Evaluation of periostin and factors associated with new bone formation in ankylosing spondylitis: Periostin may be associated with the Wnt pathway

• Published in: International journal of rheumatic diseases Vol. 21; no. 2; pp. 502 - 509
• Main Authors: Solmaz, Dilek, Uslu, Sadettin, Kozacı, Didem, Karaca, Neslihan, Bulbul, Hale, Tarhan, Emine Figen, Ozmen, Mustafa, Can, Gercek, Akar, Servet
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.02.2018
• Subjects: Ankylosing spondylitis; Biomarkers; Bone growth; Bone turnover; C-reactive protein; Dkk1 protein; Enzyme-linked immunosorbent assay; Hip; Osteogenesis; outcome measures; POSTN protein; Radiography; Serum levels; SOST protein; Spondylitis; spondyloarthritis; Vascular endothelial growth factor; Wnt protein; Wnt signaling pathway; spondyloarthritis; Wnt signaling pathway; outcome measures; POSTN protein; ankylosing spondylitis
• ISSN: 1756-1841; 1756-185X; 1756-185X
• DOI: 10.1111/1756-185X.13186

Objective Periostin has been shown to be involved in bone anabolism through the regulation of Wnt‐β‐catenin signaling. It may be one of the pathogenic mechanisms in syndesmophyte formation in ankylosing spondylitis (AS). The aim of this study was to evaluate serum periostin levels in patients with AS and to assess relationships among biomarkers of bone formation and periostin in disease outcomes, particularly radiographic changes. Methods Ninety‐seven consecutive AS patients (78% male) and 48 healthy controls (75% male) were included in the study. Serum periostin, dickkopf‐1 (DKK‐1), sclerostin and vascular endothelial growth factor (VEGF) levels were measured using commercially available enzyme‐linked immunosorbent assay kits. Disease‐related characteristics of patients were assessed using Ankylosing spondylitis disease activity score – C‐reactive protein (ASDAS‐CRP), Bath AS Disease Activity Index, Bath AS Functional Index and Bath AS metrology index. Radiographs were scored using the modified New York criteria and modified Stokes AS spinal score (mSASSS). Results Compared with control subjects, patients with AS had significantly lower serum levels of periostin (P < 0.001) and sclerostin (P < 0.001), but higher serum levels of VEGF (P < 0.001) and high‐sensitivity CRP (P < 0.001). Serum periostin (P = 0.005) and sclerostin levels (P = 0.016) were significantly lower in patients with very high disease activity according to ASDAS‐CRP. Current age (P = 0.009), age at symptom onset (P = 0.021) and hip joint involvement (P = 0.012) were independently associated with the development of syndesmophyte, in contrast to biomarkers of bone metabolism that we evaluated. Conclusion Our results suggest that periostin is down‐regulated in AS patients with highly active disease and may contribute to disease pathogenesis through an interaction with Wnt signaling.