Disease Differentiation and Monitoring of Anti-TNF Treatment in Rheumatoid Arthritis and Spondyloarthropathies

Int J Mol Sci. 2021 Jul 9;22(14):7389. doi: 10.3390/ijms22147389.


Rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) are comprehensive immunological disorders. The treatment of these disorders is limited to ameliorating the symptoms and improving the quality of life of patients. In this study, serum samples from RA, AS, and PsA patients were analyzed with metabolomic tools employing the 1H NMR method in combination with univariate and multivariate analyses. The results obtained in this study showed that the changes in metabolites were the highest for AS > RA > PsA. The study demonstrated that the time until remission or until low disease activity is achieved is shortest (approximately three months) for AS, longer for RA and longest for PsA. The statistically common metabolite that was found to be negatively correlated with the healing processes of these disorders is ethanol, which may indicate the involvement of the gut microflora and/or the breakdown of malondialdehyde as a cell membrane lipid peroxide product.

Keywords: ankylosing spondylitis; biological treatment outcome; metabolomics; psoriatic arthritis; rheumatoid arthritis.

MeSH terms

  • Adult
  • Arthritis, Psoriatic / blood*
  • Arthritis, Psoriatic / drug therapy
  • Arthritis, Rheumatoid / blood*
  • Arthritis, Rheumatoid / drug therapy
  • Cohort Studies
  • Computational Biology
  • Ethanol / blood*
  • Female
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Metabolome
  • Principal Component Analysis
  • Spondylitis, Ankylosing / blood*
  • Spondylitis, Ankylosing / drug therapy
  • Tumor Necrosis Factor Inhibitors / therapeutic use*


  • Tumor Necrosis Factor Inhibitors
  • Ethanol