Article Text

Download PDFPDF
Extended report
Systemic levels of IL-23 are strongly associated with disease activity in rheumatoid arthritis but not spondyloarthritis
  1. Lode Melis1,
  2. Bernard Vandooren1,
  3. Elli Kruithof1,
  4. Peggy Jacques1,
  5. Martine De Vos2,
  6. Herman Mielants1,
  7. Gust Verbruggen1,
  8. Filip De Keyser1,
  9. Dirk Elewaut1
  1. 1Department of Rheumatology, Ghent University Hospital, Belgium
  2. 2Department of Gastroenterology, Ghent University Hospital, Belgium
  1. Correspondence to Dr Dirk Elewaut, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, Ghent University Hospital, 0K12IB, De Pintelaan 185, 9000 Ghent, Belgium; dirk.elewaut{at}


Objectives Th17 cells are an effector T-cell population that plays a role in chronic inflammatory conditions and is dependent on IL-23 for their survival and expansion. More recently, a genetic association was discovered between polymorphisms in the gene coding for the IL-23 receptor and spondyloarthritis. This study aimed to evaluate the role of Th17-associated cytokines in spondyloarthritis pathogenesis by measuring their levels in the joints and circulation as well as correlating them with disease activity parameters.

Methods Paired synovial fluid (SF), serum and synovial biopsies were obtained from 30 non-PsA (psoriatic arthritis) spondyloarthritis, 22 PsA and 22 rheumatoid arthritis (RA) patients. IL-17, IL-23 and CCL20 were measured by ELISA in the SF and serum of patients and correlated with systemic and local parameters of disease activity.

Results Concentrations of CCL20, a major Th17-attracting chemokine, tended to be higher in the joints of RA than in spondyloarthritis patients. Interestingly, levels of CCL20 were markedly higher in SF as opposed to serum. In addition, there was a remarkable association between the expression of the Th17 cytokine system and the presence of intimal lining layer hyperplasia in RA. Also in the serum, there was a tendency for higher IL-23 levels in RA, which correlated strongly with disease activity parameters.

Conclusions Th17-related cytokines are expressed in joints of spondyloarthritis as well as RA patients. IL-23 levels, however, correlate with disease activity parameters in RA only. These results point towards a differential regulation of the Th17 cytokine system in spondyloarthritis compared with RA.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This study was supported by a concerted action grant of the Ghent University (GOA), grants from the Research Foundation Flanders (FWO-Vlaanderen) and a grant from Centocor Inc. Bernard Vandooren and Peggy Jacques are research assistants of the Research Foundation-Flanders (FWO-Vlaanderen).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Ethics Committee of the Ghent University Hospital.

  • Patient consent Obtained.