IMMUNOLOGICAL SIGNATURES AND BIOMARKERS FOR ANKYLOSING SPONDYLITIS: FROM PATHOGENESIS TO PRECISION MEDICINE

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disorder that primarily affects the axial skeleton, leading to sacroiliitis, progressive spinal stiffness, structural damage, and long-term disability. Although human leukocyte antigen B27 (HLA-B27) remains the strongest genetic risk factor associated with AS, recent advances have identified a broader spectrum of immunological biomarkers, including cytokines, acute-phase reactants, autoantibodies, immune-cell signatures, and genetic and epigenetic determinants. These biomarkers contribute to early diagnosis, assessment of disease activity, prediction of radiographic progression, and monitoring of therapeutic response. This review summarizes the current understanding of immunological biomarkers in AS, with emphasis on their mechanistic relevance, diagnostic value, and emerging role in precision medicine.