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Atherosclerosis has been shown to be increased in chronic inflammatory diseases including ankylosing spondylitis (AS). Impaired endothelial function, the first step in atherosclerosis, may be reflected by changes in various endothelial biomarkers of hemostasis and the release of several cellular adhesion molecules or cytokines. In this study, we investigated changes in the levels of various possible markers with regard to disease activity and treatment regimen with/without anti-TNF-α drugs. Fifty-six AS patients (44 males) and 27 controls (19 males) with no known cardiovascular risk factors were included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index, and patients were evaluated with the Bath Ankylosing Spondylitis Functional Index and the Bath Ankylosing Spondylitis Disease Activity Index. Cytokines and various endothelial biomarkers were measured in serum samples using commercially available ELISA kits. Age, sex, BMI, waist circumference, fasting glucose, MAP, lipids are all similar between patients and controls. von Willebrand factor (vWF), soluble thrombomodulin (sTM), and urotensin (UT-II) were found to be significantly higher in the sera of the patients compared to the controls. Treatment with anti-TNF-α compared to conventional therapy and disease activity in AS patients seemed to have no effect on the blood levels of UT-II, sTM, CD146, vWF, plasminogen activator inhibitor-1, tissue plasminogen activator, or the thrombin-antithrombin complex. The increased UT-II, sTM, and vWF in AS patient sera regardless of treatment and disease activity suggest an increased tendency for atherosclerosis. [ABSTRACT FROM AUTHOR]

It is well established that there are people with higher risk of developing acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Mediterranean fever (MEFV) gene mutations might be one of the genetic predisposition factors in the development of ARF/RHD since defect in familial Mediterranean fever (FMF) patients is proposed to be heightened inflammatory response to certain stimuli. Previous clinical observations suggested a relationship between FMF and ARF/RHD. The aim of this study was to investigate the role of the MEFV gene mutations in the susceptibility to RHD in Turkish patients. A total of 100 patients with RHD and 100 healthy controls were included in the study. Diagnosis of RHD was based on echocardiographic findings in which a predominant mitral stenosis was used as an inclusion criterion. Genetic analysis was carried out by sequence analysis investigating two hot spots (exons 2 and 10) for MEFV mutations. Mutation analysis showed that 22 RHD patients (22%) and 24 healthy controls (24%) carried at least one mutated allele. MEFV mutations were identified in 22 of 200 (11%) chromosomes in RHD patients while 26 of the 200 (13%) chromosomes of healthy controls were found to carry a mutated allele. No difference was found in allele frequencies and their distribution between the patients and healthy controls ( p = 0.54). MEFV mutations are not associated with a predisposition to develop RHD in adult Turkish patients. [ABSTRACT FROM AUTHOR]

The objective of this non-randomised controlled trial was to evaluate the impact of group-based exercise programme and a home-based exercise programme on Bath Ankylosing Spondylitis Indices, depression and quality of life in patients with ankylosing spondylitis (AS). Approximately 41 patients in a rehabilitation unit were divided into two groups, either group- or home-based exercise programme. Exercise sessions were performed three times a week for a period of 6 weeks. The patients were compared before and after the rehabilitation programme, with respect to Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Assessment Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Beck Depression Inventory (BDI) and The Nottingham Health Profile (NHP). A statistically significant improvement was observed on BASDAI, BASMI and energy, pain, reaction of emotional and sleep subscores of NHP in both exercise groups after the exercise programme (p < 0.05). No statistically significant changes were detected in BASFI, BDI and social and mobility subscores of NHP in both exercise groups (p > 0.05). No statistically significant differences were found between the two exercise programmes (p > 0.05). Group and home-based exercise programmes are efficient in improving symptoms and mobility and had an important effect on quality of life in patients with AS. Home-based exercise programme, as it is cheaper, more easily performed and efficient, may be preferable for the management programme in AS.