{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:17:06Z","timestamp":1790414226130,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006472","name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy in Ia\u0219i, Romania","doi-asserted-by":"publisher","award":["179\/10.08.2023"],"award-info":[{"award-number":["179\/10.08.2023"]}],"id":[{"id":"10.13039\/501100006472","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Axial spondyloarthritis (axSpA) is a chronic immune-mediated inflammatory disorder affecting the spine and sacroiliac joints, with variable clinical expression. This study assessed serum levels of inflammatory (TNF-\u03b1, IL-17A) and metabolic (leptin, adiponectin) biomarkers and their associations with disease activity, inflammation, structural damage, and comorbidities. Methods: This prospective cross-sectional study assessed 89 axSpA patients using clinical, laboratory, and radiological evaluations. Disease activity was measured using ASDAS-CRP and BASDAI scores. Radiographic damage was quantified using the Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Serum concentrations of TNF-\u03b1, IL-17A, leptin, and adiponectin were quantified by enzyme-linked immunosorbent assay (ELISA). Clinical and imaging correlations were analyzed. Results: Serum leptin levels correlated significantly with higher disease activity scores, inflammatory markers (CRP, ESR), radiographic progression (syndesmophyte formation, mSASSS), and arterial hypertension. Adiponectin levels were inversely associated with disease activity, structural damage, and arterial hypertension, suggesting anti-inflammatory, bone- and cardio-protective properties. TNF-\u03b1 levels showed an association with inflammatory markers and were higher in patients with peripheral enthesitis. IL-17A levels were weakly correlated with disease activity and structural severity and were significantly lower in patients with a history of anterior uveitis. Conclusions: Leptin and adiponectin may serve as complementary biomarkers in axSpA, reflecting both inflammatory burden and structural damage. While TNF-\u03b1 and IL-17A remain key therapeutic targets, their correlation with structural changes appears limited. Biomarker profiling could support personalized disease monitoring. Longitudinal studies are needed to validate prognostic implications.<\/jats:p>","DOI":"10.3390\/jcm14155605","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T09:56:42Z","timestamp":1754647002000},"page":"5605","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Biomarkers of Inflammation and Radiographic Progression in Axial Spondyloarthritis: A Clinical Evaluation of Leptin, Adiponectin, TNF-\u03b1, and IL-17A"],"prefix":"10.3390","volume":"14","author":[{"given":"Alexandra-Diana","family":"Diaconu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"2nd Internal Medicine Department, \u201cSf. Spiridon\u201d Clinical Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren\u021biu","family":"\u0218orodoc","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"2nd Internal Medicine Department, \u201cSf. Spiridon\u201d Clinical Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2828-7758","authenticated-orcid":false,"given":"Cristina","family":"Pom\u00eerleanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7558-0711","authenticated-orcid":false,"given":"Liliana Georgeta","family":"Foia","sequence":"additional","affiliation":[{"name":"Biochemistry Department, Faculty of Dental Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-2360","authenticated-orcid":false,"given":"Victori\u021ba","family":"\u0218orodoc","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"2nd Internal Medicine Department, \u201cSf. Spiridon\u201d Clinical Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0525-0645","authenticated-orcid":false,"given":"C\u0103t\u0103lina","family":"Lionte","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"2nd Internal Medicine Department, \u201cSf. Spiridon\u201d Clinical Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8395-1808","authenticated-orcid":false,"given":"Mara","family":"Russu","sequence":"additional","affiliation":[{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2516-1058","authenticated-orcid":false,"given":"Vladia","family":"L\u0103pu\u0219te","sequence":"additional","affiliation":[{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8351-9048","authenticated-orcid":false,"given":"Larisa","family":"Ghemi\u0219","sequence":"additional","affiliation":[{"name":"Biochemistry Department, Faculty of Dental Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-8121","authenticated-orcid":false,"given":"Codrina","family":"Ancu\u021ba","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"ref_1","first-page":"697","article-title":"Recent advances in managing axial spondylarthritis","volume":"9","author":"Agrawal","year":"2020","journal-title":"Fac. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11926-020-00924-5","article-title":"Treatment of Axial Spondyloarthritis: What Does the Future Hold?","volume":"22","author":"Poddubnyy","year":"2020","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/rheumatology\/keaa250","article-title":"Classification vs. diagnostic criteria: The challenge of diagnosing axial spondyloarthritis","volume":"59","author":"Poddubnyy","year":"2020","journal-title":"Rheumatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1007\/s00296-024-05601-9","article-title":"Axial Spondyloarthritis: An overview of the disease","volume":"44","author":"Ivanova","year":"2024","journal-title":"Rheumatol. Int."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Toussirot, E. (2023). The Influence of Adipokines on Radiographic Damage in Inflammatory Rheumatic Diseases. Biomedicines, 11.","DOI":"10.3390\/biomedicines11020536"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1136\/annrheumdis-2021-221035","article-title":"Axial spondyloarthritis","volume":"80","author":"Sepriano","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Maksymowych, W.P. (2019). Biomarkers for Diagnosis of Axial Spondyloarthritis, Disease Activity, Prognosis, and Prediction of Response to Therapy. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.00305"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s10067-015-2949-3","article-title":"Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis","volume":"34","author":"Reveille","year":"2015","journal-title":"Clin. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1759720X20934277","DOI":"10.1177\/1759720X20934277","article-title":"An update on serum biomarkers to assess axial spondyloarthritis and to guide treatment decision","volume":"12","author":"Lorenzin","year":"2020","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jang, D.I., Lee, A.H., Shin, H.Y., Song, H.R., Park, J.H., Kang, T.B., Lee, S.R., and Yang, S.H. (2021). The Role of Tumor Necrosis Factor Alpha (TNF-\u03b1) in Autoimmune Disease and Current TNF-\u03b1 Inhibitors in Therapeutics. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052719"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Osta, B., Benedetti, G., and Miossec, P. (2014). Classical and Paradoxical Effects of TNF-\u03b1 on Bone Homeostasis. Front. Immunol., 5.","DOI":"10.3389\/fimmu.2014.00048"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta20090","article-title":"Tumour necrosis factor-\u03b1 inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis: A systematic review and economic evaluation","volume":"20","author":"Corbett","year":"2016","journal-title":"Health Technol. Assess."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1136\/annrheumdis-2019-215356","article-title":"The role of IL-17A in axial spondyloarthritis and psoriatic arthritis: Recent advances and controversies","volume":"78","author":"McGonagle","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Toussirot, E. (2020). Mini-Review: The Contribution of Adipokines to Joint Inflammation in Inflammatory Rheumatic Diseases. Front. Endocrinol., 11.","DOI":"10.3389\/fendo.2020.606560"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"47","DOI":"10.2147\/ITT.S73223","article-title":"The role of adipokines in chronic inflammation","volume":"5","author":"Mancuso","year":"2016","journal-title":"Immunotargets Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/cc10021","article-title":"Clinical review: Adiponectin biology and its role in inflammation and critical illness","volume":"15","author":"Robinson","year":"2011","journal-title":"Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3603","DOI":"10.1210\/en.2008-1639","article-title":"In Vitro and in Vivo Effects of Adiponectin on Bone","volume":"150","author":"Williams","year":"2009","journal-title":"Endocrinology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jbspin.2008.04.018","article-title":"Pro-inflammatory effect of leptin on peripheral blood mononuclear cells of patients with ankylosing spondylitis","volume":"76","author":"Park","year":"2009","journal-title":"Jt. Bone Spine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1177\/0300060517708693","article-title":"Association of adipokines, interleukin-6, and tumor necrosis factor-\u03b1 concentrations with clinical characteristics and presence of spinal syndesmophytes in patients with ankylosing spondylitis: A cross-sectional study","volume":"45","year":"2017","journal-title":"J. Int. Med. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s00403-017-1755-y","article-title":"Association between serum\/plasma adiponectin levels and immune-mediated diseases: A meta-analysis","volume":"309","author":"Zhang","year":"2017","journal-title":"Arch. Dermatol. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1136\/annrheumdis-2016-eular.2307","article-title":"THU0387 Serum Levels of TNF Alpha and VEGF as Markers of Disease Activity in Patients with Axial Spondyloarthritis","volume":"75","author":"Mahendran","year":"2016","journal-title":"Ann. Rheum. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/15\/5605\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:25:59Z","timestamp":1760034359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/15\/5605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,7]]},"references-count":21,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jcm14155605"],"URL":"https:\/\/doi.org\/10.3390\/jcm14155605","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,7]]}}}