{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:21:36Z","timestamp":1760059296278,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T00:00:00Z","timestamp":1749254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad de Guadalajara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Ankylosing spondylitis (AS) is a severe chronic inflammatory rheumatic disease involving the spine, sacroiliacs, and peripheral joints. A lack of therapeutic response leads to severe sequelae. Currently, new markers are being tested to identify patients with poor outcomes. Tenascin C (TNC) is involved in triggering some relevant mechanisms of inflammation. Today, it remains unclear whether TNC levels might be useful as a biomarker of persistent activity. The aim of this study was to evaluate in AS whether serum levels of tenascin C are associated with persistent disease activity despite treatment. Methods: We included AS patients who had been treated with conventional synthetic disease-modifying antirheumatic drugs (cs-DMARDS) or anti-TNF agents for at least three months in a cross-sectional study. Response was assessed with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); scores \u2265 4 indicate persistent disease activity, while scores &lt; 4 indicate inactive disease. Serum TNC levels, C-reactive protein (CRP) levels, and Erythrocyte Sedimentation Rate (ESR) were determined through the ELISA technique, nephelometry, and the Westergren method, respectively. Results: We evaluated 58 patients with AS (62.1% men); of them, 33 (56.9%) had persistent active disease (BASDAI \u2265 4) despite treatment and 25 (43.1%) had inactive disease (BASDAI &lt; 4). The median TNC level was 18.6 ng\/mL. BASDAI correlated with TNC levels (rho: 0.528, p &lt; 0.001), CRP (0.352, p = 0.007), and ESR (0.342, p = 0.009). Patients with persistently active AS had higher serum TNC levels than those with inactive AS (35.2 vs. 6 ng\/mL, p &lt; 0.001). No differences in TNC level were found in patients treated with cs-DMARDS vs. anti-TNF agents. The ROC curve for serum tenascin C in active AS patients had an area under the curve\u2009= 0.78 (CI 95%: 0.65\u20130.91) with optimal serum tenascin C cutoff (&gt;13.85 ng\/mL). Sensitivity for detecting active AS was higher with TNC compared to ESR and CRP. Conclusions: We suggest that an elevated TNC level may be a useful biomarker of persistent disease activity despite treatment in AS; further studies should investigate the role of TNC levels in predicting the progression of the disease.<\/jats:p>","DOI":"10.3390\/diagnostics15121457","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T04:23:02Z","timestamp":1749442982000},"page":"1457","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Role of High Serum Tenascin C Levels as Potential Biomarker of Persistent Inflammation in Patients with Ankylosing Spondylitis Despite Treatment with cs-DMARDS or Anti-TNF Agents"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6409-1162","authenticated-orcid":false,"given":"Alejandro","family":"Martelli-Garcia","sequence":"first","affiliation":[{"name":"Programa de Doctorado en Farmacolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-9052","authenticated-orcid":false,"given":"Yussef","family":"Esparza-Guerrero","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Departamento de Aparatos y Sistemas II, Decanato de Ciencias de la Salud, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Lomas del Valle, Zapopan 45129, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heriberto","family":"Jacobo-Cuevas","sequence":"additional","affiliation":[{"name":"Group for the Assessment of Prognosis Biomarkers in Autoimmune Disorders, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Programa de Postdoctorado, Departamento de Psicolog\u00eda B\u00e1sica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2272-9612","authenticated-orcid":false,"given":"Ana Miriam","family":"Salda\u00f1a-Cruz","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Group for the Assessment of Prognosis Biomarkers in Autoimmune Disorders, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norma Guadalupe","family":"Gonzalez-Montoya","sequence":"additional","affiliation":[{"name":"Departamento de Bienestar y Desarrollo Sustentable, Centro Universitario del Norte, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3562-7033","authenticated-orcid":false,"given":"Cesar Arturo","family":"Nava-Valdivia","sequence":"additional","affiliation":[{"name":"Departamento de Microbiologia y Patolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2052-4755","authenticated-orcid":false,"given":"Eli Efrain","family":"Gomez-Ramirez","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Departamento de Aparatos y Sistemas II, Decanato de Ciencias de la Salud, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Lomas del Valle, Zapopan 45129, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luisa","family":"Vazquez-Villegas","sequence":"additional","affiliation":[{"name":"Departamento de Epidemiolog\u00eda, Unidad de Medicina Familiar No. 4, Instituto Mexicano del Seguro Social (IMSS), Guadalajara 44340, Jalisco, Mexico"},{"name":"Instituto Regional de Investigaci\u00f3n en Salud P\u00fablica, Programa de Doctorado y Coordinaci\u00f3n del Programa de Doctorado en Salud P\u00fablica, Departamento de Salud P\u00fablica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5035-3347","authenticated-orcid":false,"given":"Juan Manuel","family":"Ponce-Guarneros","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Ramirez-Villafa\u00f1a","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Departamento de Aparatos y Sistemas II, Decanato de Ciencias de la Salud, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Lomas del Valle, Zapopan 45129, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7643-6298","authenticated-orcid":false,"given":"Norma Alejandra","family":"Rodriguez-Jimenez","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto Daniel","family":"Rocha-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Departamento de Salud-Enfermedad Como Proceso Individual, Centro Universitario de Tonal\u00e1, Universidad de Guadalajara, Guadalajara 44100, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-667X","authenticated-orcid":false,"given":"Ernesto German","family":"Cardona-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-1797","authenticated-orcid":false,"given":"Jaime","family":"Morales-Romero","sequence":"additional","affiliation":[{"name":"Instituto de Salud P\u00fablica, Universidad Veracruzana, Xalapa 91190, Veracruz, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6517-6344","authenticated-orcid":false,"given":"Laura","family":"Gonzalez-Lopez","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Group for the Assessment of Prognosis Biomarkers in Autoimmune Disorders, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Instituto Regional de Investigaci\u00f3n en Salud P\u00fablica, Programa de Doctorado y Coordinaci\u00f3n del Programa de Doctorado en Salud P\u00fablica, Departamento de Salud P\u00fablica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0001-3787","authenticated-orcid":false,"given":"Jorge Ivan","family":"Gamez-Nava","sequence":"additional","affiliation":[{"name":"Instituto de Terap\u00e9utica Experimental y Cl\u00ednica, Departamento de Fisiolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Group for the Assessment of Prognosis Biomarkers in Autoimmune Disorders, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"},{"name":"Instituto Regional de Investigaci\u00f3n en Salud P\u00fablica, Programa de Doctorado y Coordinaci\u00f3n del Programa de Doctorado en Salud P\u00fablica, Departamento de Salud P\u00fablica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1136\/ard.61.5.453","article-title":"Prevalence of rheumatic diseases in a rheumatological outpatient practice","volume":"61","author":"Vanhoof","year":"2002","journal-title":"Ann. 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