and correlations with relevant cytokines from male AS patients. The correlation between Th17 and syndesmophytes supports a role of Th17 in the pathogenic process.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
ankylosing spondylitis, radiographic axial spondyloarthritis, T cells
National Category
Public Health, Global Health, Social Medicine and Epidemiology Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-196537 (URN)10.1111/sji.13190 (DOI)000804576100001 ()35506752 (PubMedID)2-s2.0-85131064416 (Scopus ID)
Funder
Swedish Research Council, 2016‐02035Region Västerbotten, ALFVLL‐640251Stiftelsen Konung Gustaf V:s 80-årsfond, FAI‐2017‐0454Swedish Rheumatism Association
Available from: 2022-06-14 Created: 2022-06-14 Last updated: 2022-11-29Bibliographically approved
Wiginder, A., Sahlin-Ingridsson, C., Geijer, M., Blomberg, A., Franklin, K. A. & Forsblad-d'Elia, H. (2022). Prevalence and factors related to sleep apnoea in ankylosing spondylitis. Clinical Rheumatology, 41, 491-498
Open this publication in new window or tab >>Prevalence and factors related to sleep apnoea in ankylosing spondylitis
Show others...
2022 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 41, p. 491-498Article in journal (Refereed) Published
Abstract [en]

An increased prevalence of obstructive sleep apnoea (OSA) has been suggested in patients with ankylosing spondylitis (AS) in a few controlled studies. We aimed to study the prevalence of OSA compared to controls and to investigate if disease-related and non-disease-related factors were determinants of OSA in AS patients. One hundred and fifty-five patients with AS were included in the Backbone study, a cross-sectional study that investigates severity and comorbidities in AS. Controls were recruited from the Swedish CArdioPulmonary bioImage Study. To evaluate OSA, the participants were asked to undergo home sleep-monitoring during one night’s sleep. For each AS patient 45–70 years old, four controls were matched for sex, age, weight, and height. OSA was defined as an apnoea-hypopnoea index (AHI) ≥ 5 events/hour. Sixty-three patients with AS were examined with home sleep-monitoring, and 179 controls were matched with 46 patients, 45–70 years. Twenty-two out of 46 (47.8%) patients with AS vs. 91/179 (50.8%) controls had OSA (AHI ≥ 5 events/hour), P = 0.72. No differences in the sleep measurements were noted in AS patients vs. controls. In logistic regression analysis adjusted for age and sex, higher age, higher BMI, and lesser chest expansion were associated with the presence of OSA in the 63 AS patients. In the current study, patients with AS did not have a higher prevalence of OSA compared to matched controls. AS patients with OSA had higher BMI, were older, and had lesser chest expansion because of more severe AS compared to patients without OSA.

Key points:

• Patients with ankylosing spondylitis did not have a higher prevalence of obstructive sleep apnoea versus matched controls.

• Patients with ankylosing spondylitis and obstructive sleep apnoea were older and had higher body mass index versus patients without obstructive sleep apnoea.

• Patients with ankylosing spondylitis and obstructive sleep apnoea had lesser chest expansion versus patients without obstructive sleep apnoea.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Ankylosing spondylitis, Observational study, Risk factors, Sleep apnoea
National Category
Respiratory Medicine and Allergy Rheumatology and Autoimmunity Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-188141 (URN)10.1007/s10067-021-05924-z (DOI)000701592300002 ()34581892 (PubMedID)2-s2.0-85115838391 (Scopus ID)
Available from: 2021-10-05 Created: 2021-10-05 Last updated: 2023-09-05Bibliographically approved
Do, L., Granåsen, G., Hellman, U., Lejon, K., Geijer, M., Baraliakos, X., . . . Forsblad-d'Elia, H. (2021). Anti-CD74 IgA autoantibodies in radiographic axial spondyloarthritis: a longitudinal Swedish study. Rheumatology, 60(9), 4085-4093
Open this publication in new window or tab >>Anti-CD74 IgA autoantibodies in radiographic axial spondyloarthritis: a longitudinal Swedish study
Show others...
2021 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 60, no 9, p. 4085-4093Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Antibodies against anti-CD74 are related to axial spondyloarthritis (axSpA). The objectives were (i) to study IgA anti-CD74 in radiographic (r)-axSpA patients in the Backbone cohort and to calculate the sensitivity and specificity of anti-CD74, (ii) to study the fluctuation of IgA anti-CD74 levels in prospectively collected samples, and (iii) to explore the relation between IgA anti-CD74 and radiographic spinal changes.

METHODS: IgA anti-CD74 was analysed by ELISA in 155 patients with r-axSpA and age- and sex-matched controls. BASDAI, ASDAS, BASFI and BASMI were assessed and spinal radiographs were scored for r-axSpA-related changes with mSASSS. Previously donated samples, before inclusion in the Backbone study, were identified in the Medical Biobank of Northern Sweden.

RESULTS: A total of 155 patients comprising 69% men and 31% women, age [mean (s.d.)] 55.5 (11.4) years and 152 (98.1%) HLA-B27 positive, were included. The plasma level of IgA anti-CD74 was significantly higher in the patients [median (interquartile range), 12.9 (7.9-17.9) U/ml] compared with controls [10.9 (7.2-14.6) U/ml, P = 0.003]. IgA anti-CD74 was above the cut-off level of 20 U/ml in 36/155 (23.2%) patients and in 15/151 (9.9%) controls (P = 0.002). Multivariable logistic regression analyses revealed ≥1 syndesmophyte associated with IgA anti-CD74 (odds ratio 5.64; 95% CI: 1.02, 35.58; P = 0.048) adjusted for hsCRP, smoking, BMI, sex and age. No distinct pattern of IgA anti-CD74 over time was revealed.

CONCLUSION: Plasma levels of IgA anti-CD74 were increased in r-axSpA and independently associated with radiographic spinal changes, which suggests that IgA anti-CD74 could play a role in the pathogenies of r-axSpA.

Place, publisher, year, edition, pages
Oxford University Press, 2021
Keywords
IgA anti-CD74, outcomes research, radiographic axial spondyloarthritis ankylosing spondylitis
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-191231 (URN)10.1093/rheumatology/keaa882 (DOI)000710982100036 ()33369649 (PubMedID)2-s2.0-85114422689 (Scopus ID)
Funder
Swedish Research Council, 2016-02035Region Västerbotten, ALFVLL-640251Stiftelsen Konung Gustaf V:s 80-årsfond, FAI-2017-0454
Available from: 2022-01-17 Created: 2022-01-17 Last updated: 2023-03-23Bibliographically approved
Forsblad-d'Elia, H., Law, L., Bengtsson, K., Smeds, J., Ketonen, M., Sundström, B., . . . Lindqvist, P. (2021). Biomechanical properties of common carotid arteries assessed by circumferential two-dimensional strain and β stiffness index in patients with ankylosing spondylitis. Journal of Rheumatology, 48(3), 352-360
Open this publication in new window or tab >>Biomechanical properties of common carotid arteries assessed by circumferential two-dimensional strain and β stiffness index in patients with ankylosing spondylitis
Show others...
2021 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 48, no 3, p. 352-360Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, two-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to 1) compare with age- and sex-matched controls and to 2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in AS patients.

METHODS: In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3±11.2 years, 102(68.5%) men, 146 (98%) HLA-B27 positive, were examined. Bilateral CCAs were examined for circumferential 2D strain and β stiffness index. A subgroup of 46 patients were compared with 46 age- and sex-matched controls, both groups without hypertensive disease, diabetes, myocardial infarction or stroke.

RESULTS: Mean bilateral circumferential 2D strain was lower in AS patients compared with controls, 7.9±2.6% vs 10.3±1.9%, p<0.001 whereas mean bilateral β stiffness index was higher, 13.1±1.6mmHg/mm vs 12.3±1.3mmHg/mm, p=0.018. In multivariable linear regression analyses strain was associated with age, erythrocyte sedimentation rate, history of anterior uveitis and treatment with csDMARD and/or bDMARD (R2 0.33), while stiffness was associated with age (R2 0.19).

CONCLUSION: Both CCA circumferential 2D strain and β stiffness index differed between AS patients and controls. Strain was associated with AS-related factors and age while stiffness with age, suggesting that the obtained results reflect different pathogenic vascular processes.

Place, publisher, year, edition, pages
The Journal of Rheumatology, 2021
Keywords
ankylosing spondylitis, cardiovascular disease, common carotid artery, ultrasound
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-173519 (URN)10.3899/jrheum.200146 (DOI)000658238100009 ()32611672 (PubMedID)2-s2.0-85102932664 (Scopus ID)
Available from: 2020-07-13 Created: 2020-07-13 Last updated: 2024-04-17Bibliographically approved
Södergren, A., Askling, J., Bengtsson, K., Forsblad-d'Elia, H., Jernberg, T., Lindström, U., . . . Jacobsson, L. T. H. (2021). Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis. Clinical Rheumatology, 40, 1321-1329
Open this publication in new window or tab >>Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis
Show others...
2021 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 40, p. 1321-1329Article in journal (Refereed) Published
Abstract [en]

Objectives: To study clinical characteristics, mortality, and secondary prevention, after a first incident acute myocardial infarction (AMI) in patients with ankylosing spondylitis (AS) compared with the general population.

Methods: In total, 292 subjects with AS and a first AMI between Jan 2006 and Dec 2014 were identified using the Swedish national patient register. Each subject was matched with up to 5 general population comparators per AS-patient (n = 1276). Follow-up started at the date of admission for AMI and extended until death or 365 days of follow-up. Cox regression was used to assess mortality in two time intervals: days 0–30 and days 31–365. For a subgroup with available data, clinical presentation at admission, course, treatment for AMI, and secondary prevention were compared.

Results: During the 365-day follow-up, 56/292 (19%) AS patients and 184/1276 (14%) comparators died. There were no difference in mortality due to cardiovascular-related causes, although the overall mortality day 31–365 was increased among patients with AS compared with comparators (HR [95% CI] = 2.0 [1.3;3.0]). At admission, AS patients had a higher prevalence of cardiovascular comorbidities compared with comparators. At discharge, patients with AS were less often prescribed lipid-lowering drugs and non-aspirin antiplatelet therapy.

Conclusions: Patients with AS tend to have a higher comorbidity burden at admission for first AMI. The mortality after a first AMI due to cardiovascular-related causes does not seem to be elevated, despite an increased overall mortality during days 31–365 among patients with AS compared with the general population.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Acute myocardial infarction, Ankylosing spondylitis, Cardiovascular disease, Mortality
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-175091 (URN)10.1007/s10067-020-05354-3 (DOI)000565618000003 ()32845439 (PubMedID)2-s2.0-85089868954 (Scopus ID)
Available from: 2020-10-01 Created: 2020-10-01 Last updated: 2023-03-24Bibliographically approved
Bengtsson, K., Forsblad-d'Elia, H., Deminger, A., Klingberg, E., Dehlin, M., Exarchou, S., . . . Jacobsson, L. T. (2021). Comment on: Incidence of extra-articular manifestations in AS, PsA and undifferentiated SpA:: results from a national register-based cohort study. Reply [Letter to the editor]. Rheumatology, 61(1), e31
Open this publication in new window or tab >>Comment on: Incidence of extra-articular manifestations in AS, PsA and undifferentiated SpA:: results from a national register-based cohort study. Reply
Show others...
2021 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 61, no 1, p. e31-Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Oxford University Press, 2021
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-192064 (URN)10.1093/rheumatology/keab745 (DOI)000757902800020 ()34647986 (PubMedID)2-s2.0-85123390063 (Scopus ID)
Available from: 2022-02-03 Created: 2022-02-03 Last updated: 2023-09-05Bibliographically approved
Deminger, A., Klingberg, E., Nurkkala, M., Geijer, M., Carlsten, H., Jacobsson, L. T. H. & Forsblad-d'Elia, H. (2021). Elevated serum level of hepatocyte growth factor predicts development of new syndesmophytes in men with ankylosing spondylitis. Rheumatology, 60(4), 1804-1813
Open this publication in new window or tab >>Elevated serum level of hepatocyte growth factor predicts development of new syndesmophytes in men with ankylosing spondylitis
Show others...
2021 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 60, no 4, p. 1804-1813Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To study baseline serum hepatocyte growth factor (s-HGF) as a predictor of spinal radiographic progression overall and by sex and to analyse factors correlated to changes in s-HGF in patients with AS.

METHODS: At baseline and the 5-year follow-up, s-HGF was analysed with ELISA. Spinal radiographs were graded according to modified Stoke Ankylosing Spondylitis Spinal Score. Radiographic progression was defined as ≥2 modified Stoke Ankylosing Spondylitis Spinal Score units/5 years or development of ≥1 syndesmophyte. Logistic regression analyses were used.

RESULTS: Of 204 baseline participants, 163 (80%) completed all examinations at the 5-year follow-up (54% men). Baseline s-HGF was significantly higher in men who developed ≥1 syndesmophyte compared with non-progressors, median (interquartile range) baseline s-HGF 1551 (1449-1898) vs 1436 (1200-1569) pg/ml, P = 0.003. The calculated optimal cut-off point for baseline s-HGF ≥1520 pg/ml showed a sensitivity of 70%, a specificity of 69% and univariate odds radio (95% CI) of 5.25 (1.69, 14.10) as predictor of development of ≥1 new syndesmophyte in men. Baseline s-HGF ≥1520 pg/ml remained significantly associated with development of ≥1 new syndesmophyte in men in an analysis adjusted for the baseline variables age, smoking, presence of syndesmophytes and CRP, odds radio 3.97 (1.36, 11.60). In women, no association with HGF and radiographic progression was found. Changes in s-HGF were positively correlated with changes in ESR and CRP.

CONCLUSION: In this prospective cohort study elevated s-HGF was shown to be associated with development of new syndesmophytes in men with AS.

Keywords
AS, hepatocyte growth factor, outcomes research
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-182482 (URN)10.1093/rheumatology/keaa460 (DOI)000644544400042 ()2-s2.0-85104047152 (Scopus ID)
Funder
Swedish Research Council, 2016–02035Swedish Rheumatism Association
Available from: 2021-04-29 Created: 2021-04-29 Last updated: 2023-09-05Bibliographically approved
Projects
Longitudinal and translational study on disease severity and comorbidities in ankylosing spondylitis [2016-02035_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7871-5303

Search in DiVA

Show all publications