{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:05:51Z","timestamp":1780977951961,"version":"3.54.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Radiographic axial spondyloarthritis (r-axSpA) is a chronic inflammatory disease that primarily affects the axial skeleton and entheses, leading to pathological spinal bone formation and systemic bone loss. Treatments with tumor necrosis factor inhibitors (TNFi) and interleukin-17 inhibitors (IL-17i) have shown efficacy in reducing inflammation and potentially impacting bone remodeling in r-axSpA. Osteoclasts, crucial for bone resorption, are derived from the monocytic cell lineage and regulated by proinflammatory cytokines. This study aimed to evaluate the osteoclast development capacity from peripheral blood monocytes in patients with r-axSpA with different treatment strategies and compare it to controls.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study included 28 patients with long-standing r-axSpA receiving various treatments, including disease-modifying anti-rheumatic drugs (DMARDs) and NSAIDs, as well as 16 blood-donor controls. Disease activity was assessed using the Ankylosing Spondylitis Disease Activity Score (ASDAS). CD14\u2009+\u2009monocytes were isolated from blood samples and differentiated into osteoclasts in vitro by stimulation with three different conditions: (I) macrophage colony-stimulating factor (M-CSF), (II) M-CSF and receptor activator of nuclear factor-\u03ba\u03b2 (RANKL), and (III) M-CSF, RANKL, and tumor necrosis factor-alpha (TNF). Osteoclast and osteoclast precursor formation were assessed using tartrate-resistant acid phosphatase (TRAP) staining, and TRAP5b concentration in supernatants was measured by ELISA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The frequency of CD14\u2009+\u2009monocytes was similar in patients with r-axSpA and controls, but the capacity to develop osteoclasts and osteoclast precursors was significantly decreased in the r-axSpA patients. Stratification of the patients based on treatment with or without biological DMARDs (bDMARDs) revealed no significant differences in ASDAS or frequency of CD14\u2009+\u2009monocytes. Notably, only r-axSpA patients receiving bDMARDs exhibited a reduced ability to develop osteoclasts and osteoclast precursors compared to those not on bDMARDs and controls. Lower Trap5b concentrations in supernatants corroborated these findings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our study demonstrates that patients with r-axSpA exhibit a reduced capacity for osteoclast formation from CD14\u2009+\u2009monocytes isolated from peripheral blood. The process was modulated by treatment with bDMARDs, which might explain the previously shown sparing effect of bDMARDs on bone mineral density in r-axSpA.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13075-025-03578-9","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T10:22:22Z","timestamp":1748600542000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Osteoclast development from peripheral blood monocytes is reduced in patients with radiographic axial spondyloarthritis on biological therapy"],"prefix":"10.1186","volume":"27","author":[{"given":"Cecilia","family":"Engdahl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin C.","family":"Erlandsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Hallstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Deminger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Forsblad-d\u2019Elia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"5","key":"3578_CR1","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1136\/ard-2023-225185","volume":"83","author":"D van der Heijde","year":"2024","unstructured":"van der Heijde D, et al. Goodbye to the term \u2018ankylosing spondylitis\u2019, hello \u2018axial spondyloarthritis\u2019: time to embrace the ASAS-defined nomenclature. Ann Rheum Dis. 2024;83(5):547\u20139.","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"3578_CR2","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/s13075-017-1480-0","volume":"19","author":"A Deminger","year":"2017","unstructured":"Deminger A, et al. Which measuring site in ankylosing spondylitis is best to detect bone loss and what predicts the decline: results from a 5-year prospective study. Arthritis Res Ther. 2017;19(1):273.","journal-title":"Arthritis Res Ther"},{"key":"3578_CR3","doi-asserted-by":"crossref","unstructured":"Bengtsson K et al. Occurrence and relative risks for non-vertebral fractures in patients with ankylosing spondylitis compared with the general population: a register-based study from Sweden. 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Serum levels of OPG, RANKL, and RANKL\/OPG ratio in patients with ankylosing spondylitis: A systematic review and Meta-analysis. Immunol Invest. 2019;48(5):490\u2013504.","journal-title":"Immunol Invest"},{"issue":"1","key":"3578_CR7","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1186\/s13018-021-02721-x","volume":"16","author":"F Ni","year":"2021","unstructured":"Ni F, et al. Serum RANKL levels in Chinese patients with ankylosing spondylitis: a meta-analysis. J Orthop Surg Res. 2021;16(1):615.","journal-title":"J Orthop Surg Res"},{"key":"3578_CR8","doi-asserted-by":"publisher","first-page":"998554","DOI":"10.3389\/fimmu.2022.998554","volume":"13","author":"N Iwamoto","year":"2022","unstructured":"Iwamoto N, Kawakami A. The monocyte-to-osteoclast transition in rheumatoid arthritis: recent findings. 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