{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T20:06:53Z","timestamp":1762200413208,"version":"build-2065373602"},"reference-count":68,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Oxidative stress represents a key pathogenic factor in spondyloarthritis (SpA), yet its comprehensive assessment remains underutilized in routine clinical practice. Objectives: We evaluated oxidative stress biomarker profiles in SpA patients to determine associations with disease activity, systemic inflammation, structural damage, lifestyle factors, and therapeutic responses for practical clinical implementation. Methods: This cross-sectional study included 101 patients meeting the Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria. Oxidative stress assessment utilized a validated biomarker panel: copper, zinc, glutathione peroxidase (GPx), ceruloplasmin (Cp), transferrin (TF), haptoglobin (Hp), bilirubin (BR), and uric acid (UA). Clinical, radiological, lifestyle, and therapeutic data underwent systematic analysis. Results: Glutathione peroxidase activity was elevated in 82.1% of patients, establishing it as the most sensitive oxidative stress marker. Copper levels increased in 30.7% and zinc deficiency occurred in 36.4% of cases. Oxidative stress markers correlated significantly with inflammatory parameters (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], neutrophil-to-monocyte ratio [NMR], systemic immune-inflammation index [SII]) and disease activity scores (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score based on CRP [ASDAS-CRP], Disease Activity Score 44 [DAS44-CRP]). Higher oxidative stress was associated with a poorer quality of life, as indicated by elevated Ankylosing Spondylitis Quality of Life (ASQoL) scores. Physical activity and adherence to a Mediterranean diet were independently associated with better antioxidant capacity. Smoking and nonsteroidal anti-inflammatory drug (NSAID) use correlated with increased oxidative burden. Anti-tumor necrosis factor alpha (anti-TNF\u03b1) therapy was associated with reduced levels of oxidative stress. Structural damage, particularly cervical spine involvement, correlated with heightened oxidative stress. Conclusions: This comprehensive evaluation reveals significant clinical correlations between oxidative stress and multiple disease domains in SpA. Modifiable lifestyle factors and therapeutic interventions have a significant impact on the redox balance. These findings establish practical targets for personalized management. The integration of oxidative stress assessment into routine practice could enhance disease monitoring and inform the development of antioxidant-based therapeutic strategies.<\/jats:p>","DOI":"10.3390\/jcm14217747","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:30:27Z","timestamp":1762198227000},"page":"7747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive Oxidative Stress Profiling and Clinical Correlates in Spondyloarthritis: The Role of Glutathione Peroxidase and Modifiable Lifestyle Factors"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7297-0837","authenticated-orcid":false,"given":"Rim","family":"Dhahri","sequence":"first","affiliation":[{"name":"Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1001, Tunisia"},{"name":"Rheumatology Department, Military Hospital of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2798-5021","authenticated-orcid":false,"given":"Insaf","family":"Fenniche","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1001, Tunisia"},{"name":"Rheumatology Department, Military Hospital of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8091-1856","authenticated-orcid":false,"given":"Ismail","family":"Dergaa","sequence":"additional","affiliation":[{"name":"High Institute of Sport and Physical Education of Ksar Said, University of Manouba, Manouba 2010, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2214-4667","authenticated-orcid":false,"given":"Halil \u0130brahim","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Physical Education of Sports Teaching Department, Faculty of Sports Sciences, Ataturk University, Erzurum 25240, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-868X","authenticated-orcid":false,"given":"Nicola Luigi","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5264-3329","authenticated-orcid":false,"given":"Lobna","family":"Ben Ammar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1001, Tunisia"},{"name":"Rheumatology Department, Military Hospital of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8126-5339","authenticated-orcid":false,"given":"Hiba Ben","family":"Ayed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1001, Tunisia"},{"name":"Rheumatology Department, Military Hospital of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3206-7720","authenticated-orcid":false,"given":"Ba","family":"Afif","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy of Monastir, University of Monastir, Monastir 5000, Tunisia"},{"name":"Biochemistry Department, Military Hospital of Tunis, Tunis 1008, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chakib","family":"Mazigh","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy of Monastir, University of Monastir, Monastir 5000, Tunisia"},{"name":"Biochemistry Department, Military Hospital of Tunis, Tunis 1008, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Im\u00e8ne","family":"Gharsallah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1001, Tunisia"},{"name":"Rheumatology Department, Military Hospital of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1002\/acr.22831","article-title":"Global prevalence of spondyloarthritis: A systematic review and meta-regression analysis","volume":"68","author":"Stolwijk","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1093\/rheumatology\/keab544","article-title":"Age at Onset in Axial Spondyloarthritis around the World: Data from the Assessment in SpondyloArthritis International Society Peripheral 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