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Editorial

What do biomarkers tell us about the pathogenesis of ankylosing spondylitis?

Walter P Maksymowych

Author Affiliations

Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2S2 Canada

Arthritis Research & Therapy 2009, 11:101  doi:10.1186/ar2565


See related research article by Appel et al., http://arthritis-research.com/content/10/5/R125

Published: 7 January 2009

Abstract

Biomarkers may provide information that promotes understanding of prognosis, disease activity, and pathogenesis in ankylosing spondylitis. Biomarkers reflecting disease activity (metallo-proteinase-3) and inflammatory lesions on magnetic resonance imaging predict new bone formation and are ameliorated by anti-tumor necrosis factor therapy, yet this treatment may not prevent new bone formation. Moreover, elevated levels of biomarkers reflecting tissue repair (bone-specific alkaline phosphatase) post-treatment together with magnetic resonance imaging indicates such treatment may even promote repair through new bone formation. Tumor necrosis factor regulation of Dickkopf-1 may constitute a molecular brake that controls osteoblastogenesis through wingless and bone morphogenetic proteins in an established inflammatory lesion in ankylosing spondylitis.