{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:24Z","timestamp":1787013744728,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,3,6]],"date-time":"2014-03-06T00:00:00Z","timestamp":1394064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["81071523"],"award-info":[{"award-number":["81071523"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To examine the histopathological changes in spinal tissues of ankylosing spondylitis (\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      ) patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Tissue samples from 10\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients and 10 control subjects were obtained. Hematoxylin and eosin, picrosirius, Masson and van Gieson stainings were utilized to determine the pathological changes in tissues. Ultrastructural alterations were examined by electronic microscopy. Proteoglycan levels were assessed by enzyme\u2010linked immunosorbent assays (\n                      <jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content>\n                      ). Matrix metalloproteinase\u20103 (\n                      <jats:styled-content style=\"fixed-case\">MMP<\/jats:styled-content>\n                      \u20103), transforming growth factor\u2010\u03b21 (\n                      <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\n                      \u2010\u03b21) and tumor necrosis factor\u2010\u03b1 (\n                      <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\n                      \u2010\u03b1) levels were evaluated by immunohistochemistry.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our results demonstrate that the density of collagen fibrils was reduced in the supraspinous ligaments of\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      tissue and fibrils were loosely and irregularly organized as compared to a regular distribution of collagen fibrils in controls. In ligamentum flava from\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients, activated fibroblasts with enlarged nuclei were detected, while the number of elastic fibers was greatly decreased. Paraspinal muscle tissues of\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients exhibited increased collagen fibril accumulation and atrophy. Significantly decreased proteoglycan and elevated\n                      <jats:styled-content style=\"fixed-case\">MMP<\/jats:styled-content>\n                      \u20103 levels were found in supraspinous ligament samples from\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). Additionally, the levels of\n                      <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\n                      \u2010\u03b21 in ligamentum flava and paraspinal muscle tissues of\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients were increased (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). The expression of\n                      <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\n                      \u2010\u03b1 was also upregulated in the ligamentum flavum (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), with no significant difference in the paraspinal muscle between control and\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&gt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our findings reveal histopathological changes that occur in certain spinal tissues of\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      patients and suggest that increased levels of\n                      <jats:styled-content style=\"fixed-case\">MMP<\/jats:styled-content>\n                      \u20103 and\n                      <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\n                      \u2010\u03b21 may contribute to the pathogenesis of\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.12305","type":"journal-article","created":{"date-parts":[[2014,3,6]],"date-time":"2014-03-06T01:58:39Z","timestamp":1394071119000},"page":"420-429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Histopathological changes in supraspinous ligaments, ligamentum flava and paraspinal muscle tissues of patients with ankylosing 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