OBJECTIVES: This study aimed to identify circular RNAs (circRNAs) associated enthesitis in patient with ankylosing spondylitis (AS) and to elucidate the underlying mechanism. METHODS: A multi-phase study was conducted. In the discovery phase, circRNA microarray analysis was performed on peripheral blood mononuclear cells (PBMCs) isolated from 3 AS patients and 3 healthy controls. Differentially expressed circRNAs were subsequently validated in two stages: an initial pilot verification followed by replication in an expanded cohort. The functional role of hsa_circ_0001707 in macrophage polarization was investigated in vitro using THP-1 cells. RESULTS: Microarray analysis and subsequent validation showed that AS patients exhibited significantly increased levels of hsa_circ_0001707 and reduced levels of hsa_circ_0075522 in PBMC compared to healthy controls. Stratified analysis revealed that hsa_circ_0001707 expression was significantly upregulated in AS patients with enthesitis compared to those without. Multivariate logistic regression analyses demonstrated that hsa_circ_0001707 was independently associated with enthesitis. In vitro, hsa_circ_0001707 overexpression promoted M1 polarization, increasing the secretion of pro-inflammatory cytokines such as TNF-
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