Background: Ankylosing spondylitis (AS) is as an inflammatory and autoimmune disease. Sestrin2 is activated in inflammatory response and protects from cells in injuries. Sestrin inhibits reactive oxygen species (ROS) by activating the nuclear-factor erythroid 2 related factor 2 (NRF2). Nuclear factor of activated T-cell cytoplasmic1 (NFATc1) is induced subsequent the stimulation of receptor activator of nuclear factor kappa-Β ligand (RANKL). This study analyzed the expression of these genes in new case AS patients and taking etanercept, as an anti-tumor necrosis factor (anti-TNF) drug, compared to the control group.

Methods: We analyzed the expression levels of Sestrin2, NRF2, and NFATc1 genes by real-time PCR on 60 peripheral blood mononuclear cells (PBMC) which were divided into three different groups of new case AS patients, AS patients taking etanercept(etanercept-group), and the control individuals. Statistical analysis was then done with software SPSS.18. P-Value<0.05 was considered as significant.

Results: NRF2 gene expression increased in the new case group compared to the control (p˂0.001). Also, it increased in the etanercept-group in comparison with the control group (p˂0.01). The expression levels of both other genes (SESN2 and NFATc1) analyzed in the etanercept-group was higher than both the new case and control groups (p>0.05).

Conclusion: The expression level of these genes, which are important in the control of inflammation, increased in the condition of treatment with etanercept. our results can demonstrate that this drug, in addition to the inhibitory effects on the TNF-a pathway, is probably also effective on the expression of these controlling genes in inflammation.