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Deutscher Rheumatologiekongress 2024

52. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh)
34. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)
38. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh)

18.09. - 21.09.2024, Düsseldorf

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Sex differences in bone metabolism in axial spondyloarthritis

Meeting Abstract

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  • Mia Juditzki - Leibniz-Institut für Arbeitsforschung an der TU Dortmund, Dortmund
  • Dimitra Karagkiozidou - Rheumazentrum Ruhrgebiet, Herne
  • Styliani Tsiami - Rheumazentrum Ruhrgebiet, Herne
  • Xenofon Baraliakos - Rheumazentrum Ruhrgebiet, Herne
  • Silvia Capellino - Leibniz-Institut für Arbeitsforschung an der TU Dortmund, Dortmund

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2024, 52. Kongress der Deutschen Gesellschaft für Rheumatologie und Klinische Immmunologie (DGRh), 34. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR), 38. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh). Düsseldorf, 18.-21.09.2024. Düsseldorf: German Medical Science GMS Publishing House; 2024. DocSpA.12

doi: 10.3205/24dgrh178, urn:nbn:de:0183-24dgrh1780

Published: September 18, 2024

© 2024 Juditzki et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Female and male axial Spondyloarthritis (axSpA) patients show differentially pronounced disease progression, treatment efficacy, and bone morphogenic and inflammatory biomarkers, suggesting that there are sex-specific differences in the pathophysiology of axSpA. Nevertheless, knowledge of sex-specific differences in axSpA pathology is still limited and treatment response is worse in female patients. The aim of this study is therefore to delineate sex-specific differences in bone morphogenic and axSpA-related biomarkers in biologically naïve nr-axSpA and r-axSpA patients.

Methods: Plasma samples from biologically naïve nr-axSpA (males n=14–18, females n=6–8) and r-axSpA (males n=30–34, females n=12–15), and healthy controls (males n=6–9, females n=7–15) were analyzed for levels of HGF, IL-10, IL-12(p40), VEGF, IL-17A, IL-22, IL-23, OPG, OPN, PDGF-BB, ALPL, ACP5, Leptin, RANKL, TNF, IL-6, PTH, IL-1b, BMP-2, DKK-1 by multiplex analysis and MMP-3 by ELISA. Osteoclasts were differentiated in vitro from blood monocytes and stained with tartrate-resistant acid phosphatase (TRAP).

Results: We observed high levels of markers associated with bone formation in female axSpA. Specifically, osteoprotegerin (OPG) and leptin were significantly higher in female nr-axSpA compared to male nr-axSpA. On the contrary, levels of Acid Phosphatase 5 Tartrate Resistant (ACP5), a marker of osteoclast activation, were significantly higher in r-axSpA male compared to female patients. Preliminary results of in vitro osteoclast differentiation did not confirm sex-specific differences so far, probably due to the low n-number of analyzed samples, but osteoclast differentiation was lower in axSpA compared to healthy control. Additionally, the levels of vascular endothelial growth factor (VEGF), which stimulates cell migration and proliferation of both osteoblasts and osteoclasts, were higher in all axSpA patients compared to healthy controls.

Conclusion: Plasma expression of bone morphogenic markers is significantly different in male and female axSpA patients, which demonstrates a sex-specific imbalance of bone metabolism in axSpA and highlights the importance and clinical relevance of sex-specific analysis. Such comprehensive studies will help to understand the pathophysiology of axSpA and to identify sex-specific therapeutic targets to improve personalized treatment response.

Disclosures: Nothing to disclose.