الفهرس 
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Abstract
Ankylosing spondylitis (AS) is a form of chronic inflammatory arthritis characterized by sacroiliitis, enthesitis and a marked propensity for sacroiliac joint and spinal fusion.
The exact etiology of SpA is still elusive but is likely to be a complex interplay of genetic, environmental factors with the microbiome and biomechanical stress.
More recently, large genome-wide association studies have identified many non-MHC genes, which associated with SpA. Many genes implicate antigen-presentation, innate immunity, and the IL-23/17 pathway.
Interleukin 35 (IL-35) is the newest identified member of the interleukin-12 cytokine family, a unique group of heterodimeric cytokines including IL-12, IL-23, IL-27, and IL-35, which share structural similarities but mediate diverse immunological functions. In contrast to the proinflammatory effect of other cytokines of the IL-12 family (IL-12, IL-23), IL-35 potently inhibits the CD4+ effector T cells including Th1 and Th17 cells through the expansion of Treg cells and IL-10 production.
In this study, we aimed to:
Explore the impact of IL-35 in AS patients and assess the correlation between serum IL-35 levels, Disease activity and radiographic progression including bone erosions.
The study was conducted on:
Forty AS patients, and twenty healthy controls matched by age and sex. Patients affected by AS, referred to the University of Alexandria Faculty of Medicine Rheumatology Unit will be consecutively enrolled in this case control study. For all the patients enrolled in the study, the following data will be collected: demographic data, disease duration, extra-articular manifestations (EAM) (uveitis, inflammatory bowel diseases (IBD), and psoriasis), and clinical pattern (presence of peripheral arthritis, enthesitis, and dactylitis).
All patients were subjected to:
All patients will undergo a clinical assessment, and the following indices will be evaluated:
Disease activity will be assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Funcional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Disease Activity Score-C reactive protein (ASDAS-CRP), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Ankylosing Spondylitis Quality of Life (ASQol) and Patient Global Assessment score will be measured in AS patients.
The Ankylosing Spondylitis Disease Activity Score (ASDAS) was also calculated. Plain xray of the spine antroposterior(AP) and lateral views, AP view for pelvis and sacroiliac joint will be done for all patients. Each radiograph will be evaluated using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). According to the criteria of New York, the involvement of the sacroiliac joints will be evaluated by assigning a score ranging from I (doubtful) to IV (complete ankylosis).
Blood samples will be obtained for detecting the levels of IL-35 and the level of CRP.
The results of the current study revealed that:
The mean IL-35 level in the studied cases was significantly less than the mean IL-35 level in the control group in a highly significant way.
There is statistically significant negative correlation between IL-35 level and BASDAI Similarly, there is highly statistically significant negative correlation between IL-35 level and BASMI and ASDASCRP where these scores decrease as the IL-35 increases. However, there were no statistically significant correlations between the remaining parameters and the IL-35 level