Brain, behavior, & immunity - health · 2026
Effects of neuroinflammation and neurotrophic factors on mental health of people with axial spondyloarthritis.
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Hušáková Markéta, Pavelka Karel, Kuchaříková Karolína, Kotrs Jan, Balajková Veronika, Kuklová Markéta, Škubica Patrik, Hulejová Hana, Šenolt Ladislav, Mohr Pavel, Olejárová Marta
Аннотация
INTRODUCTION: Mood and anxiety disturbances can aggravate axial spondyloarthritis (axSpA). This study investigated the relationship between depression, anxiety, disease activity, systemic inflammation, and neurotrophins, specifically brain-derived neurotrophic factor (BDNF) and its precursor proBDNF.
METHODS: Seventy-four patients with axSpA and 79 age- and sex-matched healthy controls (HCs) completed the Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). Clinical parameters included Ankylosing Spondylitis Disease Activity Score (ASDAS) with C-reactive protein (-CRP) and patient-reported outcomes (PROs). Serum concentrations of interleukin-6 (IL-6), BDNF, proBDNF, and sortilin were determined by ELISA.
RESULTS: Depression and anxiety were more prevalent in axSpA patients (13.5% and 25.7%) than in HCs (2.1%, p < 0.05 and 8.9%, p < 0.01, respectively). Both BDI-II and BAI scores correlated with ASDAS-CRP and PROs. The severity of depression symptoms did not differ by sex, whereas anxiety was higher in female than in male axSpA patients and healthy controls. Patients with depression showed a lower BDNF/proBDNF ratio and elevated CRP levels (p < 0.05). Serum BDNF levels were reduced in axSpA compared with HCs (median 160.90, IQR 127.90-236.50 vs. 195.00, IQR 150.90-279.90, p < 0.05), with significant sex-related variability (p < 0.05). In a model adjusted for age and sex, a doubling of CRP levels was associated with a 10% decrease in BDNF. ProBDNF levels were positively correlated with IL-6 and sortilin levels.
CONCLUSION: These findings indicate that sex and systemic inflammation contribute to the psychological burden of axSpA. Effective control of inflammation may reduce mental health comorbidities, such as depression and anxiety, which are linked to worse outcomes.
METHODS: Seventy-four patients with axSpA and 79 age- and sex-matched healthy controls (HCs) completed the Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). Clinical parameters included Ankylosing Spondylitis Disease Activity Score (ASDAS) with C-reactive protein (-CRP) and patient-reported outcomes (PROs). Serum concentrations of interleukin-6 (IL-6), BDNF, proBDNF, and sortilin were determined by ELISA.
RESULTS: Depression and anxiety were more prevalent in axSpA patients (13.5% and 25.7%) than in HCs (2.1%, p < 0.05 and 8.9%, p < 0.01, respectively). Both BDI-II and BAI scores correlated with ASDAS-CRP and PROs. The severity of depression symptoms did not differ by sex, whereas anxiety was higher in female than in male axSpA patients and healthy controls. Patients with depression showed a lower BDNF/proBDNF ratio and elevated CRP levels (p < 0.05). Serum BDNF levels were reduced in axSpA compared with HCs (median 160.90, IQR 127.90-236.50 vs. 195.00, IQR 150.90-279.90, p < 0.05), with significant sex-related variability (p < 0.05). In a model adjusted for age and sex, a doubling of CRP levels was associated with a 10% decrease in BDNF. ProBDNF levels were positively correlated with IL-6 and sortilin levels.
CONCLUSION: These findings indicate that sex and systemic inflammation contribute to the psychological burden of axSpA. Effective control of inflammation may reduce mental health comorbidities, such as depression and anxiety, which are linked to worse outcomes.