Axial spondyloarthritis research highlights  

03 May 2024
Smiling female researcher wearing glasses and green gloves using microscope

Right now, around 60,000 adults across the UK have a diagnosis of axial spondyloarthritis in their healthcare records, 

However, more people may have symptoms but not have a diagnosis recorded. In fact, one study has suggested that there may be around 220,000 people living with this condition.

We want to help stop axial spondyloarthritis in its tracks — and your generous support is driving life-changing research into the condition. 

What is axial spondyloarthritis? 

Axial spondyloarthritis (AxSpa) is a type of inflammatory arthritis that mainly affects joints in your back.  

It happens when our immune system (which is the body’s self defence system) mistakenly attacks your spine and sometimes other joints. This can cause pain and stiffness in your back, rib cage and neck. 

What is ankylosing spondylitis? 

When you can see structural changes visible on an X-ray, you may be diagnosed with a type of axial spondyloarthritis called ankylosing spondylitis (AS).

Learn more about ankylosing spondylitis

“In a weird way, it’s a mental battle as much as a physical one. There will be times where I have to cancel plans last minute because it’s so unpredictable."

James, 30, who lives with ankylosing spondylitis and rheumatoid arthritis.

Our axial spondyloarthritis research 

Our researchers are determined to find new ways to diagnose, treat and manage ankylosing spondylitis. Here are just a few of the incredible studies we’re funding right now.

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Understanding the role of T cells in ankylosing spondylitis 

Man using microscope in a labratoryEver heard of T-cells? These are a type of immune cell that co-ordinate the body’s response to infection — and they’ve been shown to play a role in causing ankylosing spondylitis.  

This research hopes to better understand how T cells contribute to ankylosing spondylitis, and, more importantly, how they can be targeted to prevent or treat the condition. 

Our researchers want to pinpoint the main 20 genes and proteins that control the activity of T-cells in people living with ankylosing spondylitis.  

Then they’ll explore whether they could ‘switch off’ these genes in T-cells taken from people living with this condition.   

How will this benefit people living with ankylosing spondylitis? 

This research will help us better understand ankylosing spondylitis. In the future, this knowledge could also help us when treating other forms of inflammatory arthritis like: 

How does the RUNX3 gene increase the likelihood of developing ankylosing spondylitis?  Smiling female researcher wearing glasses uses pipette controller in labratory

We know that the genes you inherit from your parents can increase your chances of developing ankylosing spondylitis.  

One of these genes is called RUNX3. It controls other genes and influences the development of immune cells. When things go wrong, this can contribute to ankylosing spondylitis.  

So, what if we could target RUNX3 with new and effective treatments? That’s exactly what this ground-breaking research project aims to find out.  

So far, researchers have found that when genetic changes happen close to the RUNX3 gene, it can cause proteins to bind to the DNA of these genes incorrectly. This stops RUNX3 from working properly.  

How will the findings benefit patients? 

Understanding how changes to the RUNX3 gene contribute to ankylosing spondylitis may help us develop new treatments for the disease.  

By bringing back the normal function of RUNX3 we may be able to stop the changes in the immune system that leads to ankylosing spondylitis.  

Which genes and cells lead to inflammation in early ankylosing spondylitis? 

Illustration of a geneThe causes of ankylosing spondylitis are still unclear. So, our researchers want to pinpoint the cells, pathways, and genes that cause inflammation in ankylosing spondylitis. 

A cell is the smallest unit that can live on its own and they make up the living organisms and tissues in your body. Pathways are the series of actions that lead to a new product or change in a cell.  

And genes carry information that determines your traits, such as your eye colour or your risk of developing a certain health condition. 

We know that specific genes (such as HLA-B27) are key, as well as immune cells. These defend our bodies from harmful substances like bacteria, viruses, and parasites 

But important pieces of the jigsaw are still missing — and this research aims to find them.  

What are the aims of this study? 

In one study, our researchers are using a technique called single cell RNA-sequencing, which allows you to scan thousands of cells side by side. 

Using this, they want to spot which genes and biological pathways are active and may lead to the development of ankylosing spondylitis.  

To find common genes, they’ll look at patient’s cells from three typical sites of inflammation, including the: 

  • Pelvis
  • Knee
  • Eye  

How will this benefit people living with ankylosing spondylitis?  

The goal of this study is simple: we want to bring the genes and biological pathways that contribute to ankylosing spondylitis to light.  

This could help us spot which molecules or cells we need to target when developing new treatments. It could also help us understand and treat other forms of spondyloarthritis. 

Do anti-inflammatory drugs undermine the use of MRI in axial spondyloarthritis?

Hand holding medicine tabletsThere’s no single test that shows for certain that you have axial spondyloarthritis.  

Instead, you’ll usually get a diagnosis based on several things, including blood tests and a physical examination.  

Your healthcare team might also check if they can see inflammation using magnetic resonance imaging (MRI). 

But what happens if you’re taking non-steroidal anti-inflammatory (NSAID) medicines, like ibuprofen or naproxen? Could these drugs mask the inflammation and make diagnosis more difficult?   

MRI (magnetic resonance imaging) is a scan that uses magnets to look at what is happening inside your body. An MRI scan can show soft-tissue damage - in the muscles, ligaments or nerves - as well as any problems with the bones and joints. 

Why is this research important?   

There’s a worry that the level of inflammation in people living with axial spondyloarthritis might be masked if they’ve taken NSAIDs before their scan.  

Not only could this limit your ability to get a quick and accurate diagnosis, but it could also delay treatment.  

From this research, we now know that, for around a quarter of people, taking NSAIDs does affect their MRI scan. Research is ongoing to find out why this is the case.  

How will the findings benefit patients? 

This research could shape guidelines about whether patients should stop taking NSAIDs immediately before an MRI scan and whether they could take other types of pain medicine instead.  

In doing so, this would help healthcare professionals get a more accurate picture of joint inflammation – and ensure patients get accurate diagnosis and treatment more quickly.  

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