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Zalesak M, Danisovic L, Harsanyi S. Psoriasis and Psoriatic Arthritis-Associated Genes, Cytokines, and Human Leukocyte Antigens. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:815. [PMID: 38792999 PMCID: PMC11123327 DOI: 10.3390/medicina60050815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
In recent years, research has intensified in exploring the genetic basis of psoriasis (PsO) and psoriatic arthritis (PsA). Genome-wide association studies (GWASs), including tools like ImmunoChip, have significantly deepened our understanding of disease mechanisms by pinpointing risk-associated genetic loci. These efforts have elucidated biological pathways involved in PsO pathogenesis, particularly those related to the innate immune system, antigen presentation, and adaptive immune responses. Specific genetic loci, such as TRAF3IP2, REL, and FBXL19, have been identified as having a significant impact on disease development. Interestingly, different genetic variants at the same locus can predispose individuals to either PsO or PsA (e.g., IL23R and deletion of LCE3B and LCE3C), with some variants being uniquely linked to PsA (like HLA B27 on chromosome 6). This article aims to summarize known and new data on the genetics of PsO and PsA, their associated genes, and the involvement of the HLA system and cytokines.
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Affiliation(s)
- Marek Zalesak
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia (L.D.)
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia (L.D.)
- National Institute of Rheumatic Diseases, Nábrežie Ivana Krasku 4, 921 12 Piestany, Slovakia
| | - Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia (L.D.)
- National Institute of Rheumatic Diseases, Nábrežie Ivana Krasku 4, 921 12 Piestany, Slovakia
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2
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Zhang C, Qin Q, Li Y, Zheng X, Chen W, Zhen Q, Li B, Wang W, Sun L. Multifactor dimensionality reduction reveals the effect of interaction between ERAP1 and IFIH1 polymorphisms in psoriasis susceptibility genes. Front Genet 2022; 13:1009589. [PMID: 36425068 PMCID: PMC9679141 DOI: 10.3389/fgene.2022.1009589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/18/2022] [Indexed: 09/18/2023] Open
Abstract
Background: Psoriasis is a common immune-mediated hyperproliferative skin dysfunction with known genetic predisposition. Gene-gene interaction (e.g., between HLA-C and ERAP1) in the psoriasis context has been reported in various populations. As ERAP1 has been recognized as a psoriasis susceptibility gene and plays a critical role in antigen presentation, we performed this study to identify interactions between ERAP1 and other psoriasis susceptibility gene variants. Methods: We validated psoriasis susceptibility gene variants in an independent cohort of 5,414 patients with psoriasis and 5,556 controls. Multifactor dimensionality reduction (MDR) analysis was performed to identify the interaction between variants significantly associated with psoriasis in the validation cohort and ERAP1 variants. We then conducted a meta-analysis of those variants with datasets from exome sequencing, target sequencing, and validation analyses and used MDR to identify the best gene-gene interaction model, including variants that were significant in the meta-analysis and ERAP1 variants. Results: We found that 19 of the replicated variants were identified with p < 0.05 and detected six single-nucleotide polymorphisms of psoriasis susceptibility genes in the meta-analysis. MDR analysis revealed that the best predictive model was that between the rs27044 polymorphism of ERAP1 and the rs7590692 polymorphism of IFIH1 (cross-validation consistency = 9/10, test accuracy = 0.53, odds ratio = 1.32 (95% CI, 1.09-1.59), p < 0.01). Conclusion: Our findings suggest that the interaction between ERAP1 and IFIH1 affects the development of psoriasis. This hypothesis needs to be tested in basic biological studies.
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Affiliation(s)
- Chang Zhang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Qin Qin
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yuanyuan Li
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Xiaodong Zheng
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Weiwei Chen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Qi Zhen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Bao Li
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Wenjun Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Liangdan Sun
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Dermatology, Anhui Medical University, Hefei, China
- Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
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3
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Schett G, Rahman P, Ritchlin C, McInnes IB, Elewaut D, Scher JU. Psoriatic arthritis from a mechanistic perspective. Nat Rev Rheumatol 2022; 18:311-325. [PMID: 35513599 DOI: 10.1038/s41584-022-00776-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
Psoriatic arthritis (PsA) is part of a group of closely related clinical phenotypes ('psoriatic disease') that is defined by shared molecular pathogenesis resulting in excessive, prolonged inflammation in the various tissues affected, such as the skin, the entheses or the joints. Psoriatic disease comprises a set of specific drivers that promote an aberrant immune response and the consequent development of chronic disease that necessitates therapeutic intervention. These drivers include genetic, biomechanical, metabolic and microbial factors that facilitate a robust and continuous mobilization, trafficking and homing of immune cells into the target tissues. The role of genetic variants involved in the immune response, the contribution of mechanical factors triggering an exaggerated inflammatory response (mechanoinflammation), the impact of adipose tissue and altered lipid metabolism and the influence of intestinal dysbiosis in the disease process are discussed. Furthermore, the role of key cytokines, such as IL-23, IL-17 and TNF, in orchestrating the various phases of the inflammatory disease process and as therapeutic targets in PsA is reviewed. Finally, the nature and the mechanisms of inflammatory tissue responses inherent to PsA are summarized.
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Affiliation(s)
- Georg Schett
- Department of Medicine 3, Friedrich Alexander University Erlangen-Nuremberg and Universitaets-klinikum Erlangen, Erlangen, Germany. .,Deutsches Zentrum Immuntherapie DZI, Friedrich Alexander University Erlangen-Nuremberg and Universitaets-klinikum Erlangen, Erlangen, Germany.
| | - Proton Rahman
- St. Clare's Mercy Hospital, St. John's, Newfoundland, Canada
| | - Christopher Ritchlin
- Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center Rochester, Rochester, NY, USA
| | - Iain B McInnes
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Dirk Elewaut
- VIB-UGent Center for Inflammation Research and Ghent University Hospital, Ghent, Belgium
| | - Jose U Scher
- Department of Medicine, Division of Rheumatology, NYU Grossman School of Medicine, New York, NY, USA
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Xu Q, Zheng X, Mao Y, Chen W, Chen S, Zhang H, Zhen Q, Li B, Yong L, Ge H, Yu Y, Zhang R, Cao L, Cheng H, Wang W, Sun L. Gene interaction analysis of psoriasis in Chinese Han population. Mol Genet Genomic Med 2022; 10:e1858. [PMID: 35352505 PMCID: PMC9034666 DOI: 10.1002/mgg3.1858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/10/2021] [Accepted: 12/17/2021] [Indexed: 11/21/2022] Open
Abstract
Background/aims Psoriasis is a chronic immune‐mediated inflammatory skin disease characterized by excessive proliferation of keratinocytes. It has a strong genetic predisposition; gene‐gene interactions are important genetic models for common diseases. In this study, we explore pair‐wise interactions among SNPs contributing to psoriasis susceptibility. Methods We first performed gene interactions with exome‐sequencing, next, we analyzed gene interactions combining the exome sequencing data with the targeted sequencing data. After we sequenced HLA region, we analyzed gene interactions including HLA regions and non‐HLA regions. Results We found interactions between HLA regions were significant. We observed significant interactions between HLA‐C*06:02 and rs118179173 (snp31443520; p = 8.21 × 10−20, OR = 0.22) and between HLA‐C*06:02 and HLA‐B:AA67 (p = 1.22 × 10−12, OR = 0.45). Conclusion This study provides evidence that HLA is the most important susceptibility region on the risk of psoriasis and interactions that occur in this region are still significant.
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Affiliation(s)
- Qiongqiong Xu
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Xiaodong Zheng
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Yiwen Mao
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Weiwei Chen
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Shirui Chen
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Hui Zhang
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Qi Zhen
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Bao Li
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Liang Yong
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Huiyao Ge
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Yafen Yu
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Ruixue Zhang
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Lu Cao
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Hui Cheng
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Wenjun Wang
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Liangdan Sun
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Anhui Medical University, Anhui Provincial Institute of Translational Medicine, Hefei, China.,Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
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O'Rielly DD, Rahman P. Clinical and molecular significance of genetic loci associated with psoriatic arthritis. Best Pract Res Clin Rheumatol 2021; 35:101691. [PMID: 34020887 DOI: 10.1016/j.berh.2021.101691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Psoriatic arthritis (PsA) is caused by a combination of environmental and multiple genetic factors, with clear evidence for a strong genetic basis. The remarkable accumulation of knowledge gained from genetic, pharmacogenetic, and therapeutic response of biologic agents in PsA has fundamentally changed and advanced our understanding of disease pathogenesis and has identified key signalling pathways. However, only one-quarter of the genetic contribution of PsA has been accounted for; and dissecting the genetic contributors of the cutaneous disease from those that would identify joint disease has been challenging. More importantly, the clinical utility of multiple proposed loci is unclear. In this review, we summarize the potential clinical relevance from established genetic associations and provide insight on the proposed molecular pathways that arise from these associations.
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Affiliation(s)
- Darren D O'Rielly
- Faculty of Medicine, Memorial University, Craig L Dobbin Genetics Research Centre, Suite 3M500, 300 Prince Philip Drive, St. John's, NL, A1B3V6, Canada
| | - Proton Rahman
- St. Clare's Mercy Hospital, 154 LeMarchant Rd, St. John's, Newfoundland, A1C5B8, Canada.
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Morin M, Hellgren K, Lindström U, Frisell T. Is family history a predictor of response to tumour necrosis factor inhibitors in spondyloarthritis? A Swedish nationwide cohort study. Scand J Rheumatol 2021; 51:10-20. [PMID: 33755519 DOI: 10.1080/03009742.2021.1887928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: To determine whether a family history of spondyloarthritis (SpA) is associated with clinical presentation at the start of tumour necrosis factor inhibitor (TNFi) treatment, or predictive of TNFi drug survival and treatment response in patients with SpA.Method: Family history of SpA in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), and undifferentiated SpA (uSpA) from the Swedish Rheumatology Quality register starting a TNFi as their first biologic in 2006-2018 was assessed through national registers. Clinical characteristics at treatment start were compared by family history status. We used Cox regression to estimate hazard ratios for drug discontinuation, and analysed treatment response at 3 and 12 months with linear regression. Multiple imputation was used to address missing data.Results: We included 9608 patients. Patients with family history had an earlier age at onset and longer disease duration at TNFi treatment start, but did not differ regarding disease activity and presence of SpA manifestations. Hazard ratios for drug discontinuation were 1.08 [95% confidence interval (CI) 0.89-1.31] for AS patients with a family history of AS, 1.02 (95% CI 0.89-1.18) for PsA patients with a family history of PsA, and 1.11 (95% CI 0.85-1.45) for uSpA patients with a family history of uSpA, after adjusting for demographic, socioeconomic, and SpA-related factors. Treatment response at 3 and 12 months was similar between groups.Conclusion: Family history of SpA was not found to be associated with clinical presentation at the start of TNFi treatment, nor was it associated with drug survival or treatment response in SpA patients starting a first TNFi.
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Affiliation(s)
- M Morin
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - K Hellgren
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Rheumatology, Theme Inflammation and Infection, Karolinska University Hospital, Stockholm, Sweden
| | - U Lindström
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - T Frisell
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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Shi C, Rattray M, Barton A, Bowes J, Orozco G. Using functional genomics to advance the understanding of psoriatic arthritis. Rheumatology (Oxford) 2021; 59:3137-3146. [PMID: 32778885 PMCID: PMC7590405 DOI: 10.1093/rheumatology/keaa283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/17/2020] [Accepted: 04/28/2020] [Indexed: 01/03/2023] Open
Abstract
Psoriatic arthritis (PsA) is a complex disease where susceptibility is determined by genetic and environmental risk factors. Clinically, PsA involves inflammation of the joints and the skin, and, if left untreated, results in irreversible joint damage. There is currently no cure and the few treatments available to alleviate symptoms do not work in all patients. Over the past decade, genome-wide association studies (GWAS) have uncovered a large number of disease-associated loci but translating these findings into functional mechanisms and novel targets for therapeutic use is not straightforward. Most variants have been predicted to affect primarily long-range regulatory regions such as enhancers. There is now compelling evidence to support the use of chromatin conformation analysis methods to discover novel genes that can be affected by disease-associated variants. Here, we will review the studies published in the field that have given us a novel understanding of gene regulation in the context of functional genomics and how this relates to the study of PsA and its underlying disease mechanism.
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Affiliation(s)
- Chenfu Shi
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Centre for Genetics and Genomics Versus Arthritis
| | - Magnus Rattray
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, University of Manchester.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre
| | - Anne Barton
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Centre for Genetics and Genomics Versus Arthritis.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre.,Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - John Bowes
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Centre for Genetics and Genomics Versus Arthritis.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre
| | - Gisela Orozco
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Centre for Genetics and Genomics Versus Arthritis.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre.,Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Pathogenesis of psoriasis in the "omic" era. Part IV. Epidemiology, genetics, immunopathogenesis, clinical manifestation and treatment of psoriatic arthritis. Postepy Dermatol Alergol 2020; 37:625-634. [PMID: 33239999 PMCID: PMC7675087 DOI: 10.5114/ada.2020.100478] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/16/2020] [Indexed: 12/25/2022] Open
Abstract
Psoriatic arthritis (PsA) is a chronic, progressive, inflammatory arthropathy associated with psoriasis as well as a complex pathogenesis. Genetic and environmental factors trigger the development of the immune-mediated auto-inflammatory response in different sites: skin, bone marrow, entheses and synovial tissues. Studies of the last two decades have changed the view of PsA from a mild, non-progressive arthritis to an inflammatory systemic disease with serious health consequences, not only associated with joint dysfunction, but also with an increased risk of cardiovascular disease and socioeconomic consequences with significantly reduced quality of life. The joint damage starts early in the course of the disease, thus early recognition and treatment with modern biological treatments, which may modify the natural history and slow down progression of this debilitating disease, is essential for the patient long-term outcome.
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10
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The Genetics of Spondyloarthritis. J Pers Med 2020; 10:jpm10040151. [PMID: 33023259 PMCID: PMC7711559 DOI: 10.3390/jpm10040151] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022] Open
Abstract
The term spondyloarthritis (SpA) encompasses a group of chronic inflammatory diseases with common features in terms of clinical presentation and genetic predisposition. SpA is characterized by inflammation of the spine and peripheral joints, and is also be associated with extra-articular inflammatory manifestations such as psoriasis, uveitis, or inflammatory bowel disease (IBD). The etiology of SpA is not completely understood, but it is known to have a strong genetic component dominated by the human leukocyte antigen (HLA)-B27. In the last few years, our understanding of genetic susceptibility to SpA, particularly ankylosing spondylitis (AS), has greatly improved thanks to the findings derived from powered genome-wide association studies (GWAS) based on single nucleotide polymorphism (SNP) arrays. These studies have identified many candidate genes, therefore providing new potential directions in the exploration of disease mechanisms, especially with regard to the key role of the immune system in the pathogenesis of SpA. SpA is a complex disease where genetic variability, environmental factors, and random events interact to trigger pathological pathways. The aim of this review is to summarize current findings on the genetics of SpA, some of which might help to study new treatment approaches.
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Köhm M, Zerweck L, Ngyuen PH, Burkhardt H, Behrens F. Innovative Imaging Technique for Visualization of Vascularization and Established Methods for Detection of Musculoskeletal Inflammation in Psoriasis Patients. Front Med (Lausanne) 2020; 7:468. [PMID: 32984365 PMCID: PMC7492526 DOI: 10.3389/fmed.2020.00468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022] Open
Abstract
Psoriasis (PsO) is one of the common chronic inflammatory skin diseases. Approximately 3% of the European Caucasian population is affected. Psoriatic arthritis (PsA) is a chronic immune-mediated disease associated with PsO characterized by distinct musculoskeletal inflammation. Due to its heterogeneous clinical manifestations (e.g., oligo- or polyarthritis, enthesitis, dactylitis, and axial inflammation), early diagnosis of PsA is often difficult and delayed. Approximately 30% of PsO patients will develop PsA. The responsible triggers for the transition from PsO only to PsA are currently unclear, and the impacts of different factors (e.g., genetic, environmental) on disease development are currently discussed. There is a high medical need, recently unmet, to specifically detect those patients with an increased risk for the development of clinically evident PsA early to initiate sufficient treatment to inhibit disease progression and avoid structural damage and loss of function or even intercept disease development. Increased neoangiogenesis and enthesial inflammation are hypothesized to be early pathological findings in PsO patients with PsA development. Different disease states describe the transition from PsO to PsA. Two of those phases are of value for early detection of PsA at-risk patients to prevent later development of PsA as changes in biomarker profiles are detectable: the subclinical phase (soluble and imaging biomarkers detectable, no clinical symptoms) and the prodromal phase (imaging biomarkers detectable, unspecific musculoskeletal symptoms such as arthralgia and fatigue). To target the unmet need for early detection of this at-risk population and to identify the subgroup of patients who will transition from PsO to PsA, imaging plays an important role in characterizing patients precisely. Imaging techniques such as ultrasound (US), magnetic resonance imaging (MRI), and computerized tomography (CT) are advanced techniques to detect sensitively inflammatory changes or changes in bone structure. With the use of these techniques, anatomic structures involved in inflammatory processes can be identified. These techniques are complemented by fluorescence optical imaging as a sensitive method for detection of changes in vascularization, especially in longitudinal measures. Moreover, high-resolution peripheral quantitative CT (HR-pQCT) and dynamic contrast-enhanced MRI (DCE-MRI) may give the advantage to identify PsA-related early characteristics in PsO patients reflecting transition phases of the disease.
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Affiliation(s)
- Michaela Köhm
- Division of Rheumatology, Goethe-University Frankfurt, Frankfurt, Germany.,Clinical Research, Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Branch for Translational Medicine and Pharmacology TMP, Frankfurt, Germany.,Fraunhofer Cluster of Excellence Immune-Mediated Diseases CIMD, Frankfurt, Germany
| | - Lukas Zerweck
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases CIMD, Frankfurt, Germany.,Fraunhofer Institute for Applied Information Technology FIT, St. Augustin, Germany
| | - Phuong-Ha Ngyuen
- Fraunhofer Cluster of Excellence Immune-Mediated Diseases CIMD, Frankfurt, Germany.,Fraunhofer Institute for Applied Information Technology FIT, St. Augustin, Germany
| | - Harald Burkhardt
- Division of Rheumatology, Goethe-University Frankfurt, Frankfurt, Germany.,Clinical Research, Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Branch for Translational Medicine and Pharmacology TMP, Frankfurt, Germany.,Fraunhofer Cluster of Excellence Immune-Mediated Diseases CIMD, Frankfurt, Germany.,Centre of Innovative Diagnostics and Therapeutics Rheumatology/Immunology CIRI, Frankfurt, Germany
| | - Frank Behrens
- Division of Rheumatology, Goethe-University Frankfurt, Frankfurt, Germany.,Clinical Research, Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Branch for Translational Medicine and Pharmacology TMP, Frankfurt, Germany.,Fraunhofer Cluster of Excellence Immune-Mediated Diseases CIMD, Frankfurt, Germany.,Centre of Innovative Diagnostics and Therapeutics Rheumatology/Immunology CIRI, Frankfurt, Germany
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12
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Zabotti A, Tinazzi I, Aydin SZ, McGonagle D. From Psoriasis to Psoriatic Arthritis: Insights from Imaging on the Transition to Psoriatic Arthritis and Implications for Arthritis Prevention. Curr Rheumatol Rep 2020; 22:24. [PMID: 32418006 PMCID: PMC7230038 DOI: 10.1007/s11926-020-00891-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW To describe the recent advances in the field towards the prevention and early recognition of Psoriatic Arthritis (PsA). RECENT FINDINGS Defining the preclinical phase of PsA remains challenging since up to 50% of subjects with psoriasis have subclinical imaging enthesopathy, but many of these do not progress to PsA. Nevertheless, there is evidence that subjects with subclinical imaging enthesopathy are at increased risk of developing PsA. In recent years, it has been shown that both PsA and anti-citrullinated protein antibodies (ACPA) positive rheumatoid arthritis (RA) are characterized by a subclinical phase of non-specific or brief duration arthralgia with shared imaging features accounting for joint symptomatology. Sonographically determined tenosynovitis and enthesitis are the key imaging features present in non-specific PsO arthralgia that are at risk of future PsA development. Furthermore, the early phases of PsA are complicated by factors including body mass index (BMI), which is a risk factor for PsA, but BMI is also associated with imaging abnormalities on enthesopathy. Fully disentangling these clinical and imaging factors will be important for enrichment for imminent PsA so that disease prevention strategies can be investigated. Psoriasis patients with arthralgia have a higher prevalence of tenosynovitis and imaging enthesopathy is at higher risk of transitioning to overt PsA.
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Affiliation(s)
- Alen Zabotti
- Department of Medical and Biological Science, Rheumatology Clinic, University of Udine, Udine, Italy
| | - Ilaria Tinazzi
- Unit of Rheumatology, IRCSS Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Sibel Zehra Aydin
- Faculty of Medicine, Division of Rheumatology, University of Ottawa, the Ottawa Hospital Research Institute, Ottawa, Canada
| | - Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
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13
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Li Q, Chandran V, Tsoi L, O'Rielly D, Nair RP, Gladman D, Elder JT, Rahman P. Quantifying Differences in Heritability among Psoriatic Arthritis (PsA), Cutaneous Psoriasis (PsC) and Psoriasis vulgaris (PsV). Sci Rep 2020; 10:4925. [PMID: 32188927 PMCID: PMC7080781 DOI: 10.1038/s41598-020-61981-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/06/2020] [Indexed: 02/08/2023] Open
Abstract
Chronic plaque psoriasis and psoriatic arthritis are multifactorial inter-related diseases with strong genetic contributions. Better elucidation of the heritability of psoriatic disease subsets is important for identifying novel genes, risk stratification and potential clinical applications. In this study, we used two mixed-effect modelling methodologies to assess the additive contribution of common single nucleotide polymorphisms from genome-wide association studies to estimate the heritability of cutaneous psoriasis, psoriasis vulgaris and psoriatic arthritis. We found that cutaneous psoriasis and psoriatic arthritis both exhibit considerable heritability, with a greater contribution coming from cutaneous psoriasis.
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Affiliation(s)
- Quan Li
- Department of Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland, St. John's, Newfoundland and Labrador, A1B 3X9, Canada
| | - Vinod Chandran
- Department of Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland, St. John's, Newfoundland and Labrador, A1B 3X9, Canada.,Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.,Krembil Research Institute, University Health Network, Toronto, Ontario, M5S 1A8, Canada
| | - Lam Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, 48109, USA.,Department of Computational Medicine & Bioinformatics, University of Michigan, Michigan, USA.,Department of Biostatistics, University of Michigan, Michigan, USA
| | - Darren O'Rielly
- Department of Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland, St. John's, Newfoundland and Labrador, A1B 3X9, Canada
| | - Rajan P Nair
- Krembil Research Institute, University Health Network, Toronto, Ontario, M5S 1A8, Canada
| | - Dafna Gladman
- Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.,Krembil Research Institute, University Health Network, Toronto, Ontario, M5S 1A8, Canada
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, 48109, USA.,Ann Arbor Veterans Affairs Hospital, Ann Arbor, MI, USA
| | - Proton Rahman
- Department of Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland, St. John's, Newfoundland and Labrador, A1B 3X9, Canada.
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14
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Impact of Having Family History of Psoriasis or Psoriatic Arthritis on Psoriatic Disease. Arthritis Care Res (Hoboken) 2019; 72:63-68. [DOI: 10.1002/acr.23836] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 01/15/2019] [Indexed: 11/07/2022]
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15
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Frischknecht L, Vecellio M, Selmi C. The role of epigenetics and immunological imbalance in the etiopathogenesis of psoriasis and psoriatic arthritis. Ther Adv Musculoskelet Dis 2019; 11:1759720X19886505. [PMID: 31723358 PMCID: PMC6836300 DOI: 10.1177/1759720x19886505] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/10/2019] [Indexed: 12/14/2022] Open
Abstract
Psoriasis (Ps) and psoriatic arthritis (PsA) represent a clinical and immunopathogenic continuum, called psoriatic disease, cumulatively affecting approximately 3% of the general population. Psoriatic disease is a chronic inflammatory disorder affecting the skin and musculoskeletal system. The immuno-pathogenesis is characterized by an activation of the TNF/IL-23/IL-17 cytokine axis, leading to an immunologic imbalance of T-cells resident in all affected tissues, mainly entheses. In the majority of cases, skin Ps predates rheumatological manifestations. Secondary to the higher incidence and the availability of mouse models, there is stronger data available on skin Ps, and data are, in most cases, relevant also to PsA. In a widely accepted model, environmental trigger factors like infections or trauma are capable of initiating an inflammatory cascade, ultimately creating a sustained state of chronic inflammation in genetically susceptible individuals. Besides well-known genetic susceptibility loci, epigenetic DNA modifications, which are associated with Ps development have been characterized recently and will be discussed in this article. The current evidence is promising in the possibility to provide new therapeutic avenues and fill the unmet need of patients, for whom current treatments either do not allow the disease to be controlled or must be continued for life.
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Affiliation(s)
- Lukas Frischknecht
- Rheumatology and Clinical Immunology Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Matteo Vecellio
- Rheumatology and Clinical Immunology Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Carlo Selmi
- Rheumatology and Clinical Immunology Unit, Humanitas Clinical and Research Center-IRCCS, via A. Manzoni 56, 20089 Rozzano, Milan, Italy
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16
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Feld J, Chandran V, Haroon N, Inman R, Gladman D. Axial disease in psoriatic arthritis and ankylosing spondylitis: a critical comparison. Nat Rev Rheumatol 2019; 14:363-371. [PMID: 29752461 DOI: 10.1038/s41584-018-0006-8] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Ankylosing spondylitis (AS) was first identified in the late 17th century. 250 years later, inflammatory spine disease was recognized to be one of the patterns of psoriatic arthritis (PsA). Isolated spondylitis is rare among patients with PsA, occurring in less than 5% of patients; however, many patients with PsA have axial disease that is concurrent with peripheral arthritis. At the other end of the spondyloarthritis spectrum, psoriasis is observed in 10% of patients with AS. Although axial involvement in PsA can be indistinguishable from axial disease in AS, it can also differ in several respects, raising the question of whether axial PsA and AS (with or without psoriasis) are different clinical presentations of the same disease, or whether they are separate diseases that have overlapping features. In this Review, the clinical presentation, metrology, radiographic characteristics, genetic factors, treatment options and axial prognosis of the two diseases are addressed. The aim of this Review is to capture all available comparisons made to date, to highlight the similarities and differences between AS and axial PsA and to propose a research agenda.
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Affiliation(s)
- Joy Feld
- Centre for Prognosis Studies in Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Vinod Chandran
- Centre for Prognosis Studies in Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Nigil Haroon
- Centre for Prognosis Studies in Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Robert Inman
- Centre for Prognosis Studies in Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Immunology, Medical Sciences Building, University of Toronto, Toronto, Ontario, Canada
| | - Dafna Gladman
- Centre for Prognosis Studies in Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. .,Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. .,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
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17
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Tateiwa D, Yoshikawa H, Kaito T. Cartilage and Bone Destruction in Arthritis: Pathogenesis and Treatment Strategy: A Literature Review. Cells 2019; 8:cells8080818. [PMID: 31382539 PMCID: PMC6721572 DOI: 10.3390/cells8080818] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 02/07/2023] Open
Abstract
Arthritis is inflammation of the joints accompanied by osteochondral destruction. It can take many forms, including osteoarthritis, rheumatoid arthritis, and psoriatic arthritis. These diseases share one commonality—osteochondral destruction based on inflammation. The background includes a close interaction between osseous tissues and immune cells through various inflammatory cytokines. However, the tissues and cytokines that play major roles are different in each disease, and as a result, the mechanism of osteochondral destruction also differs. In recent years, there have been many findings regarding not only extracellular signaling pathways but also intracellular signaling pathways. In particular, we anticipate that the intracellular signals of osteoclasts, which play a central role in bone destruction, will become novel therapeutic targets. In this review, we have summarized the pathology of arthritis and the latest findings on the mechanism of osteochondral destruction, as well as present and future therapeutic strategies for these targets.
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Affiliation(s)
- Daisuke Tateiwa
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hideki Yoshikawa
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
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18
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Preventing psoriatic arthritis: focusing on patients with psoriasis at increased risk of transition. Nat Rev Rheumatol 2019; 15:153-166. [DOI: 10.1038/s41584-019-0175-0] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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19
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Mechanistic immunological based classification of rheumatoid arthritis. Autoimmun Rev 2018; 17:1115-1123. [PMID: 30213700 DOI: 10.1016/j.autrev.2018.06.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 06/14/2018] [Indexed: 12/12/2022]
Abstract
The classical autoimmunity paradigm in rheumatoid arthritis (RA) is strongly supported by immunogenetics suggesting follicular helper T-cell responses driving high titre specific autoantibodies that pre-dates disease onset. Using the immunological disease continuum model of inflammation against self with "pure" adaptive and innate immune disease at opposite boundaries, we propose a novel immune mechanistic classification describing the heterogeneity within RA. Mutations or SNPs in autoinflammatory genes including MEFV and NOD2 are linked to seronegative RA phenotypes including some so called palindromic RA cases. However, just as innate and adaptive immunity are closely functionally integrated, some ACPA+ RA cases have superimposed "autoinflammatory" features including abrupt onset attacks, severe attacks, self-limiting attacks, relevant autoinflammatory mutations or SNPs and therapeutic responses to autoinflammatory pathway therapies including colchicine and IL-1 pathway blockade. An emergent feature from this classification that non-destructive RA phenotypes, both innate and adaptive, have disease epicentres situated in the extracapsular tissues. This mixed innate and adaptive immunopathogenesis may be the key to understanding severe disease flares, resistant disease subsets that are unresponsive to standard therapy and for therapies that target the autoinflammatory component of disease that are not currently considered by expert therapeutic recommendations.
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20
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Veale DJ, Fearon U. The pathogenesis of psoriatic arthritis. Lancet 2018; 391:2273-2284. [PMID: 29893226 DOI: 10.1016/s0140-6736(18)30830-4] [Citation(s) in RCA: 309] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/21/2018] [Accepted: 03/28/2018] [Indexed: 12/15/2022]
Abstract
Psoriatic arthritis is a chronic, immune-mediated, inflammatory arthropathy that presents with inflammation of the joints and entheses, including those of the axial skeleton, and is associated with increased mortality from cardiovascular disease. Diagnosis is primarily based on clinical phenotype because of the diversity of the associated features, which can include skin and nail disease, dactylitis, uveitis, and osteitis. Improved understanding of the pathogenesis of psoriatic arthritis has led to the development of effective biologics and small-molecular drugs targeting specific cytokines and signalling pathways, which can prevent disease progression and improve quality of life. However, at least 40% of patients with psoriatic arthritis have only a partial response or fail to respond to such treatments. Cytokine inhibitors, mainly those specific for tumour necrosis factor and, more recently, the interleukin 23-T-helper-17 cell pathway, have been highly successful in the treatment of disease manifestations in several different tissues, although targeting the interleukin 23-T-helper-17 cell pathway might be more effective in psoriasis than in arthritis. However, the precise mechanisms underlying the pathogenesis of psoriatic arthritis-which include genetics, environmental factors, and immune-mediated inflammation-are complex, and the relationship between disease of the joint and that of other domains is poorly understood. Improving our understanding of psoriatic arthritis pathogenesis could help to establish validated biomarkers for diagnosis, predict therapeutic response and remission, develop precision medicines, and predict which patients will respond to which therapy. We discuss advances in pathogenetic translational research that could inform these issues.
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Affiliation(s)
- Douglas J Veale
- Rheumatology EULAR Centre of Excellence, St Vincent's University Hospital and University College Dublin, Dublin, Ireland.
| | - Ursula Fearon
- Rheumatology EULAR Centre of Excellence, St Vincent's University Hospital and University College Dublin, Dublin, Ireland; Department of Molecular Rheumatology, Trinity Biomedical Science Institute, Trinity College Dublin, Dublin, Ireland
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21
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Kitzen JM, Pergolizzi Jr. JV, Taylor Jr. R, Raffa RB. Crisaborole and Apremilast: PDE4 Inhibitors with Similar Mechanism of Action, Different Indications for Management of Inflammatory Skin Conditions. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/pp.2018.99028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Greb JE, Goldminz AM, Elder JT, Lebwohl MG, Gladman DD, Wu JJ, Mehta NN, Finlay AY, Gottlieb AB. Psoriasis. Nat Rev Dis Primers 2016; 2:16082. [PMID: 27883001 DOI: 10.1038/nrdp.2016.82] [Citation(s) in RCA: 525] [Impact Index Per Article: 65.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative effects on patient quality of life. Psoriasis has a strong, albeit polygenic, genetic basis. Whereas approximately half of the accountable genetic effect of psoriasis maps to the major histocompatibility complex, >70 other loci have been identified, many of which implicate nuclear factor-κB, interferon signalling and the IL-23-IL-23 receptor axis. Psoriasis pathophysiology is characterized by abnormal keratinocyte proliferation and immune cell infiltration in the dermis and epidermis involving the innate and adaptive immune systems, with important roles for dendritic cells and T cells, among other cells. Frequent comorbidities are rheumatological and cardiovascular in nature, in particular, psoriatic arthritis. Current treatments for psoriasis include topical agents, photo-based therapies, traditional systemic drugs and biologic agents. Treatments can be used in combination or as monotherapy. Biologic therapies that target specific disease mediators have become a mainstay in the treatment of moderate-to-severe disease, whereas advances in the treatment of mild-to-moderate disease have been limited.
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Affiliation(s)
- Jacqueline E Greb
- Tufts University School of Medicine, Boston, Massachusetts, USA.,Tufts Medical Center, Department of Dermatology, Boston, Massachusetts, USA
| | - Ari M Goldminz
- Tufts Medical Center, Department of Dermatology, Boston, Massachusetts, USA
| | - James T Elder
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dafna D Gladman
- University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Jashin J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Alice B Gottlieb
- Department of Dermatology, New York Medical College, 40 Sunshine Cottage Rd, Valhalla, New York 10595, USA
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23
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Garbers LEFDM, Slongo H, Fabricio LHZ, Schmitt JV, Bonalumi Filho A. Incidence, clinical manifestations and clipping of nail psoriasis in the dermatology center of the Hospital Universitário Evangélico de Curitiba. An Bras Dermatol 2016; 91:300-5. [PMID: 27438196 PMCID: PMC4938273 DOI: 10.1590/abd1806-4841.20164296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/27/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory skin disease that often progresses with nail alterations. It is suspected that there is a correlation between nail psoriasis and enthesitis of the distal interphalangeal joint, seeming to serve as a predictor. OBJECTIVES To analyze the profile of patients with nail psoriasis and correlate the presence of nail alterations with psoriatic arthritis, quality of life, extent of psoriasis and the histopathology of the nail. METHODS An observational cross-sectional study with 40 patients with a diagnosis of psoriasis and without systemic treatment. The patient profile was researched, including quality of life and evaluated for the presence of psoriatic arthritis. The severity of the skin psoriasis and the presence of nail lesions were evaluated. Nail fragments were collected and analyzed through clipping. It obtained 100% of positivity for psoriasis in the histopathology exam of the nail plate. RESULTS Of the 40 patients, 65% were diagnosed with nail psoriasis. Suggestive findings of psoriatic arthritis in hands were present in 33%, being more frequent in those with nail alteration (p = 0.01). In 92.3% of patients diagnosed with psoriatic arthritis in the hands there was some nail injury. The most frequent injuries were pitting and onycholysis. CONCLUSIONS Patients with nail psoriasis are usually men, with worse quality of life and higher chance of psoriatic arthritis. The correlation between the nail involvement of psoriasis and psoriatic arthritis in hands confirms the association between these two forms. The clinical diagnosis of nail psoriasis did not correlate with the histological diagnosis.
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Affiliation(s)
| | - Helena Slongo
- Faculdade Evangélica do Paraná (Fepar) -
Curitiba (PR), Brazil
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24
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Stuart P, Nair R, Tsoi L, Tejasvi T, Das S, Kang H, Ellinghaus E, Chandran V, Callis-Duffin K, Ike R, Li Y, Wen X, Enerbäck C, Gudjonsson J, Kõks S, Kingo K, Esko T, Mrowietz U, Reis A, Wichmann H, Gieger C, Hoffmann P, Nöthen M, Winkelmann J, Kunz M, Moreta E, Mease P, Ritchlin C, Bowcock A, Krueger G, Lim H, Weidinger S, Weichenthal M, Voorhees J, Rahman P, Gregersen P, Franke A, Gladman D, Abecasis G, Elder J. Genome-wide Association Analysis of Psoriatic Arthritis and Cutaneous Psoriasis Reveals Differences in Their Genetic Architecture. Am J Hum Genet 2015; 97:816-36. [PMID: 26626624 DOI: 10.1016/j.ajhg.2015.10.019] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/29/2015] [Indexed: 12/17/2022] Open
Abstract
Psoriasis vulgaris (PsV) is a common inflammatory and hyperproliferative skin disease. Up to 30% of people with PsV eventually develop psoriatic arthritis (PsA), an inflammatory musculoskeletal condition. To discern differences in genetic risk factors for PsA and cutaneous-only psoriasis (PsC), we carried out a genome-wide association study (GWAS) of 1,430 PsA case subjects and 1,417 unaffected control subjects. Meta-analysis of this study with three other GWASs and two targeted genotyping studies, encompassing a total of 9,293 PsV case subjects, 3,061 PsA case subjects, 3,110 PsC case subjects, and 13,670 unaffected control subjects of European descent, detected 10 regions associated with PsA and 11 with PsC at genome-wide (GW) significance. Several of these association signals (IFNLR1, IFIH1, NFKBIA for PsA; TNFRSF9, LCE3C/B, TRAF3IP2, IL23A, NFKBIA for PsC) have not previously achieved GW significance. After replication, we also identified a PsV-associated SNP near CDKAL1 (rs4712528, odds ratio [OR] = 1.16, p = 8.4 × 10(-11)). Among identified psoriasis risk variants, three were more strongly associated with PsC than PsA (rs12189871 near HLA-C, p = 5.0 × 10(-19); rs4908742 near TNFRSF9, p = 0.00020; rs10888503 near LCE3A, p = 0.0014), and two were more strongly associated with PsA than PsC (rs12044149 near IL23R, p = 0.00018; rs9321623 near TNFAIP3, p = 0.00022). The PsA-specific variants were independent of previously identified psoriasis variants near IL23R and TNFAIP3. We also found multiple independent susceptibility variants in the IL12B, NOS2, and IFIH1 regions. These results provide insights into the pathogenetic similarities and differences between PsC and PsA.
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Julià A, Pinto JA, Gratacós J, Queiró R, Ferrándiz C, Fonseca E, Montilla C, Torre-Alonso JC, Puig L, Pérez Venegas JJ, Fernández Nebro A, Fernández E, Muñoz-Fernández S, Daudén E, González C, Roig D, Sánchez Carazo JL, Zarco P, Erra A, López Estebaranz JL, Rodríguez J, Ramírez DM, de la Cueva P, Vanaclocha F, Herrera E, Castañeda S, Rubio E, Salvador G, Díaz-Torné C, Blanco R, Willisch Domínguez A, Mosquera JA, Vela P, Tornero J, Sánchez-Fernández S, Corominas H, Ramírez J, López-Lasanta M, Tortosa R, Palau N, Alonso A, García-Montero AC, Gelpí JL, Codó L, Day K, Absher D, Myers RM, Cañete JD, Marsal S. A deletion at ADAMTS9-MAGI1 locus is associated with psoriatic arthritis risk. Ann Rheum Dis 2015; 74:1875-81. [PMID: 25990289 DOI: 10.1136/annrheumdis-2014-207190] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 04/23/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Copy number variants (CNVs) have been associated with the risk to develop multiple autoimmune diseases. Our objective was to identify CNVs associated with the risk to develop psoriatic arthritis (PsA) using a genome-wide analysis approach. METHODS A total of 835 patients with PsA and 1498 healthy controls were genotyped for CNVs using the Illumina HumanHap610 BeadChip genotyping platform. Genomic CNVs were characterised using CNstream analysis software and analysed for association using the χ(2) test. The most significant genomic CNV associations with PsA risk were independently tested in a validation sample of 1133 patients with PsA and 1831 healthy controls. In order to test for the specificity of the variants with PsA aetiology, we also analysed the association to a cohort of 822 patients with purely cutaneous psoriasis (PsC). RESULTS A total of 165 common CNVs were identified in the genome-wide analysis. We found a highly significant association of an intergenic deletion between ADAMTS9 and MAGI1 genes on chromosome 3p14.1 (p=0.00014). Using the independent patient and control cohort, we validated the association between ADAMTS9-MAGI1 deletion and PsA risk (p=0.032). Using next-generation sequencing, we characterised the 26 kb associated deletion. Finally, analysing the PsC cohort we found a lower frequency of the deletion compared with the PsA cohort (p=0.0088) and a similar frequency to that of healthy controls (p>0.3). CONCLUSIONS The present genome-wide scan for CNVs associated with PsA risk has identified a new deletion associated with disease risk and which is also differential from PsC risk.
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Affiliation(s)
- Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - José Antonio Pinto
- Rheumatology Department, Complejo Hospitalario Juan Canalejo, A Coruña, Spain
| | - Jordi Gratacós
- Rheumatology Department, Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - Rubén Queiró
- Rheumatology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carlos Ferrándiz
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Eduardo Fonseca
- Dermatology Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Carlos Montilla
- Rheumatology Department, Hospital Virgen de la Vega, Salamanca, Spain
| | | | - Lluís Puig
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Antonio Fernández Nebro
- UGC Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Emilia Fernández
- Department of Dermatology, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | - Esteban Daudén
- Dermatology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - Carlos González
- Rheumatology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Daniel Roig
- Rheumatology Service, Hospital Moisès Broggi, Barcelona, Spain
| | | | - Pedro Zarco
- Rheumatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Alba Erra
- Rheumatology Department, Hospital Sant Rafael, Barcelona, Spain
| | | | - Jesús Rodríguez
- Rheumatology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Pablo de la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Enrique Herrera
- Dermatology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Santos Castañeda
- Rheumatology Department, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain
| | - Esteban Rubio
- Rheumatology Department, Centro de Salud Virgen de los Reyes, Sevilla, Spain
| | - Georgina Salvador
- Rheumatology Department, Hospital Mútua de Terrassa, Terrassa, Spain
| | - César Díaz-Torné
- Rheumatology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ricardo Blanco
- Rheumatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - José Antonio Mosquera
- Rheumatology Department, Complejo Hospitalario Hospital Provincial de Pontevedra, Pontevedra, Spain
| | - Paloma Vela
- Rheumatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Jesús Tornero
- Rheumatology Department, Hospital Universitario Guadalajara, Guadalajara, Spain
| | | | | | - Julio Ramírez
- Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain
| | - María López-Lasanta
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Raül Tortosa
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Nuria Palau
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Arnald Alonso
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | | | - Josep Lluís Gelpí
- Life Sciences, Barcelona Supercomputing Centre, National Institute of Bioinformatics, Barcelona, Spain
| | - Laia Codó
- HudsonAlpha Institute for Biotechnology, Alabama, USA
| | - Kenneth Day
- HudsonAlpha Institute for Biotechnology, Alabama, USA
| | - Devin Absher
- HudsonAlpha Institute for Biotechnology, Alabama, USA
| | | | - Juan D Cañete
- Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
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What have we learned about genetic susceptibility in psoriasis and psoriatic arthritis? Curr Opin Rheumatol 2015; 27:91-8. [DOI: 10.1097/bor.0000000000000136] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Chiraz BS, Myriam A, Ines Z, Catherine J, Fatma B, Ilhem C, Raoudha T, Hela Z, Hela F, Elyes B, Nejib D, Cindy H, Amel E, Slaheddine S. Deletion of late cornified envelope genes, LCE3C_LCE3B-del, is not associated with psoriatic arthritis in Tunisian patients. Mol Biol Rep 2014; 41:4141-6. [PMID: 24566688 DOI: 10.1007/s11033-014-3285-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 02/13/2014] [Indexed: 11/30/2022]
Abstract
A deletion of two genes from the late cornified envelope (LCE), LCE3B and LCE3C within epidermal differentiation complex on chromosome 1 was shown to be associated with both psoriasis and psoriatic arthritis (PsA) in several populations. To assess whether this deletion may contribute to the genetic predisposition to PsA in Tunisia, a total of 73 patients with PsA and 120 healthy matched controls were screened for the deletion, LCE3C_LCE3B-del, and its tag SNP, rs4112788. We also evaluated a possible relationship between PSORS1 and LCE3C_LCE3B-del through genotyping two proxy markers to HLA-C (rs12191877 and rs2073048). Our results did not provide evidence for association between the LCE3C_LCE3B-del nor the rs4112788 and the PsA. Similarly, no significant epistatic effect was observed. Our data suggest that The LCE deletion, previously identified in patients with psoriasis, is not of a major importance in the development of PsA in Tunisian patients supporting the current perception that different genetic risk factors contribute to skin and joint disease. However, these results need to be confirmed by additional large-scale studies of Tunisian PsA patients and controls.
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Affiliation(s)
- Bouchlaka Souissi Chiraz
- Laboratory of Genetics, Immunology and Human Pathologies, Faculty of Sciences, University of Tunis El Manar, 2092, Tunis, Tunisia,
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Queiro R, Alperi M, Alonso S, Riestra JL, Ballina J. Determinants of psoriatic arthritis in patients with psoriasis. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.09.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Queiro R, Tejón P, Alonso S, Coto P. Age at disease onset: a key factor for understanding psoriatic disease. Rheumatology (Oxford) 2013; 53:1178-85. [PMID: 24273020 DOI: 10.1093/rheumatology/ket363] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Psoriasis and PsA are immune-mediated diseases with a strong genetic component. More than 20 new loci have been recently linked to these diseases. However, interactions between these genes and the phenotypic traits of both diseases are poorly understood at present. Stratification of psoriatic disease according to the sex of the patients, genetic factors or age at onset has allowed in the last few years a better understanding of the principles governing the onset and progression of these processes. The age of onset of psoriasis has been used for decades as an appropriate descriptor to define two subpopulations of psoriatic patients (types I and II) whose clinical and immunogenetic characteristics have been very well differentiated. Moreover, in patients with PsA this distinction between type I and II psoriasis also seems equally operative. In patients with PsA expressing the HLA-C*06 antigen, the latency between the onset of psoriasis and onset of joint symptoms is longer than in those without this marker. It is also known that PsA tends to appear earlier in patients with HLA-B*27 positivity, and that these patients also show a shorter interval of time between the onset of cutaneous lesions and the onset of joint disease. This review highlights the growing importance of age at disease onset as a key stratification factor in worldwide clinical and genetic studies of psoriatic disease.
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Affiliation(s)
- Rubén Queiro
- Rheumatology Division and Dermatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.
| | - Patricia Tejón
- Rheumatology Division and Dermatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Sara Alonso
- Rheumatology Division and Dermatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Pablo Coto
- Rheumatology Division and Dermatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
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Ciurtin C, Roussou E. Cross-sectional study assessing family members of psoriatic arthritis patients affected by the same disease: differences between Caucasian, South Asian and Afro-Caribbean populations living in the same geographic region. Int J Rheum Dis 2013; 16:418-24. [PMID: 23992262 DOI: 10.1111/1756-185x.12109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To determine the likelihood of an individual developing psoriatic arthritis (PsA) if they have a relative diagnosed with this disease, and to compare rates among different ethnic groups living in the same geographic region. METHOD Family histories of patients with PsA were assessed using a semi-structured questionnaire. RESULTS Data on family members of patients with SpA were collected for 151 patients (46.6%) of the total cohort of 324. A total of 146 patients in the SpA cohort had PsA (45%) and 88 of these patients (60.2%) also had relatives with PsA. Psoriatic arthritis was seen more commonly in Caucasians (n = 88, 58.3%) than in South Asians (n = 28, 18.5%; P < 0.001) or African/Afro-Caribbean (n = 11, 7.3%; P < 0.002) individuals. Caucasians more commonly had relatives affected by the disease (49/78, 62.8%) than in South Asians (16/33, 48.4%; P < 0.034). CONCLUSIONS Psoriatic arthritis was more common in Caucasian than in South Asian patients. The relatives of Caucasian patients were also more likely to have PsA compared with South Asian patients. Among South Asian patients, the relatives of Pakistani patients were significantly more likely to have PsA compared with other South Asian populations. Patients with a relative with PsA were three times more likely to develop PsA, with an increased likelihood for Pakistani individuals (by a factor of 5.29) compared with other South Asians (2.88) and Caucasians (4.32).
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Affiliation(s)
- Coziana Ciurtin
- Department of Rheumatology and Rehabilitation, Barking, Havering and Redbridge University Hospitals NHS Trust, King George Hospital, Goodmayes, Essex, UK
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Chin YY, Yu HS, Li WC, Ko YC, Chen GS, Wu CS, Lu YW, Yang YH, Lan CCE. Arthritis as an important determinant for psoriatic patients to develop severe vascular events in Taiwan: a nation-wide study. J Eur Acad Dermatol Venereol 2012; 27:1262-8. [PMID: 23004680 DOI: 10.1111/j.1468-3083.2012.04706.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psoriasis is an important systemic inflammatory disease that often leads to severe vascular diseases. This study was launched to determine if joint involvement affects incidence of vascular comorbidities in psoriatic patients. In addition, potential vasculo-protective effects of methotrexate in psoriatic patients were also evaluated. METHOD A population-based retrospective cohort study was conducted using the Taiwanese National Health Insurance database spanning from 1996 to 2006. Accordingly, 7648 and 284 psoriatic patients without or with arthritis, respectively, were identified. To ensure the temporal relationship between different events, those with date of first diagnosis psoriasis during the year of 1996 were excluded from subsequent analyses. In addition, those with diagnosis of cerebrovascular or cardiovascular diseases prior to onset of psoriasis were also excluded from relevant subsequent analyses. RESULT Taking psoriatic patients without arthritis as the referent group, the hazard ratio for incident cerebrovascular disease was 1.82 (95% CI = 1.17-2.82) for psoriatic patient with arthritis. In addition, psoriatic patients without arthritis who had methotrexate treatment showed reduced risks for incident cerebrovascular disease as compared with those with no arthritis and had received no methotrexate/retinoid treatment. Similar analyses were performed on cardiovascular diseases, and equivalent results were obtained. CONCLUSION Our study indicated that arthritis is a potential determinant for psoriatic patients in terms of incident vascular comorbidities. In addition, methotrexate treatment may be associated with reduced risks for development of severe vascular diseases in psoriatic patients without arthritis. Further studies should focus on the clinical complications associated with psoriatic patients with or without arthritis.
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Affiliation(s)
- Yi-Ying Chin
- Department of Dermatology, Kaohsiung Medical University Hospital, and Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Dermatology, Kaohsiung Municipal Ta-Tung Hospital, Kaoshiung Medical University, Kaohsiung, Taiwan Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
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IL-23A, IL-23R, IL-17A and IL-17R polymorphisms in different psoriatic arthritis clinical manifestations in the northern Italian population. Rheumatol Int 2012; 33:1165-76. [PMID: 22955875 DOI: 10.1007/s00296-012-2501-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 08/23/2012] [Indexed: 01/05/2023]
Abstract
To investigate the genetic variability of IL-17A, IL17-RA, IL-23A and IL-23R genes on an in-depth phenotypically characterized northern Italian Psoriatic arthritis (PsA) case-control cohort, in search for associations specific to different PsA clinical sub-phenotypes. We examined 118 patients with PsA according to CASPAR criteria (mean age 57 ± 13, female 38.4 %, mean disease duration 13.9 ± 8.6 years, peripheral disease 83.8 %, axial manifestations 34.5 %, radiological erosive disease 49 %) compared with 248 controls of the same ethnic origin matched for age and sex. The presence of axial disease was defined by the clinical axial involvement and/or the presence of radiological alteration consistent with spondyloarthropathy according to New York criteria. The presence of peripheral disease (arthritis and/or enthesitis) was defined only on clinical basis. A total of 40 SNPs, mapping within the genes mentioned above, were genotyped in both groups and used to perform association analyses by subdividing the PsA sample into subgroups according to different clinical manifestations on the basis of axial and peripheral involvements. No differences between patients and controls were found in the distribution of the IL-17A, IL17-RA, IL-23A and IL-23R genes allelic variants. Comparing patients with axial disease versus those without, we found that axial manifestations were significantly associated with the presence of IL-23R rs12401432 GG homozygosity (26.8 % vs. 5.3 %, p corr = 0.019, OR 2.63 [95 % CI 1.13-6.16]). No differences in distribution of the allelic variants were found comparing patients with versus those without peripheral disease or patients with versus without radiological peripheral erosions. In PA patients of northern Italian origin, IL-17A, IL17-RA, IL-23A and IL-23R genes allelic variants are not associated with disease susceptibility. However, a strong association with the IL-23RA rs12401432 GG genotype is associated with axial involvement of the disease.
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Hébert H, Ali F, Bowes J, Griffiths C, Barton A, Warren R. Genetic susceptibility to psoriasis and psoriatic arthritis: implications for therapy. Br J Dermatol 2012; 166:474-82. [DOI: 10.1111/j.1365-2133.2011.10712.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Ellinghaus E, Stuart PE, Ellinghaus D, Nair RP, Debrus S, Raelson JV, Belouchi M, Tejasvi T, Li Y, Tsoi LC, Onken AT, Esko T, Metspalu A, Rahman P, Gladman DD, Bowcock AM, Helms C, Krueger GG, Koks S, Kingo K, Gieger C, Wichmann HE, Mrowietz U, Weidinger S, Schreiber S, Abecasis GR, Elder JT, Weichenthal M, Franke A. Genome-wide meta-analysis of psoriatic arthritis identifies susceptibility locus at REL. J Invest Dermatol 2011; 132:1133-40. [PMID: 22170493 PMCID: PMC3305829 DOI: 10.1038/jid.2011.415] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease affecting up to 30% of psoriasis vulgaris (PsV) cases and approximately 0.25% to 1% of the general population. To identify common susceptibility loci, we performed a meta-analysis of three imputed genome-wide association studies (GWAS) on psoriasis, stratified for PsA. A total of 1,160,703 SNPs were analyzed in the discovery set consisting of 535 PsA cases and 3,432 controls from Germany, the United States and Canada. We followed up two SNPs in 1,931 PsA cases and 6,785 controls comprising six independent replication panels from Germany, Estonia, the United States and Canada. In the combined analysis, a genome-wide significant association was detected at 2p16 near the REL locus encoding c-Rel (rs13017599, P=1.18×10−8, OR=1.27, 95% CI=1.18–1.35). The rs13017599 polymorphism is known to associate with rheumatoid arthritis (RA), and another SNP near REL (rs702873) was recently implicated in PsV susceptibility. However, conditional analysis indicated that rs13017599, rather than rs702873, accounts for the PsA association at REL. We hypothesize that c-Rel, as a member of the Rel/NF-κB family, is associated with PsA in the context of disease pathways that involve other identified PsA and PsV susceptibility genes including TNIP1, TNFAIP3 and NFκBIA.
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Affiliation(s)
- Eva Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Kiel, Germany.
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Docampo E, Giardina E, Riveira-Muñoz E, de Cid R, Escaramís G, Perricone C, Fernández-Sueiro JL, Maymó J, González-Gay MA, Blanco FJ, Hüffmeier U, Lisbona MP, Martín J, Carracedo Á, Reis A, Rabionet R, Novelli G, Estivill X. Deletion of LCE3C and LCE3B is a susceptibility factor for psoriatic arthritis: A study in Spanish and Italian populations and meta-analysis. ACTA ACUST UNITED AC 2011; 63:1860-5. [DOI: 10.1002/art.30340] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Cantini F, Niccoli L, Nannini C, Kaloudi O, Bertoni M, Cassarà E. Psoriatic arthritis: a systematic review. Int J Rheum Dis 2011; 13:300-17. [PMID: 21199465 DOI: 10.1111/j.1756-185x.2010.01540.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Psoriatic arthritis is an inflammatory rheumatic disorder of unknown etiology occurring in patients with psoriasis. The Classification Criteria for Psoriatic Arthritis study group has recently developed a validated set of classification criteria for psoriatic arthritis with a sensitivity of 91.4% and a specificity of 98.7%. Three main clinical patterns have been identified: oligoarticular (≤ 4 involved joints) or polyarticular (≥ 5 involved joints) peripheral disease and axial disease with or without associated peripheral arthritis. In this context distal interphalangeal arthritis and arthritis mutilans may occur. According to other reports, also in our centre, asymmetric oligoarthritis is the most frequent pattern at onset. Axial disease has been estimated between 5% and 36% of patients. It is characterized by an irregular involvement of the axial skeleton with a predilection for the cervical spine. Recurrent episodes of enthesitis and dactylitis represent a hallmark of psoriatic arthritis. In around 20% of cases distal extremity swelling with pitting edema of the hands or feet is observed. Unilateral acute iridocyclitis, usually recurrent in alternate fashion, is the most frequent extra-articular manifestation, and accelerated atherosclerosis is the prominent comorbidity. The clinical course of peripheral and axial psoriatic arthritis is usually less severe than rheumatoid arthritis and ankylosing spondylitis, respectively. Local corticosteroid injections and non-steroidal anti-inflammatory drugs are recommended in milder forms. Sulphasalazine and methotrexate are effective in peripheral psoriatic arthritis. Recent studies have provided evidence on the efficacy of anti-tumor necrosis factor-α drugs to control symptoms and to slow or arrest radiological disease progression.
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Affiliation(s)
- Fabrizio Cantini
- 2nd Department of Internal Medicine, Rheumatology Unit, Hospital Misericordia e Dolce, Prato, Italy.
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Bowes J, Eyre S, Flynn E, Ho P, Salah S, Warren RB, Marzo-Ortega H, Coates L, McManus R, Ryan AW, Kane D, Korendowych E, McHugh N, FitzGerald O, Packham J, Morgan AW, Griffiths CEM, Bruce IN, Worthington J, Barton A. Evidence to support IL-13 as a risk locus for psoriatic arthritis but not psoriasis vulgaris. Ann Rheum Dis 2011; 70:1016-9. [PMID: 21349879 PMCID: PMC3086035 DOI: 10.1136/ard.2010.143123] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective There is great interest in the identification of genetic factors that differentiate psoriatic arthritis (PsA) from psoriasis vulgaris (PsV), as such discoveries could lead to the identification of distinct underlying aetiological pathways. Recent studies identified single nucleotide polymorphisms (SNPs) in the interleukin 13 (IL-13) gene region as risk factors for PsV. Further investigations in one of these studies found the effect to be primarily restricted to PsA, thus suggesting the discovery of a specific genetic risk factor for PsA. Given this intriguing evidence, association to this gene was investigated in large collections of PsA and PsV patients and healthy controls. Methods Two SNPs (rs20541 and rs1800925) mapping to the IL-13 gene were genotyped in 1057 PsA and 778 type I PsV patients using the Sequenom genotyping platform. Genotype frequencies were compared to those of 5575 healthy controls. Additional analyses were performed in phenotypic subgroups of PsA (type I or II PsV and in those seronegative for rheumatoid factor). Results Both SNPs were found to be highly associated with susceptibility to PsA (rs1800925 ptrend = 6.1×10−5 OR 1.33, rs20541 ptrend = 8.0×10−4 OR 1.27), but neither SNP was significantly associated with susceptibility to PsV. Conclusions This study confirms that the effect of IL-13 risk locus is specific for PsA, thus highlighting a key biological pathway that differentiates PsA from PsV. The identification of markers that differentiate the two diseases raises the possibility in future of allowing screening of PsV patients to identify those at risk of developing PsA.
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Affiliation(s)
- John Bowes
- Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
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Rodríguez E, Eyerich K, Weidinger S. Genetik häufiger chronisch-entzündlicher Hauterkrankungen. Hautarzt 2011; 62:107-18. [DOI: 10.1007/s00105-010-2053-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Duffin KC, Woodcock J, Krueger GG. Genetic variations associated with psoriasis and psoriatic arthritis found by genome-wide association. Dermatol Ther 2010; 23:101-13. [PMID: 20415816 DOI: 10.1111/j.1529-8019.2010.01303.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Psoriasis and psoriatic arthritis are immune disorders with a complex polygenic basis. HLA-Cw6, which lies in the major histocompatibility region on chromosome 6, is considered the major genetic determinant of psoriasis. Recent genome-wide association studies have identified new variants outside of the MHC with relevance to the immunology of psoriasis. Variants in or near genes that encode subunits of cytokines (IL12B, IL23A) or cytokine receptors (IL23R) are interesting given that the gene product of IL12B, p40, is the target of a recently approved monoclonal antibody therapy for psoriasis (ustekinumab). Association with psoriasis and psoriatic arthritis has been found in TNFAIP3 and TNFIP1, ubiquitin ligases in the NF-kappaB pathway, and IL13, a Th2 cytokine. Copy number variation of human beta-defensin and late cornified envelope genes also associate with psoriasis. Many of these genetic variations also associate with immune disorders considered psoriatic co-morbidities, including Crohn's disease and diabetes.
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Bowes J, Flynn E, Ho P, Aly B, Morgan AW, Marzo-Ortega H, Coates L, McManus R, Ryan AW, Kane D, Korendowych E, McHugh N, FitzGerald O, Packham J, Bruce IN, Barton A. Variants in linkage disequilibrium with the late cornified envelope gene cluster deletion are associated with susceptibility to psoriatic arthritis. Ann Rheum Dis 2010; 69:2199-203. [PMID: 20643763 PMCID: PMC3002763 DOI: 10.1136/ard.2010.130575] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE A common deletion mapping to the psoriasis susceptibility locus 4 on chromosome 1q21, encompassing two genes of the late cornified envelope (LCE) gene cluster, has been associated with an increased risk of psoriasis vulgaris (PsV). One previous report found no association of the deletion with psoriatic arthritis (PsA), suggesting it may be a specific risk factor for PsV. Given the genetic overlap between PsA and PsV, a study was undertaken to investigate whether single nucleotide polymorphisms (SNPs) mapping to this locus are risk factors for PsA in a UK and Irish population. METHODS Three SNPs with prior evidence of association with susceptibility to PsV were genotyped in 1057 patients with PsA using Sequenom iPlex chemistry and genotype frequencies compared with data available for 5575 healthy controls. Two of the SNPs, rs4112788 and rs4085613, were reported to be highly correlated with the LCE deletion. The third SNP, rs6701216, was previously reported to be associated with PsV in a US population. RESULTS Alleles tagging the deletion for both rs4112788 and rs4085613 were found to be enriched in cases compared with controls (69% vs 65%) and significantly associated with increased susceptibility to PsA (p(trend) = 0.001, OR 1.19 and p(trend) = 0.001, OR 1.18, respectively). No association was observed with rs6701216. CONCLUSIONS The evidence presented here supports LCE deletion as a risk factor for PsA in a UK and Irish population. It suggests that this locus is a risk factor within a shared aetiological pathway that contributes to psoriatic skin disease in both PsV and PsA.
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Affiliation(s)
- John Bowes
- Arthritis Research UK Epidemiology Unit, Stopford Building, University of Manchester, Manchester, UK
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Karason A, Love TJ, Gudbjornsson B. A strong heritability of psoriatic arthritis over four generations--the Reykjavik Psoriatic Arthritis Study. Rheumatology (Oxford) 2009; 48:1424-8. [DOI: 10.1093/rheumatology/kep243] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hüffmeier U, Estivill X, Riveira-Munoz E, Traupe H, Wendler J, Lohmann J, Böhm B, Burkhardt H, Reis A. Deletion of LCE3C and LCE3B genes at PSORS4 does not contribute to susceptibility to psoriatic arthritis in German patients. Ann Rheum Dis 2009; 69:876-8. [PMID: 19439430 PMCID: PMC2925148 DOI: 10.1136/ard.2009.108951] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Introduction Psoriasis susceptibility locus 4 (PSORS4) is a susceptibility locus for psoriasis vulgaris (PsV), a common inflammatory, hyperproliferative skin disorder. Recently, a deletion of 2 late cornified envelope (LCE) genes within epidermal differentiation complex on chromosome 1 was shown to be enriched in 1426 patients with PsV, suggesting compromised barrier function in deletion carriers. This genetic association was subsequently confirmed in a German cohort. Methods In order to investigate whether this variant also predisposes to psoriatic arthritis (PsA), this deletion and 3 single nucleotide polymorphisms (SNPs) in strong linkage disequilibrium with it were genotyped in a case-control cohort of 650 patients and 937 control individuals of German origin. Results LCE deletion frequency did not significantly differ between patients with PsA and controls (65.0% vs 65.5%). Similarly, no evidence for association to the three SNPs was observed. Discussion This is the first non-human leucocyte antigen (HLA) risk factor predisposing only to skin type of psoriasis, supporting the concept of partially overlapping but different aetiological factors underlying skin and joint manifestations.
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Affiliation(s)
- Ulrike Hüffmeier
- Institute of Human Genetics, University Hospital Erlangen, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
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Nograles KE, Brasington RD, Bowcock AM. New insights into the pathogenesis and genetics of psoriatic arthritis. NATURE CLINICAL PRACTICE. RHEUMATOLOGY 2009; 5:83-91. [PMID: 19182814 PMCID: PMC2790861 DOI: 10.1038/ncprheum0987] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Accepted: 12/04/2008] [Indexed: 02/06/2023]
Abstract
Psoriasis vulgaris and psoriatic arthritis (PsA) are inter-related heritable diseases. Psoriatic skin is characterized by hyperproliferative, poorly differentiated keratinocytes and severe inflammation. Psoriatic joints are characterized by highly inflamed synovia and entheses with focal erosions of cartilage and bone. Genetic analyses have uncovered risk factors shared by both psoriasis and PsA. Predisposition to psoriasis and PsA arising from common variation is most strongly conferred by the HLA class I region. Other genetic risk factors implicate the interleukin (IL)-23 pathway and the induction and regulation of type 17 T-helper cells in the pathogenesis of both diseases. Secretion of cytokines, such as IL-22 and IL-17, could result in the hyperproliferative phenotype of keratinocytes and potentially synoviocytes, leading to a vicious cycle of cellular proliferation and inflammation in both the skin and joints. In synovial tissue, disease-related cytokines could also promote osteoclast formation, resulting in bone erosion. The next step will be to identify genetic risk factors specifically associated with PsA. Although therapies that target tumor necrosis factor are often highly successful in the treatment of both diseases, genetic findings are likely to lead to the development of treatments tailored to an individual's genetic profile.
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Affiliation(s)
- Kristine E Nograles
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
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Pedersen OB, Junker P. On the recurrence risk of arthritis among psoriatic patients. Scand J Rheumatol Suppl 2009; 38:321-2. [DOI: 10.1080/03009740902776901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Filer C, Ho P, Smith RL, Griffiths C, Young HS, Worthington J, Bruce IN, Barton A. Investigation of association of the IL12B and IL23R genes with psoriatic arthritis. ARTHRITIS AND RHEUMATISM 2008; 58:3705-9. [PMID: 19035472 PMCID: PMC3001112 DOI: 10.1002/art.24128] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Accepted: 08/29/2008] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Recent reports have confirmed association of single-nucleotide polymorphisms (SNPs) mapping to the interleukin-23 receptor (IL-23R) and IL-12beta genes with psoriasis susceptibility. The aim of this study was to determine whether these variants are also associated with susceptibility to psoriatic arthritis (PsA). METHODS Two IL23R SNPs (rs7530511 and rs11209026) and 2 IL12B SNPs (rs3212227 and rs6887695) were genotyped in DNA samples from 520 white patients with PsA and 2,260 control subjects, all of whom resided in the UK. For SNP rs3212227, data on a larger group of controls (n = 4,681) were publicly available; this information was used in the analysis. Genotype counts were compared between patients with PsA and population controls, using the trend test. RESULTS A haplotype comprising carriage of the common variants of both IL23R SNPs was associated with PsA susceptibility (adjusted P = 0.013 [1,000 permutations]). Both IL12B SNPs were independently associated with PsA susceptibility, and this association was strongest under a dominant model, with homozygosity for the common allele being more frequent in patients with PsA than in control subjects: for rs3212227, the odds ratio (OR) for carriage of AA versus other genotypes was 1.43 (95% confidence interval [95% CI] 1.17-1.76); for rs6887695, the OR for carriage of GG versus other genotypes was 1.43 (95% CI 1.18-1.74). CONCLUSION Variation within IL23R and IL12B is associated with susceptibility to both psoriasis and PsA. The effect sizes observed in patients with PsA appear to be smaller than those previously reported in patients with psoriasis, suggesting that both loci are primarily associated with psoriasis susceptibility. However, this does support the idea that the genetic etiology of the psoriasis present in patients with PsA has susceptibility loci in common with those observed in patients with uncomplicated psoriasis.
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Affiliation(s)
| | | | | | | | - Helen S Young
- Hope Hospital, and University of ManchesterManchester, UK
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Liu Y, Helms C, Liao W, Zaba LC, Duan S, Gardner J, Wise C, Miner A, Malloy MJ, Pullinger CR, Kane JP, Saccone S, Worthington J, Bruce I, Kwok P, Menter A, Krueger J, Barton A, Saccone NL, Bowcock AM. A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci. PLoS Genet 2008; 4:e1000041. [PMID: 18369459 PMCID: PMC2274885 DOI: 10.1371/journal.pgen.1000041] [Citation(s) in RCA: 528] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Accepted: 02/28/2008] [Indexed: 12/11/2022] Open
Abstract
A genome-wide association study was performed to identify genetic factors involved in susceptibility to psoriasis (PS) and psoriatic arthritis (PSA), inflammatory diseases of the skin and joints in humans. 223 PS cases (including 91 with PSA) were genotyped with 311,398 single nucleotide polymorphisms (SNPs), and results were compared with those from 519 Northern European controls. Replications were performed with an independent cohort of 577 PS cases and 737 controls from the U.S., and 576 PSA patients and 480 controls from the U.K.. Strongest associations were with the class I region of the major histocompatibility complex (MHC). The most highly associated SNP was rs10484554, which lies 34.7 kb upstream from HLA-C (P = 7.8x10(-11), GWA scan; P = 1.8x10(-30), replication; P = 1.8x10(-39), combined; U.K. PSA: P = 6.9x10(-11)). However, rs2395029 encoding the G2V polymorphism within the class I gene HCP5 (combined P = 2.13x10(-26) in U.S. cases) yielded the highest ORs with both PS and PSA (4.1 and 3.2 respectively). This variant is associated with low viral set point following HIV infection and its effect is independent of rs10484554. We replicated the previously reported association with interleukin 23 receptor and interleukin 12B (IL12B) polymorphisms in PS and PSA cohorts (IL23R: rs11209026, U.S. PS, P = 1.4x10(-4); U.K. PSA: P = 8.0x10(-4); IL12B:rs6887695, U.S. PS, P = 5x10(-5) and U.K. PSA, P = 1.3x10(-3)) and detected an independent association in the IL23R region with a SNP 4 kb upstream from IL12RB2 (P = 0.001). Novel associations replicated in the U.S. PS cohort included the region harboring lipoma HMGIC fusion partner (LHFP) and conserved oligomeric golgi complex component 6 (COG6) genes on chromosome 13q13 (combined P = 2x10(-6) for rs7993214; OR = 0.71), the late cornified envelope gene cluster (LCE) from the Epidermal Differentiation Complex (PSORS4) (combined P = 6.2x10(-5) for rs6701216; OR 1.45) and a region of LD at 15q21 (combined P = 2.9x10(-5) for rs3803369; OR = 1.43). This region is of interest because it harbors ubiquitin-specific protease-8 whose processed pseudogene lies upstream from HLA-C. This region of 15q21 also harbors the gene for SPPL2A (signal peptide peptidase like 2a) which activates tumor necrosis factor alpha by cleavage, triggering the expression of IL12 in human dendritic cells. We also identified a novel PSA (and potentially PS) locus on chromosome 4q27. This region harbors the interleukin 2 (IL2) and interleukin 21 (IL21) genes and was recently shown to be associated with four autoimmune diseases (Celiac disease, Type 1 diabetes, Grave's disease and Rheumatoid Arthritis).
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Arthritis, Psoriatic/genetics
- Arthritis, Psoriatic/immunology
- Autoimmunity/genetics
- Case-Control Studies
- Child
- Chromosomes, Human, Pair 13/genetics
- Chromosomes, Human, Pair 15/genetics
- Chromosomes, Human, Pair 4/genetics
- Cohort Studies
- Female
- Genes, MHC Class I
- Genetic Predisposition to Disease
- Genome, Human
- Humans
- Interleukin-12 Subunit p40/genetics
- Male
- Middle Aged
- Polymorphism, Single Nucleotide
- Psoriasis/genetics
- Psoriasis/immunology
- Receptors, Interleukin/genetics
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Affiliation(s)
- Ying Liu
- Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Cynthia Helms
- Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Wilson Liao
- Cardiovascular Research Institute and Center for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
| | - Lisa C. Zaba
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, United States of America
| | - Shenghui Duan
- Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Jennifer Gardner
- Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Carol Wise
- Seay Center for Musculoskeletal Research, Texas Scottish Rite Hospital for Children, Dallas, Texas, United States of America
| | - Andrew Miner
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - M. J. Malloy
- Cardiovascular Research Institute and Center for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
| | - Clive R. Pullinger
- Cardiovascular Research Institute and Center for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
| | - John P. Kane
- Cardiovascular Research Institute and Center for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
| | - Scott Saccone
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Jane Worthington
- Arc Epidemiology Research Unit, University of Manchester, Manchester, United Kingdom
| | - Ian Bruce
- Arc Epidemiology Research Unit, University of Manchester, Manchester, United Kingdom
| | - Pui–Yan Kwok
- Cardiovascular Research Institute and Center for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
| | - Alan Menter
- Department of Internal Medicine, Division of Dermatology, Baylor University Medical Center, Dallas, Texas, United States of America
| | - James Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, United States of America
| | - Anne Barton
- Arc Epidemiology Research Unit, University of Manchester, Manchester, United Kingdom
| | - Nancy L. Saccone
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Anne M. Bowcock
- Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail:
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Myers H, Nicholls E, Handy J, Peat G, Thomas E, Duncan R, Wood L, Marshall M, Tyson C, Hay E, Dziedzic K. The Clinical Assessment Study of the Hand (CAS-HA): a prospective study of musculoskeletal hand problems in the general population. BMC Musculoskelet Disord 2007; 8:85. [PMID: 17760988 PMCID: PMC2000877 DOI: 10.1186/1471-2474-8-85] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Accepted: 08/30/2007] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pain in the hand affects an estimated 12-21% of the population, and at older ages the hand is one of the most common sites of pain and osteoarthritis. The association between symptomatic hand osteoarthritis and disability in everyday life has not been studied in detail, although there is evidence that older people with hand problems suffer significant pain and disability. Despite the high prevalence of hand problems and the limitations they cause in older adults, little attention has been paid to the hand by health planners and policy makers. We plan to conduct a prospective, population-based, observational cohort study designed in parallel with our previously reported cohort study of knee pain, to describe the course of musculoskeletal hand problems in older adults and investigate the relative merits of different approaches to classification and defining prognosis. METHODS/DESIGN All adults aged 50 years and over registered with two general practices in North Staffordshire will be invited to take part in a two-stage postal survey. Respondents to the survey who indicate that they have experienced hand pain or problems within the previous 12 months will be invited to attend a research clinic for a detailed assessment. This will consist of clinical interview, hand assessment, screening test of lower limb function, digital photography, plain x-rays, anthropometric measurement and brief self-complete questionnaire. All consenting clinic attenders will be followed up by (i) general practice medical record review, (ii) repeat postal questionnaire at 18-months, and (iii) repeat postal questionnaire at 3 years. DISCUSSION This paper describes the protocol for the Clinical Assessment Study of the Hand (CAS-HA), a prospective, population-based, observational cohort study of community-dwelling older adults with hand pain and hand problems based in North Staffordshire.
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Affiliation(s)
- Helen Myers
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Elaine Nicholls
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - June Handy
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - George Peat
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Elaine Thomas
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Rachel Duncan
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Laurence Wood
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Michelle Marshall
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Catherine Tyson
- North Staffordshire Combined Healthcare NHS Trust, Stoke-on-Trent, Staffordshire, ST2 8LD, UK
| | - Elaine Hay
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Krysia Dziedzic
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK
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