{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:28:05Z","timestamp":1773743285902,"version":"3.50.1"},"reference-count":53,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Danish National Research Foundation through the Center for Cellular Signal Patterns","award":["DNRF135"],"award-info":[{"award-number":["DNRF135"]}]},{"DOI":"10.13039\/501100003035","name":"Aase and Ejnar Danielsen Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003035","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008368","name":"Danish Rheumatism Association","doi-asserted-by":"crossref","award":["A6093 and A6462"],"award-info":[{"award-number":["A6093 and A6462"]}],"id":[{"id":"10.13039\/100008368","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Graduate School of HEALTH, Aarhus University"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,3,14]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate lectin pathway proteins (LPPs) as biomarkers for axial spondyloarthritis (axSpA) in a cross-sectional cohort with a suspicion of axSpA, comprising newly diagnosed axSpA and chronic low back pain (cLBP) individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Serum samples from 515 participants within the OptiRef cohort, including 151 axSpA patients and 364 cLBP patients, were measured using immunoassays for LPPs (mannan-binding lectin (MBL), collectin liver-1 (CL-L1), M-ficolin, H-ficolin and L-ficolin, MBL-associated serine proteases (MASP)\u22121, \u20132 and \u20133, MBL-associated proteins (MAp19 and MAp44) and the complement activation product C3dg).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Serum levels of L-ficolin, MASP-2 and C3dg were elevated in axSpA patients, whereas levels of MASP-3 and CL-L1 were decreased, and this remained significant for C3dg and MASP-3 after adjustment for C reactive protein (CRP). A univariate regression analysis showed serum levels of CL-L1, MASP-2, MASP-3 and C3dg to predict the diagnosis of axSpA, and MASP-3 and C3dg remained significant in a multivariate logistic regression analysis. Assessment of the diagnostic potential showed that a combination of human leukocyte antigen B27 (HLA-B27) and measurements of L-ficolin, MASP-3 and C3dg increased the diagnostic specificity for axSpA, however, with a concomitant loss of sensitivity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Serum levels of complement activation, that is, C3dg, and MASP-3 differed significantly between axSpA and cLBP patients after adjustment for CRP. Although combining HLA-B27 with measurements of L-ficolin, MASP-3 and C3dg increased the diagnostic specificity for axSpA, this seems unjustified due to the concomitant loss of sensitivity. However, both C3dg and MASP-3 were associated with axSpA diagnosis in multivariate logistic regression, suggesting an involvement of complement in the inflammatory processes and possibly pathogenesis in axSpA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2024-004127","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T06:57:23Z","timestamp":1715756243000},"page":"e004127","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring complement biomarkers in suspected axial spondyloarthritis"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6359-2192","authenticated-orcid":false,"given":"Clara Elb\u00e6k","family":"Misteg\u00e5rd","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark"},{"name":"Department of Biomedicine, Aarhus University, Aarhus, 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Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5612-043X","authenticated-orcid":false,"given":"Valeria","family":"Rios Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charit\u00e9 Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4104-5080","authenticated-orcid":false,"given":"Burkhard","family":"Muche","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charit\u00e9 Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany"},{"name":"Department of Rheumatology and Clinical Immunology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Campus Mitte, Berlin, 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