Upregulated lncRNA‐NEF predicts recurrence and poor treatment outcomes of ankylosing spondylitis

INTRODUCTION: Osteoporosis is related to lncRNA‐neighboring enhancer of FOXA2 (NEF) and inversely correlated to ankylosing spondylitis (AS), implying that lncRNA‐NEF might also relate to AS. Thus, the study was carried out to investigate the involvement of lncRNA‐NEF in AS. METHODS: The study included 60 AS patients and 60 healthy controls. LncRNA‐NEF expression in synovial fluid samples was analyzed by reverse transcription quantitative real‐time polymerase chain reaction. Disease activity of the 60 AS patients was determined using the Ankylosing Spondylitis Disease Activity Score (ASDAS) 1–4 and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Western blot was carried out to investigate the effects of lncRNA‐NEF on inflammatory factors in human fibroblast‐like synovial (HFLS) cells. A 3‐year follow‐up was performed to analyze the role of lncRNA‐NEF in the prediction of the recurrence of AS. RESULTS: Our study observed that lncRNA‐NEF expression was upregulated in synovial fluid of AS patients and significantly correlated with the ASDAS 1–4, BASDAI, erythrocyte sedimentation rate (ESR), and C‐reactive protein level (p < .05). Treatment with nonsteroidal anti‐inflammatory drugs significantly downregulated lncRNA‐NEF expression (p < .01). A 3‐year follow‐up showed that patients with high lncRNA‐NEF levels had a high recurrence rate (hazard ratio = 2.266). In addition, lncRNA‐NEF was found to regulate the expression of inflammatory factors in HFLS cells. CONCLUSIONS: Therefore, lncRNA‐NEF upregulation can predict recurrence and poor treatment outcomes of AS and has a great potential to serve as a predictive biomarker factor for the recurrent AS.