BackgroundAxial spondyloarthropathy (axSpA) are group of diseases with inflammatory low back pain, asym. oligoarthritis, HLA-B27 positivity and extra-articular manifestations.Asymptomatic subclin. gut inflammation and impaired integrity of intestinal mucosa macroscopically and microscopically can be present.Fecal calprotectin is released during neutrophilic activation and is a new marker for the inflammatory process.Lipocalin-2 is one of the mediators involved in the gut-joint axis.The association of fecal calprotectin (FCP) and lipocalin-2 (LCN-2) provide new biomarkers for disease management.ObjectiveWas to investigate fecal calprotectin (FCP) and lipocalin-2 (LCN-2), their early relation to subclin. intestinal inflammation and disease activity in axSpA patients.SubjectsFifteen patients with axSpA diagnosed according to Spondyloarthritis International Society (ASAS) classification criteria.Fifteen healthy persons (age, sex matched) as controls.Exclusion CriteriaOther autoimmune diseases as rheumatoid arthritis, cancer, HBV, HCV infection.MethodsAssessment of SpA group; symptoms, onset, disease duration, course and extra-articular manifestations.Detailed history of gastrointestinal symptoms, drug history and family history.Measurement of ASDAS-ESR, ASDAS-CRP, BAS-MI, BAS-DI, BAS-FI, MASES, ASQoL, HAQ score, comorbidity assessment by BP measurement, lipid profile, kidney, liver function, FBS, 2hrPP, thyroid function tests, uric acid, ESR, CRP, HLA-B27, Plain-X ray of the affected joints.Stool anal. of FCP and LCN-2 using ELISA technique.ResultsESR, CRP, HLA-B27 were higher in axSpA compared to healthy controls.FCP and LCN-2 were statistically higher in axSpA patients.Statistically significant pos. correlation between FCP, LCN-2 and markers of disease activity ESR, CRP.Significant pos. correlation between LCN-2 and clin. scores of disease activity ASDAS-ESR, ASDAS-CRP, BAS-DI.Colonicbiopsy revealed five patients were with colonic involvement and three were with ileal mucosal involvement.ConclusionThe elevated levels of FCP and LCN-2 with intestinal inflammation indicates that FCP and LCN-2 can be used as a biomarker for monitoring disease activity in axSpA patients.