Both reactive arthritis (ReA) and undifferentiated spondyloarthritis (uSpA) belong to the group of autoinflammatory diseases- spondyloarthritis. Hypotheses have been proposed about a relationship between the intestinal mucosa and inflammation of joint tissues. The role of immunoglobulin IgA or secretory IgA (SIgA) in the inflammatory and/or clinical activity of patients with spondyloarthritis (SpA) remains poorly understood. Objective: To evaluate the status of total IgA and SIgA, and the association between the levels of SIgA, IgA, IgA anti-Chlamydia trachomatis and anti-Shigella spp. with the disease activity measures, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, were compared in a cohort of patients with ReA and uSpA and healthy subjects. Methods: This was a cross-sectional study.The serum concentrations of SIgA, IgA anti-Chlamydia trachomatis, anti-Shigella spp., and total IgA were measured. Disease activity was measured in each patient by means of Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score(ASDAS). Statistical analysis did include a as bivariate evaluation, comparisons by Student t-test, Kruskal Wallis test, U Mann Whitney test, with a multivariate evaluation by principal components analysis(PCA). A correlation analysis was carried out using the Pearson correlation coefficient and a linear regression models. All analysis were made using Stata version 11.2® for Windows, R V3.3.21. Statistical significance was defined a p-value <0.05. Results: In all, 46 patients (78.2% men; mean age, 34.8±12.3 years) and 53 controls (41% men; mean age, 32±11.4 years) were included in the study. The mean serum levels of SIgA were higher in SpA patients than in healthy subjects (p<0.001). Only SIgA levels correlated with disease activity: BASDAI (r=-0.42, p=0.0046), ASDAS-CRP (r=-0.37, p=0.014), and ASDAS-ESR (r=-0.45, p=0.0021). The negative correlation between SIgA and all activity indices was higher in HLA-B27-positive patients (BASDAI r=-0.70, p=0.0009, ASDAS-CRP r=-0.58, p=0.0093 and ASDAS-ESR r=-0.57, p=0.0083).The PCA showed three factors: The first component was constituted by variables refer as clinical activity measures; The second did include the serological activity markers and the last component was compounded by age and symptoms time Conclusion: Elevated serum levels of SIgA were found to be related with low disease activity in patients with ReA and SpA

Background: The aim of this study was to assess DKK-1 levels, in Gingival Crevicular Fluid (GCF) and serum, as a biomarker for bone loss and disease activity in periodontitis and early RA (eRA). Methods: In this cross-sectional study, we obtained serum and GCF from 10 interproximal sites (Distal Buccal I/S, Mesio Buccal I/S, Distal Palatal/Lingual, Mesio Palatal/Lingual) according to the highest degree of inflammation by a patient for 240 sites from eRA patients. Patients received a periodontal assessment, a radiographic evaluation, tomography of interproximal sites, and DKK1 levels were determined by ELISA. Comparisons were performed by the Mann-Whitney U test and analysis by Chi2 test, and a logistic regression model was applied. Results: The mean age was 46.33 ± 12.0 years, the Disease Activity Score (DAS-28-ESR) was 4.08 ± 1.4. Periodontitis was present in 65.2% of the patients, and 59.6% of these patients had bone loss in interproximal sites. Higher GCF-DKK1 levels were associated with serum-DKK1 (OR:2.41 IC95% 1.14-5.09, p=0.021) and were related with DAS28-ESR (p=0.001), Routine Assessment of Patient Index Data 3 (RAPID 3) (p=0.001), and tender joints (p=0.040). Foot bone erosion and juxta-articular osteopenia were associated with high levels of serum-DKK1 (p=0.009 and 0.001, respectively). Serum-DKK1 were associated with SDAI (OR: 2.38 IC95% 1.03-5.52, p=0.043), RAPID 3 (p=0.001), and rheumatoid factor (p=0.018). The GCF-DKK1 levels were associated with periodontal bone loss (p=0.011), periodontitis (p=0.070) and its severity (OR: 2.58 IC95% 2.28-7.28, p=0.001). Bone loss was more frequent in buccal sites (73.5%) and was associated with increased levels of DKK1 (p=0.033). Conclusion: In the early stages of the eRA disease, serum and GCF-DKK1 could be a biomarker for clinical disease activity and periodontal and articular bone erosion.

Background: The strong association between HLA-B27 and spondyloarthritis (SpA) has demonstrated that typing the HLA-B27 antigen is a crucial step in diagnosis and aids in defining the progression and severity of disease. Objective: To describe the frequency of HLA-B27 in Colombian individuals with clinical manifestations associated with SpA. Materials and Methodology: We retrospectively analyzed 4109 HLA-B27 typing requests to the Hospital Militar Central and the Instituto de Referencia Andino from Colombian individuals with clinical signs suggestive of SpA between 2009 and 2012. We used basic digital cytometry followed by Polymerase Chain Reaction with sequence specific primers when confirmation was needed. We determined the frequency of HLA-B27 in the population and levels of association of HLA-B27 with SpA. Results: Our population included 1585 men (36.8%) and 2524 women (61.4%). The predominant age range was between 19 and 45 years (49.9%). The majority (95.4%) of the study population came from the Andean region and eastern plains. Only a small fraction (12.1%) of the 497 subjects were HLA-B27 positive, among whom 56.9% were male, and 62.5% were between 19 and 45 years old (p <0.0001). Women constituted 43.1% of the sample, with 7.8% under 18 years old and 37.4% above 45 years old. The most frequent clinical manifestations were peripheral: synovitis, polyarthralgias, musculoskeletal pain and heel pain. Conclusion: The frequency of the HLA-B27 allele in individuals with clinical signs suggestive of SpA was low, in accordance with the lower prevalence found in Colombian patients diagnosed with SpA compared to American and European population.

Oxygen transport is altered in hemoglobinopathies. To study the distribution of hemoglobinopathies in Andean subjects without African ancestry. We analyzed blood samples of 1,407 subjects aged 18 to 59 years (58% females), living in the central Andean region of Colombia, referred to discard hemoglobinopathies. The frequency and type of hemoglobinopathy was established by capillary and agarose gel electrophoresis. The frequency of hemoglobinopathies was 34.5% and higher among females. The structural variants found were: AS-heterozygous hemoglobin (8.1%), homozygous SS (3.7%), heterozygous SC (2.2%), AC heterozygotes (0.5%) and heterozygous AE (0.3%). Quantitative variants found were Hb A-Beta thalassemia (13.91%) and Hb H (0.06%), Beta-thalassemia heterozygotes C (0.88%), S-Beta thalassemia heterozygotes (6.07%) and compound heterozygous SC/Beta thalassemia (0.25%), with a persistence of fetal hemoglobin 0. Composite thalassemia was also found in 31%. All techniques showed good correlation and capillary electrophoresis demonstrated a greater detection of hemoglobin variants. The frequency of hemoglobin variants in the analyzed population was high, which is an important public health indicator. The most common hemoglobin variant was HbA/Increased structural Hb A2 and the mos frequent structural hemoglobinopathy was sickle cell trait. Capillary electrophoresis can discern any Hb variants present in the population.

Background: Juvenile idiopathic arthritis (JIA) is the most common inflammatory joint disease in children. JIA and autoimmune inflammatory diseases of the gastrointestinal (GI) mucosa share common etiologic mechanisms, including genetic predisposition and environmental influences. Objective: To determine the presence of autoantibodies associated with inflammatory diseases of the GI mucosa in patients with JIA and its relationship to GI symptoms. Methodology: In a cross-sectional study of patients with JIA, GI symptoms and autoantibody expression were evaluated with respect to their association with JIA disease activity indices. Categorical data were expressed as proportions and relative frequencies. Inferring the proportion of positive cases was performed by obtaining confidence intervals of 95%. A Fisher test with significance value of p <0.05 was used to determine statistical significance. The study was approved by the ethics committee of the all institutions. Results: Samples were collected from ninety-seven patients, 63% of whom were female. The average age was 14 years. The JIA subtype associated with the most common GI symptoms was enthesitis-related arthritis. Of these patients, 44.3% and 14% reported abdominal pain and diarrhea, respectively. Anti-DPG and anti-tTG antibodies were found in 9.28% and 7.22% respectively and 11.34% were positive for p-ANCA, and 2% were positive for ASCA. Conclusions: GI symptoms and autoantibodies associated with inflammation of the GI mucosa were detected in JIA patients but were not associated with autoantibodies or clinical indices. However, the high sensitivity of these tests justifies the monitoring of these patients