Role of interleukin-17 level in assessment of disease activity in peripheral and axial spondyloarthritis and its relation to different methods of treatment

Abstract

Background Spondylarthritis (SpA) is a chronic inflammatory disorder that can significantly impact either the axial or the peripheral skeleton (axial SpA or pSpA). The inflammatory cascades of SpA are primarily influenced by Interleukin-17 (IL-17). Aim To investigate the level of IL-17 level in SpA cases and its correlation with the disease activity and treatment received. Patients and methods This case-control study included 40 participants diagnosed regarding the assessment of SpA international Society assigned into three groups: group I involved 15 patients with axial SpA, group II involved 10 patients with pSpA and, group III involved 15 patients with both axial and pSpA. 20 healthy volunteers, age and sex matched, were involved as controls. All participants underwent complete clinical assessment, Ankylosing Spondylitis Disease Activity Score, assessment of SpA International Society Health index (ASASHI) to assess functional disability of patients and treatment received. The laboratory markers for disease activity were C-reactive protein and Serum IL-17. Results Patients’ groups had significantly higher IL-17 than control group ( P <0.05), Mean IL-17 titre, C-reactive protein, Ankylosing Spondylitis Disease Activity Score and assessment of SpA International Society Health index showed a significant reduction in pSpA more than axial SpA and both SpA. An insignificant difference in mean IL-17 titre between axial SpA cases receiving either anti-IL-17 or antitumor necrosis factor. Conclusion In PspA, treatment with biologic Disease-modifying antirheumatic are more effective than in axial SpA. This is in addition to the fact that conventional disease-modifying antirheumatic exhibit a more favourable response than in axial SpA. In treatment of axial SpA, we can start either with antitumor necrosis factor or anti-IL-17taking in consideration the clinical precautions.