Association of Bone Morphogenetic Proteins with Spinal Fusion in Ankylosing Spondylitis
Association of Bone Morphogenetic Proteins with Spinal Fusion in Ankylosing Spondylitis
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DOI：
10.3899/jrheum.100200
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发表时间：
2010-10-01
影响因子：
3.9
通讯作者：
Chou, Chung-Tei
中科院分区：
文献类型：
--
作者：
Chen, Hung-An;Chen, Chun-Hsiung;Chou, Chung-Tei
Objective.检测强直性脊柱炎（AS）患者血清骨形态发生蛋白（BMP）水平，探讨其与临床表现及影像学改变的关系。我们研究了60例连续的AS患者和60例未进行脊柱融合的患者。采用Bath强直性脊柱炎放射学指数（BASRI）和改良斯托克强直性脊柱炎脊柱评分（mSASSS）评估脊柱X线片。脊柱融合定义为腰椎或颈椎中2个相邻椎体之间存在完全骨性桥接。采用酶联免疫吸附法测定血清BMP水平。脊柱融合患者的血清BMP-2和BMP-4水平高于健康对照组或未进行脊柱融合的患者（p < 0.001），但后两组之间无差异。脊柱融合患者的血清BMP-7、血沉和C反应蛋白（CRP）水平高于未融合患者（p < 0.05）。有髋关节受累者血清BMP-4、BMP-7水平明显高于无髋关节受累者（P < 0.05）。BMP-2和BMP-4水平与脊柱X线片评分显著相关，尤其是腰椎BASRI评分（r分别为0.356和0.348，p < 0.001）。CRP与脊柱BASRI和mSASSS评分呈显著相关（r分别为0.261和0.260，p < 0.05）。脊柱融合后AS患者BMP水平升高，BMP与脊柱X线评分呈正相关，提示BMP可能在脊柱强直过程中发挥作用。血清BMP水平可能反映脊柱和髋关节的放射学进展。（2010年8月1日首次发布; J Rheumol 2010;37：2126-32; doi：10.3899/jrheum.100200）
Objective. To measure serum concentrations of bone morphogenetic proteins (BMP) in patients with ankylosing spondylitis (AS), and to investigate the relationship between BMP and clinical manifestations and radiographic changes.Methods. We studied 60 consecutive AS patients with and 60 patients without spinal fusion. Spinal radiographs were assessed using the Bath Ankylosing Spondylitis Radiology Index (BASRI) and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Spinal fusion was defined as the presence of total bony bridging between 2 adjacent vertebral bodies in either the lumbar or cervical spine. Serum levels of BMP were determined by enzyme-linked immunosorbent assay.Results. Patients with spinal fusion had higher serum levels of BMP-2 and BMP-4 than either the healthy controls or patients without spinal fusion (p < 0.001), but there was no difference between the latter 2 groups. Serum BMP-7, erythrocyte sedimentation rate, and C-reactive protein (CRP) levels were elevated in patients with spinal fusion compared with those without (p < 0.05). Serum BMP-4 and BMP-7 levels were higher in patients with hip involvement than in those without (p < 0.05). BMP-2 and BMP-4 levels had a significant correlation with spinal radiograph scores, especially for BASRI of the lumbar spine (r = 0.356 and 0.348, respectively, p < 0.001). CRP showed a significant correlation with spine BASRI and mSASSS scores (r = 0.261 and 0.260, respectively, p < 0.05).Conclusion. Rising levels of BMP in AS patients with spinal fusion and the positive correlation between BMP and spinal radiograph scores indicate that BMP may play a role in the process of spinal ankylosis. Serum levels of BMP may reflect radiographic progression of the spine and hip joints. (First Release August 1 2010; J Rheumatol 2010;37:2126-32; doi:10.3899/jrheum.100200)