Ankylosing spondylitis (AS) is an inflammatory arthritis mediated by the immune system. The axial skeleton is the main portion affected by AS. Interleukin-23 is a pro-inflammatory mediator that plays a complex role in the pathophysiology of AS, particularly in bone remodeling and new bone formation. The objective of this study is to determine whether IL-23 plays an effective role in the diagnosis and evaluation of AS activity. A case-control study, involving 30 patients with Ankylosing Spondylitis (AS), 30 patients with chronic back pain (CBP), and 28 healthy individuals. Also, IL-23 and CRP levels were measured for all three groups using an ELISA technique. The study also evaluated the CBC and ESR levels. The IL-23 level in AS, CBP, and healthy control groups were 37.45± 4.59 pg/ml, 50.60± 7.83 pg/ml, and 63.36± 8.04 pg/ml, respectively, with no significant difference between AS group and CBP group (P=0.153), but with a significant difference between AS group and healthy control group (P=0.008). In patients with AS, based on ASDAS-ESR, there was a significant difference in the IL-23 level among the disease activity groups (P=0.017). This study evaluates IL-23 as a diagnostic tool for AS, with the healthy group, which showed an AUC of 0.234, 72.4% sensitivity, and 69% specificity. Furthermore, IL-23 was assessed as a diagnostic tool between AS and CBP groups, with an AUC of 0.348, 60% sensitivity, and 57.1% specificity. The findings showed that IL-23 has a significant difference between the AS group and the healthy group, also, it plays a significant role in evaluating disease activity in patients with AS by the ASDAS-ESR index; however, it does not have a diagnostic value and is not involved in the initial diagnosis of AS.
Halboos et al. (Tue,) studied this question.