GLIAL NEUROTROPHIC FACTOR AS A PREDICTOR OF RESISTANCE TO THE TREATMENT OF PATIENTS WITH ANKYLOSING SPONDYLITIS
Summary. Glial neurotrophic factor (GDNF) is a promising marker of therapeutic efficacy in ankylosing spondylitis, however, its role is poorly understood. Aim: to evaluate the role of GDNF as a predictor of resistance to therapy in ankylosing spondylitis. Materials and methods. The results of treatment of 21 patients with ankylosing spondylitis with a reduced (less than 3.0 pg/ml) and 22 patients with a normal (3 pg/ml and above) level of GDNF in blood plasma were compared. Results. The specific gravity of ASAS20 responders among patients with normal GDNF levels was significantly higher: 45.5% versus 14.3%, (p<0.05). In ASAS20 non-responders, the mean GDNF level was significantly lower compared to responders: 2.915±1.466 pg/ml versus 4.395±2.298 pg/ml (p<0.01). Patients with normal GDNF content showed significantly better dynamics of neuropathic pain indicators during therapy compared to patients with reduced GDNF content according to LANNS questionnaires: 25.0±31.0% versus 1.6±3.7% (p<0, 05) and DN4: 1.5±4.9% versus 28.8±36.0% (p<0.01), respectively. Patients with normal GDNF content had better dynamics of recovery of functional ability according to BASMI: 24.5±25.1% vs. 13.3±23.7% (p<0.05), respectively. They also showed better indicators of growth in the quality of life in the course of therapy according to ASQoL: 25.0±14.6% versus 14.7±9.0% (p<0.05) and a decrease in manifestations of reactive anxiety: 20.8±20.6% versus 5.5±7.0% (p<0.05), respectively. They also showed better indicators of growth in the quality of life in the course of therapy according to ASQoL: 25.0±14.6% vs 14.7±9.0% (p<0.05) and a decrease in manifestations of reactive anxiety: 20.8±20.6% vs 5.5±7.0% (p<0.05), respectively. Patients with normal levels of GDNF in blood plasma had slightly better health, general quality of life, and depression than patients with reduced levels of GDNF. Conclusions. A reduced level of GDNF in the blood plasma (less than 3 pg/ml) is associated with lover treatment efficacy regarding ASAS20 criteria, lower positive dynamic of neuropathic pain markers, functional capacity, quality of life and mental sphere, which allows to consider a reduced level of GDNF as an additional predictor of therapeutic resistance in patients with ankylosing spondylitis.
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