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Hsieh JP, Lee YH, Wun BJ, Wang YH, Tsou HK, Wei JCC. No increased risk of alopecia in ankylosing spondylitis patients: A population-based cohort study in Taiwan. Int J Rheum Dis 2022; 25:937-944. [PMID: 35880581 DOI: 10.1111/1756-185x.14393] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
AIM To investigate the association between ankylosing spondylitis (AS) and alopecia. METHODS In this cohort study, data from over 1 000 000 patients in the Taiwan Longitudinal Health Insurance Database were extracted. We selected newly diagnosed (outpatient department visit three or more times or admission at least once) patients with AS (ICD-9-CM = 720.0) from 2000 to 2012. For the non-AS comparison group, patients never diagnosed with AS were chosen from 1999 to 2013. In all, 3640 AS patients and 14 560 non-AS controls were selected. Cox proportional hazard model and Kaplan-Meier analysis were used to present the results. The adjusted hazard ratio (HR) in the Cox proportional hazard model was adjusted for age, sex, hypertension, hyperlipidemia, diabetes, atopic dermatitis, and mental disorder. RESULTS No increased risk of alopecia in AS patients was shown in the Cox proportional hazard model (crude HR 1.16, P = 0.595; adjusted HR 1.16, P = 0.599). Negative results are found as well in subgroup analysis of different age, sex (age 20-40 y: HR 1.03, P = 0.925; Age ≥40 y: HR 1.49, P = 0.406; Female: HR 1.17, P = 0.759; Male: HR 1.15, P = 0.667), and phenotypes of alopecia (androgenetic alopecia: HR 1.19, 95% confidence interval [CI] 0.58-2.41; alopecia areata: HR 0.98, 95% CI 0.37-2.62). A significant positive correlation is found between atopic dermatitis and alopecia (adjusted HR 8.05, P = 0.039). CONCLUSION In this population-based cohort study, we found no association of risk of alopecia and AS.
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Affiliation(s)
- Jason Peijer Hsieh
- Department of Orthopedics, Taipei Veterans General Hospital, Taipei, Taiwan ROC
| | - Yung-Heng Lee
- Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu, Taiwan ROC.,Department of Recreation and Sport Management, Shu-Te University, Kaohsiung, Taiwan ROC.,Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan ROC
| | - Bo-Jyun Wun
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan ROC
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan ROC
| | - Hsi-Kai Tsou
- Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan ROC.,Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan ROC.,College of Medicine, National Chung Hsing University, Taichung, Taiwan ROC
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan ROC.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan ROC.,Institute of Integrative Medicine, China Medical University, Taichung, Taiwan ROC
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Kocaaga A, Kocaaga M. Psoriasis: An Immunogenetic Perspective. Glob Med Genet 2022; 9:82-89. [PMID: 35707771 PMCID: PMC9192173 DOI: 10.1055/s-0042-1743259] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/29/2021] [Indexed: 11/09/2022] Open
Abstract
Psoriasis is an erythematous-squamous dermatosis with a polygenic inheritance history. Both environmental and genetic factors play a role in the etiology of the disease. Over the past two decades, numerous linkage analyzes and genome-wide association studies have been conducted to investigate the role of genetic variation in disease pathogenesis and progression. To date, >70 psoriasis susceptibility loci have been identified, including HLA-Cw6, IL12B, IL23R, and LCE3B/3C. Some genetic markers are used in clinical diagnosis, prognosis, treatment, and personalized new drug development that can further explain the pathogenesis of psoriasis. This review summarizes the immunological mechanisms involved in the etiopathogenesis of psoriasis and recent advances in susceptibility genes and highlights new potential targets for therapeutic intervention.
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Affiliation(s)
- Ayca Kocaaga
- Department of Medical Genetics, Eskişehir City Hospital, Eskisehir, Turkey
| | - Mustafa Kocaaga
- Department of Medical Microbiology, Yunus Emre State Hospital, Eskisehir, Turkey
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3
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Lorenzin M, Ortolan A, Vio S, Cozzi G, Scapin V, De Conti G, Doria A, Ramonda R. Psoriasis and Imaging Progression in early Axial Spondyloarthritis: Results from a 48-month follow-up (Italian arm of SPACE study). Rheumatology (Oxford) 2021; 61:2375-2387. [PMID: 34605894 DOI: 10.1093/rheumatology/keab728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/13/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To assess the influence of psoriasis on spinal/pelvic radiographic progression and magnetic resonance imaging (MRI) features in early-stage axial spondyloarthritis (axSpA). METHODS Analysis of baseline data from the Italian SPACE cohort, including patients with chronic-back-pain (CBP; duration ≥ 3 months and ≤2 years; onset <45 years) was performed. Patients underwent a diagnostic work-up, including MRI and X-rays of the sacroiliac joints (SIJ), to establish diagnosis of axSpA (ASAS criteria). Clinical features, disease activity and functional indices, imaging were collected at baseline and yearly during 48-months. Spinal and SIJ X-rays and MRIs were scored by 2 readers following SPARCC, mSASSS and mNY-criteria. Characteristics of axSpA patients with/without psoriasis were compared over-time with descriptive statistics; multivariate-logistic-regression model was constructed to assess predictors of spinal/pelvic radiographic progression. RESULTS 88 patients had axSpA (84.1% non-radiographic; 15.9% radiographic); 36.4% had psoriasis. Patients with psoriasis were older; less frequently had HLA-B27+ and radiographic sacroiliitis with unilateral/asymmetric pattern and more signs of spondylitis. Functional and disease activity indices decreased with slightly higher BASDAI and BASFI in axSpA with psoriasis. All patients showed slight spinal/pelvic radiographic progression. Patients without psoriasis showed increased sacroiliitis progression and low-grade spinal progression. More inflammatory corner lesions on cervical/thoracic MRI-spine were observed in patients with psoriasis. Significant downtrend of SPARCC SIJ/spine scores in all patients was found. Psoriasis was a predictor of increased spinal progression (OR = 0.18; 95%CI : 0.04-0.78). CONCLUSIONS Psoriasis was associated with distinct axSpA features, increased spinal radiographic progression and low-grade radiographic sacroiliitis.
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Affiliation(s)
- Mariagrazia Lorenzin
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Augusta Ortolan
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Stefania Vio
- Radiology Unit, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Giacomo Cozzi
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Vanna Scapin
- Radiology Unit, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Giorgio De Conti
- Radiology Unit, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Giustiniani 2, Padova, 35128, Italy
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4
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The association of HLA-C and ERAP1 polymorphisms in early and late onset psoriasis and psoriatic arthritis patients of Hungary. Postepy Dermatol Alergol 2021; 38:43-51. [PMID: 34408565 PMCID: PMC8362786 DOI: 10.5114/ada.2021.104277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 06/28/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Single nucleotide polymorphisms (SNPs) of the HLA-C and ERAP1 genes were recently determined to contribute to psoriasis susceptibility. However, data regarding the association of these genes with specific subgroups of psoriasis are scarce. Aim To examine the possible association of the HLA-C and ERAP-1 polymorphisms with early and late onset psoriasis and psoriatic arthritis. Material and methods Five ERAP1 SNPs and two HLA-C SNPs were genotyped in 105 psoriatic arthritis patients, 214 cutaneous psoriasis patients and 200 healthy individuals. Haplotypes were constructed for three ERAP1 SNPs (rs17482078, rs10050860, rs30187), and interaction between HLA-Cw*0602 and ERAP1 was also analysed. Results The HLA-Cw*0602 rs10484554 SNP was found to be a strong susceptibility factor for early onset cutaneous psoriasis and early onset psoriatic arthritis. ERAP1 SNPs (rs10050860, rs17482078, rs27525) appear to have a protective function for early onset psoriatic arthritis. The haplotype B was identified as a susceptibility factor for late onset psoriatic arthritis. In HLA-C positive individuals the rs27524 ERAP1 SNP was associated with a significantly increased risk of psoriatic arthritis development, whereas the rs27525 ERAP1 SNP had the opposite effect. Conclusions These results suggest that the HLA-C and ERAP1 genes contribute to the pathogenesis of psoriasis and psoriatic arthritis in an age-dependent manner.
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5
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Insights into the pathogenesis of psoriatic arthritis from genetic studies. Semin Immunopathol 2021; 43:221-234. [PMID: 33712923 DOI: 10.1007/s00281-021-00843-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/19/2021] [Indexed: 12/20/2022]
Abstract
Psoriatic arthritis (PsA) is a relatively common inflammatory arthritis, a spondyloarthritis (SpA), that occurs most often in patients with psoriasis, a common immune-mediated inflammatory skin disease. Both psoriasis and PsA are highly heritable. Genetic and recent genomic studies have identified variants associated with psoriasis and PsA, but variants differentiating psoriasis from PsA are few. In this review, we describe recent developments in understanding the genetic burden of PsA, linkage, association and epigenetic studies. Using pathway analysis, we provide further insights into the similarities and differences between PsA and psoriasis, as well as between PsA and other immune-mediated inflammatory diseases, particularly ankylosing spondylitis, another SpA. Environmental factors that may trigger PsA in patients with psoriasis are also reviewed. To further understand the pathogenetic differences between PsA and psoriasis as well as other SpA, larger cohort studies of well-phenotyped subjects with integrated analysis of genomic, epigenomic, transcriptomic, proteomic and metabolomic data using interomic system biology approaches are required.
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6
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Applying precision medicine to unmet clinical needs in psoriatic disease. Nat Rev Rheumatol 2020; 16:609-627. [PMID: 33024296 DOI: 10.1038/s41584-020-00507-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 02/08/2023]
Abstract
Psoriatic disease (PsD) is a heterogeneous condition that can affect peripheral and axial joints (arthritis), entheses, skin (psoriasis) and other structures. Over the past decade, considerable advances have been made both in our understanding of the pathogenesis of PsD and in the treatment of its diverse manifestations. However, several major areas of continued unmet need in the care of patients with PsD have been identified. One of these areas is the prediction of poor outcome, notably radiographic outcome in patients with psoriatic arthritis, so that stratified medicine approaches can be taken; another is predicting response to the numerous current and emerging therapies for PsD, so that precision medicine can be applied to rapidly improve clinical outcome and reduce the risk of toxicity. In order to address these needs, novel approaches, including imaging, tissue analysis and the application of proteogenomic technologies, are proposed as methodological solutions that will assist the dissection of the critical immune-metabolic pathways in this complex disease. Learning from advances made in other inflammatory diseases, it is time to address these unmet needs in a multi-centre partnership aimed at improving short-term and long-term outcomes for patients with PsD.
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7
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Chimenti MS, Triggianese P, De Martino E, Conigliaro P, Fonti GL, Sunzini F, Caso F, Perricone C, Costa L, Perricone R. An update on pathogenesis of psoriatic arthritis and potential therapeutic targets. Expert Rev Clin Immunol 2019; 15:823-836. [PMID: 31177868 DOI: 10.1080/1744666x.2019.1627876] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Innate immune response and bone remodeling are key factors contributing to the pathogenesis of psoriatic arthritis (PsA). Moreover, the evidence of autoantibodies in patients' sera suggests an autoimmune side in PsA. Besides the immune pathways, studies strongly support the role of genetic risk alleles in affecting the clinical heterogeneity of PsA as well as the response to therapy. A good clinical response to treatment, indeed, represents a challenge in PsA patients and the identification of patient-targeted therapies is still a critical issue. Areas covered: We performed a systematic review aiming at describing new evidence on PsA pathogenesis and treatments. Reported items for systematic reviews (PRISMA checklist) were analyzed. Studies included from the PubMed database addressed the following items: innate immunity, autoimmunity, bone remodeling, and therapeutic targets in PsA; time frame of research 1970-2019. Specifically, we reviewed data on IL-17 inhibitors, abatacept, JAK inhibitors, ABT 122, and A (3) adenosine receptors agonist, CF101. Expert opinion: In PsA an intriguing pathogenetic network has been documented. Several biological and synthetic drugs are promising in terms of efficacy and safety profile.
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Affiliation(s)
- Maria Sole Chimenti
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Paola Triggianese
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Erica De Martino
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Paola Conigliaro
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Giulia Lavinia Fonti
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Flavia Sunzini
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Francesco Caso
- b Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University Federico II , Naples , Italy
| | - Carlo Perricone
- c Arthritis Center, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome , Italy
| | - Luisa Costa
- b Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University Federico II , Naples , Italy
| | - Roberto Perricone
- a Rheumatology, allergology and clinical immunology, Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy
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8
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Furst DE, Belasco J, Louie JS. Genetic and inflammatory factors associated with psoriatic arthritis: Relevance to diagnosis and management. Clin Immunol 2019; 202:59-75. [DOI: 10.1016/j.clim.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/21/2019] [Accepted: 02/04/2019] [Indexed: 12/22/2022]
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9
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DNA methylation and transcriptome signature of the IL12B gene in ankylosing spondylitis. Int Immunopharmacol 2019; 71:109-114. [PMID: 30889422 DOI: 10.1016/j.intimp.2019.03.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Ankylosing spondylitis (AS) is an autoimmune disease without a reliable biomarker. This study investigated the IL12B gene methylation as a robust marker by integrating DNA methylation and mRNA data. METHODS A two-stage design was used for methylome and transcriptome investigation. The first phase detected methylation level from 99 AS patients and 99 healthy controls (HCs) whilst the second phase measured mRNA level from 20 patients and 20 HCs. We conducted analysis of differential methylation sites and receiver operating characteristic (ROC) as well as mRNA level to verify methylation. RESULTS We investigated 37 methylation sites that were mapped to 2 CpG islands (IL12B-1 and IL12B-2). Compared with HCs, the two islands were hypermethylated (IL12B-1: P = 4.6 ∗ 10 ^ -4; IL12B-2: P = 1.3 ∗ 10 ^ -5) and the mRNA level was overexpressed (P = 0.004) in AS patients. The subgroup analysis results showed a significant hypermethylation of the two islands in B27 positive group (IL12B-1: P = 3.7 ∗ 10 ^ -4; IL12B-2: P = 3.7 ∗ 10 ^ -6) and in male patients (IL12B-1: P = 4.9 ∗ 10 ^ -4; IL12B-2: P = 7.2 ∗ 10 ^ -6). ROC results found that the IL12B-1 island had a sensitivity of 62.6% and a specificity of 66.7%, and the IL12B-2 had a sensitivity of 50.0% and a specificity of 77.7%. CONCLUSION DNA methylation and transcriptome signature of the IL12B gene can discriminate AS patients from HCs, and hypermethylation of the IL12B may contribute to the pathogenesis of AS.
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10
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Hemmatzadeh M, Babaie F, Ezzatifar F, Mohammadi FS, Ebrazeh M, Golabi Aghdam S, Hajaliloo M, Azizi G, Gowhari Shabgah A, Shekari N, Sehati N, Hosseinzadeh R, Mohammadi H, Babaloo Z. Susceptibility to ERAP1 gene single nucleotide polymorphism modulates the inflammatory cytokine setting in ankylosing spondylitis. Int J Rheum Dis 2019; 22:715-724. [PMID: 30740926 DOI: 10.1111/1756-185x.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 12/26/2018] [Accepted: 01/04/2019] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the association of ERAP1 gene single nucleotide polymorphisms (SNPs) with the risk of ankylosing spondylitis (AS) and their role in modulation of the inflammatory interleukin (IL)-17/IL-23 axis in the disease. METHODS For genotyping, 190 AS cases and 190 healthy controls were enrolled. After DNA extraction, all the subjects were genotyped for rs17482078, rs469876, and rs27038 polymorphisms using single specific primer polymerase chain reaction (PCR) assay. After isolation of peripheral blood mononuclear cells, RNA extraction and complementary DNA synthesis, real-time PCR using SYBR Green master mix was employed to determine messenger RNA (mRNA) expression of IL-17A and IL-23 in PBMCs. Using enzyme-linked immunosorbent assay, the concentration of these cytokines was determined in serum samples. RESULTS It was observed that the A allele of rs27038 polymorphism significantly increased AS risk (odds ratio [OR] = 1.53, 95% CI =1.11-2.12; P = 0.0096). Moreover, AA and AG genotypes of this SNP were associated with increased (OR = 2.89, 95% CI = 1.42-5.85; P = 0.0031) and decreased (OR = 0.57, 95% CI = 0.36-0.92; P = 0.021), respectively, risk of the disease. The rs27038 SNP was associated with C-reactive protein level. There were significantly increased mRNA and serum concentrations of both IL-17A and IL-23 in AS patients compared with controls. Furthermore, AS patients with the AA in comparison to other genotypes for rs27038 SNP indicated significantly increased mRNA and serum concentration levels for both cytokines. CONCLUSIONS This study demonstrated the association of ERAP1 gene rs27038 polymorphism with the risk of AS in an Iranian population. Additionally, it seems that rs27038 is involved in the modulation of the inflammatory IL-17/IL-23 axis in AS.
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Affiliation(s)
- Maryam Hemmatzadeh
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Babaie
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Ezzatifar
- Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh S Mohammadi
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrdad Ebrazeh
- Department of Biology, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Shirin Golabi Aghdam
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrzad Hajaliloo
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Azizi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Immunology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Najibeh Shekari
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Sehati
- Department of Genetic, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Ramin Hosseinzadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Mohammadi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Babaloo
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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11
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Loures MAR, Alves HV, de Moraes AG, Santos TDS, Lara FF, Neves JSF, Macedo LC, Teixeira JJV, Sell AM, Visentainer JEL. Association of TNF, IL12, and IL23 gene polymorphisms and psoriatic arthritis: meta-analysis. Expert Rev Clin Immunol 2019; 15:303-313. [PMID: 30584776 DOI: 10.1080/1744666x.2019.1564039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic skin and joint condition that considerably affects patient quality of life. Several studies have demonstrated different associations of genetic polymorphisms in the pathogenic process of PsA. Therefore, we conducted a meta-analysis to estimate the effect of polymorphisms in the cytokines TNF, IL12B, IL23A, and IL23R on PsA risk. METHODS We screened 1,097 abstracts and identified 14 relevant studies published between January 2007 and December 2017. A systematic search was conducted in PubMed, Web of Knowledge and Scopus databases. Meta-analyses were performed for the comparisons of alleles and multiple genetic models. RESULTS Among the cytokines studied, we found 17 polymorphisms that were the most investigated. The association to PsA was observed in the presence of polymorphisms: TNF-238 G > A (rs361525), -308 G > A (rs1800629), and -857 C > T (rs1799724); IL12B C > G (rs6887695) and A > C (rs3212227); IL23A A > G (rs2066808) and IL23R G > A (rs11209026). CONCLUSION Our findings suggest that these variant cytokine genes may strongly influence the immunological response of PsA.
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Affiliation(s)
- Marco Antonio Rocha Loures
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Hugo Vicentin Alves
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Amarilis Giaretta de Moraes
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Thaís da Silva Santos
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Fernanda Formaggi Lara
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Janisleya Silva Ferreira Neves
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Luciana Conci Macedo
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Jorge Juarez Vieira Teixeira
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Ana Maria Sell
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil
| | - Jeane Eliete Laguila Visentainer
- a Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine , Maringá State University , Maringá , Brazil.,b Immunogenetics Laboratory, Department of Basic Health Sciences , Maringá State University , Maringá , Brazil
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12
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Ivanova M, Manolova I, Miteva L, Gancheva R, Stoilov R, Stanilova S. Genetic variations in the IL-12B gene in association with IL-23 and IL-12p40 serum levels in ankylosing spondylitis. Rheumatol Int 2018; 39:111-119. [PMID: 30443744 DOI: 10.1007/s00296-018-4204-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/08/2018] [Indexed: 12/22/2022]
Abstract
In the present study, we evaluated the implication of IL12Bpro (rs17860508) and IL12B 3' UTR A/C single nucleotide polymorphisms (SNPs) (rs3212227) for the ankylosing spondylitis (AS) development and the impact of IL12B genetic variations on IL-23 and IL-12p40 production and musculoskeletal disease characteristics. 80 patients with AS and 242 healthy controls were studied. Genotyping for the rs3212227 was performed by restriction fragment length polymorphisms-polymerase chain reaction (PCR) and for the rs17860508 by allele-specific PCR. Cytokines were measured by an enzyme-linked immunosorbent assay (ELISA). Clinical status was evaluated by calculation of the Ankylosing Spondylitis Disease Activity Score (ASDAS) using the C-reactive protein (CRP) level, the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI). An association was found for the rs17860508 polymorphism with AS under the allelic, the dominant, and the co-dominant models. Rs3212227 was not attributable to AS susceptibility by itself, but the carriage of C allele in the genotype amplifies the genetic risk for AS in the carriers of the high-risk IL12Bpro 2-allele, especially in homozygosity. Circulating IL-23 and IL-12p40 were raised among AS patients, as some of the genotypes of both IL12B polymorphisms positively regulate their expression. Carriage of the IL12Bpro genotype 2.2 has been linked to a worsened functional disability, while 3' UTR CC genotype-with severe disease activity. IL12B polymorphisms can impact AS susceptibility and modulate IL-23 and IL-12p40 production levels, and have a contribution to the disease phenotype.
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Affiliation(s)
- Mariana Ivanova
- Clinic of Rheumatology, Medical Faculty, University Hospital "St. Ivan Rilski", Medical University, 13, Urvich St, 1612, Sofia, Bulgaria.
| | - Irena Manolova
- Department of Molecular Biology, Immunology and Medical Genetics, Medical Faculty, Trakia University, 11, Armeiska St, 6003, Stara Zagora, Bulgaria.
| | - Lyuba Miteva
- Department of Molecular Biology, Immunology and Medical Genetics, Medical Faculty, Trakia University, 11, Armeiska St, 6003, Stara Zagora, Bulgaria
| | - Rada Gancheva
- Clinic of Rheumatology, Medical Faculty, University Hospital "St. Ivan Rilski", Medical University, 13, Urvich St, 1612, Sofia, Bulgaria
| | - Rumen Stoilov
- Clinic of Rheumatology, Medical Faculty, University Hospital "St. Ivan Rilski", Medical University, 13, Urvich St, 1612, Sofia, Bulgaria
| | - Spaska Stanilova
- Department of Molecular Biology, Immunology and Medical Genetics, Medical Faculty, Trakia University, 11, Armeiska St, 6003, Stara Zagora, Bulgaria
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13
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Haroon M, Ahmad M, Baig MN, Mason O, Rice J, FitzGerald O. Inflammatory back pain in psoriatic arthritis is significantly more responsive to corticosteroids compared to back pain in ankylosing spondylitis: a prospective, open-labelled, controlled pilot study. Arthritis Res Ther 2018; 20:73. [PMID: 29665824 PMCID: PMC5905178 DOI: 10.1186/s13075-018-1565-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/13/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The efficacy of corticosteroids in patients with psoriatic arthritis (PsA) and inflammatory back pain has not been studied to date. In this controlled trial, we aimed to investigate the comparative performance of corticosteroids in patients with active axial-PsA (AxPsA) versus those with active ankylosing spondylitis (AS). METHODS Patients with AxPsA and AS (naïve to biologic therapies), who not only had clinically active disease, but also had bone marrow oedema on magnetic resonance imaging of the sacroiliac joints, were recruited. Clinically active disease was defined as inflammatory back pain (fulfilling Assessment of Spondyloarthritis International Society (ASAS) expert criteria), with spinal pain score (numerical rating scale 0-10) ≥4 and Bath AS Disease Activity Index (BASDAI) score ≥4 despite taking nonsteroidal anti-inflammatory drugs. Moreover, we recruited a control group of patients with non-inflammatory lower back pain. All patients received a single, intra-muscular dose of depot corticosteroid injection (triamcinolone acetonide 80 mg) at baseline. The intra-muscular corticosteroid option was used to overcome any drug compliance issues. Clinical outcome assessments were made at the following time points: baseline, week 2, and week 4. The primary efficacy end point was mean change in Ankylosing Spondylitis Disease Activity Score (ASDAS) at week 2. Key secondary outcomes were mean change in the BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI) and Ankylosing Spondylitis Quality of Life (ASQoL) at weeks 2 and 4. RESULTS In total, 40 patients were recruited (15 with AxPsA, 15 with AS, and 10 controls). At week 2 following corticosteroid treatment, patients with AxPsA had significantly greater improvement in the mean ASDAS compared to patients with AS (1.43 ± 0.39 vs. 1.03 ± 0.30, p = 0.004), and also when compared to controls (p < 0.001). At week-4, similar significant trend of ASDAS improvement was seen among AxPsA patients compared to AS patients (1.09 ± 0.32 vs. 0.77 ± 0.27, p = 0.007) and controls (p < 0.001). Similarly, the mean BASDAI, visual analogue scale spinal pain score, ASQoL and BASFI improved significantly among patients with AxPsA compared to patients with AS and controls at week 2 (p < 0.05), with this trend also largely maintained at week 4. CONCLUSIONS Axial inflammation in patients with PsA responds significantly better to corticosteroids than in patients with AS. This furthers the argument and adds to the growing evidence that AxPsA and AS are distinct entities.
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Affiliation(s)
- Muhammad Haroon
- Division of Rheumatology, Department of Medicine, University Hospital Kerry, Tralee, Ireland.
| | - Muddassar Ahmad
- Division of Rheumatology, Department of Medicine, University Hospital Kerry, Tralee, Ireland
| | | | - Olivia Mason
- CSTAR (Centre for Support and Training in Analysis and Research), University College Dublin, Dublin, Ireland
| | - John Rice
- Department of Orthopaedics, University Hospital Kerry, Tralee, Ireland
| | - Oliver FitzGerald
- Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland
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Abstract
Psoriasis is a multifactorial disease with a strong genetic background. HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. It is repeatedly observed to affect disease course, phenotypic features, severity, comorbidities and treatment outcomes. To the best of our knowledge, the roles of HLA-Cw6 in psoriasis have not yet been thoroughly reviewed. The worldwide frequency of the HLA-Cw6 allele varies greatly, with it being generally higher in white people than in Asians. The allele is associated with type I early-onset psoriasis. Stress, obesity and streptococcal pharyngitis are commonly observed in HLA-Cw6-positive patients. Phenotypically, HLA-Cw6 has been found to be associated with guttate psoriasis. In addition, patients carrying the allele are more likely to have arm, leg and trunk involvement, and the Koebner phenomenon. Patients with psoriatic arthritis with HLA-Cw6 more often have early onset and tend to show cutaneous symptoms before musculoskeletal symptoms. HLA-Cw6-positive patients have been shown in several studies to be more responsive to methotrexate and ustekinumab. However, this difference in ustekinumab efficacy was only moderate in a post-hoc analysis of a pivotal phase III study. HLA-Cw6 positivity also tends to be less frequent in high-need patients who fail conventional therapy. Small studies have also investigated the role of HLA-Cw6 in remission of psoriasis during pregnancy, and with the comorbidities of photosensitivity and atherosclerosis. Given the diverse nature of psoriasis pathogenesis, as well as the difference of HLA-Cw6 positivity in different ethnic groups, more studies are needed to confirm the role of HLA-Cw6 in psoriasis.
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Affiliation(s)
- L Chen
- Lake Erie College of Osteopathic Medicine, Bradenton, PA, U.S.A
| | - T-F Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan
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15
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Jadon DR, Sengupta R, Nightingale A, Lu H, Dunphy J, Green A, Elder JT, Nair RP, Korendowych E, Lindsay MA, McHugh NJ. Serum bone-turnover biomarkers are associated with the occurrence of peripheral and axial arthritis in psoriatic disease: a prospective cross-sectional comparative study. Arthritis Res Ther 2017; 19:210. [PMID: 28934972 PMCID: PMC5609020 DOI: 10.1186/s13075-017-1417-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/04/2017] [Indexed: 12/17/2022] Open
Abstract
Background A recent systematic review identified four candidate serum-soluble bone-turnover biomarkers (dickkopf-1, Dkk-1; macrophage-colony stimulating factor, M-CSF; matrix metalloproteinase-3, MMP-3; osteoprotegerin, OPG) showing possible association with psoriatic arthritis (PsA). We aimed to: (i) confirm and determine if these four biomarkers are associated with PsA; (ii) differentiate psoriasis cases with and without arthritis; and (iii) differentiate PsA cases with and without axial arthritis. Methods A prospective cross-sectional comparative two-centre study recruited 200 patients with psoriasis without arthritis (PsC), 127 with PsA without axial arthritis (pPsA), 117 with PsA with axial arthritis (psoriatic spondyloarthritis, PsSpA), 157 with ankylosing spondylitis (AS) without psoriasis, and 50 matched healthy controls (HC). Serum biomarker concentrations were measured using ELISA. Multivariable regression and receiver operating characteristic analyses were performed. Results MMP-3 concentrations were significantly higher and M-CSF significantly lower in each arthritis disease group compared with HC (p ≤ 0.02). MMP-3 concentrations were significantly higher (adjusted odds ratio, ORadj 1.02 per ng/ml increase in concentration; p = 0.0004) and M-CSF significantly lower (ORadj 0.44 per ng/ml increase; p = 0.01) in PsA (pPsA and PsSpA combined) compared with PsC. Dkk-1 concentrations were significantly higher (ORadj 1.22 per ng/mL increase; p = 0.01), and OPG concentrations significantly lower (ORadj 0.20 per ng/mL increase; p = 0.02) in patients with axial arthritis (PsSpA and AS combined) than in those without (pPsA). Furthermore, Dkk-1 concentrations were significantly higher along a spectrum of increasing axial arthritis; Dkk-1 concentrations were higher in AS compared with PsSpA (ORadj 1.18 per ng/mL increase; p = 0.02). Receiver operating characteristic analysis showed MMP-3 to be the best single biomarker for differentiating PsA from PsC (AUC 0.70 for a cut-off of 14.51 ng/mL; sensitivity 0.76, specificity 0.60). Conclusions MMP-3 and M-CSF are biomarkers for the presence of arthritis in psoriatic disease, and could therefore be used to screen for PsA in psoriasis cohorts. Dkk-1 and OPG are biomarkers of axial arthritis; they could therefore be used to screen for the presence of axial disease in PsA cases, and help differentiate PsSpA from AS. High concentrations of Dkk-1 in AS and PsSpA compared with HC, support previous reports that Dkk-1 is dysfunctional in the spondyloarthritides.
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Affiliation(s)
- Deepak R Jadon
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. .,Department of Rheumatology, Cambridge University Hospitals NHSFT, Cambridge, UK.
| | - Raj Sengupta
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | | | - Hui Lu
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
| | - Juliet Dunphy
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - Amelia Green
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
| | - James T Elder
- Department of Dermatology, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Rajan P Nair
- Department of Dermatology, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Eleanor Korendowych
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - Mark A Lindsay
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
| | - Neil J McHugh
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK.,Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
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16
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Lima CAD, Javorski NR, Souza APO, Barbosa AD, Valença APMC, Crovella S, Souza PRE, De Azevedo Silva J, Sandrin-Garcia P. Polymorphisms in key bone modulator cytokines genes influence bisphosphonates therapy in postmenopausal women. Inflammopharmacology 2017; 25:191-201. [PMID: 28220389 DOI: 10.1007/s10787-017-0322-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/28/2017] [Indexed: 12/20/2022]
Abstract
Osteoporosis is a multifactorial and debilitating disease resulting from decreased bone mineral density (BMD) and loss of tissue microarchitecture. Ineffective therapies may lead to bone fractures and subsequent death. Single nucleotide polymorphisms (SNPs) in key immune regulator genes have been associated with therapeutic response to bisphosphonates, which are the first therapeutic line of choice for osteoporosis. However, cytokine pathways and their relation with therapeutic adhesion remain to be fully elucidated. Aimed at better understanding these processes, we investigated the response to bisphosphonate therapy in postmenopausal women and four SNPs in key proinflammatory cytokines genes: IL23R +2284 (C>A) (rs10889677), IL17A +672 (G>A) (rs7747909), IL12B +1188 (T>G) (rs3212227) and INF-γ -1616 (G>A) (rs2069705). A total of 69 patients treated with bisphosphonate were followed for a period of 1 up to 4 years, genotyped and compared according to their changes in bone mineral density (BMD) and level of biochemical markers during their treatment. The INF-γ -1616 G/G associated with increased BMD values in femoral neck (GG/AA, p = 0.016) and decreased BMD values in total hip (GG/GA, p = 0.019; GG/AA, p = 0.011). In relation to biochemical markers, INF-γ -1616 SNP associated with increased alkaline phosphatase (GG/AA; p < 0.0001) and parathyroid hormone levels (AA/GA; p = 0.017). Vitamin D values changes were related to IL17A +672 (GG/GA, p = 0.034) and to IL12B +1188 (TT/TG, p = 0.046) SNPs. Besides, significant differences in changes of calcium levels correlated with IL23R +2284 (CC/CA, p = 0.016) genotypes. Altogether, we suggest that these polymorphisms may play an important role for therapeutic decisions in osteoporosis treatment.
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Affiliation(s)
- C A D Lima
- Department of Genetics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil. .,Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
| | - N R Javorski
- Department of Genetics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - A P O Souza
- Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - A D Barbosa
- Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Division of Rheumatology, Clinical Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - A P M C Valença
- Department of Oceanography, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - S Crovella
- Department of Genetics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - P R E Souza
- Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Department of Genetics, Rural Federal University of Pernambuco (UFRPE), Recife, PE, Brazil
| | - J De Azevedo Silva
- Department of Genetics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - P Sandrin-Garcia
- Department of Genetics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.,Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
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17
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ERAP1 and ERAP2 Gene Variations Influence the Risk of Psoriatic Arthritis in Romanian Population. Arch Immunol Ther Exp (Warsz) 2017; 64:123-129. [DOI: 10.1007/s00005-016-0444-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 12/01/2016] [Indexed: 01/29/2023]
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18
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Jadon DR, Sengupta R, Nightingale A, Lindsay M, Korendowych E, Robinson G, Jobling A, Shaddick G, Bi J, Winchester R, Giles JT, McHugh NJ. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis 2016; 76:701-707. [PMID: 27913376 PMCID: PMC5530328 DOI: 10.1136/annrheumdis-2016-209853] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/16/2016] [Accepted: 10/05/2016] [Indexed: 01/22/2023]
Abstract
Objectives To compare the prevalence, clinical and radiographic characteristics of psoriatic spondyloarthritis (PsSpA) in psoriatic arthritis (PsA), with ankylosing spondylitis (AS). Methods A prospective single-centre cross-sectional observational study recruited consecutive PsA and AS cases. Participants completed outcome measures, and underwent clinical examination, axial radiographic scoring and HLA-sequencing. Multivariable analyses are presented. Results The 402 enrolled cases (201 PsA, 201 AS; fulfilling classification criteria for respective conditions) were reclassified based upon radiographic axial disease and psoriasis, as: 118 PsSpA, 127 peripheral-only PsA (pPsA), and 157 AS without psoriasis (AS) cases. A significant proportion of patients with radiographic axial disease had PsSpA (118/275; 42.91%), and often had symptomatically silent axial disease (30/118; 25.42%). Modified New York criteria for AS were fulfilled by 48/201 (23.88%) PsA cases, and Classification of Psoriatic Arthritis criteria by 49/201 (24.38%) AS cases. pPsA compared with PsSpA cases had a lower frequency of HLA-B*27 (OR 0.12; 95% CI 0.05 to 0.25). Disease activity, metrology and disability were comparable in PsSpA and AS. A significant proportion of PsSpA cases had spondylitis without sacroiliitis (39/118; 33.05%); they less frequently carried HLA-B*27 (OR 0.11; 95% CI 0.04 to 0.33). Sacroiliac joint complete ankylosis (adjusted OR, ORadj 2.96; 95% CI 1.42 to 6.15) and bridging syndesmophytes (ORadj 2.78; 95% CI 1.49 to 5.18) were more likely in AS than PsSpA. Radiographic axial disease was more severe in AS than PsSpA (Psoriatic Arthritis Spondylitis Radiology Index Score: adjusted incidence risk ratio 1.13; 95% CI 1.09 to 1.19). Conclusions In a combined cohort of patients with either PsA or AS from a single centre, 24% fulfilled classification criteria for both conditions. The pattern of axial disease was influenced significantly by the presence of skin psoriasis and HLA-B*27.
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Affiliation(s)
- Deepak R Jadon
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK.,Department of Rheumatology, Addenbrooke's Hospital, Cambridge, UK
| | - Raj Sengupta
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | | | - Mark Lindsay
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
| | - Eleanor Korendowych
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - Graham Robinson
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - Amelia Jobling
- Department of Mathematical Sciences, University of Bath, Bath, UK
| | - Gavin Shaddick
- Department of Mathematical Sciences, University of Bath, Bath, UK
| | - Jing Bi
- Columbia College of Physicians & Surgeons, New York, New York, USA
| | | | - Jon T Giles
- Columbia College of Physicians & Surgeons, New York, New York, USA
| | - Neil J McHugh
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK.,Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
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19
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Wang W, Zhu Z, Zhu C, Zheng X, Zuo X, Chen G, Zhou F, Liang B, Tang H, Wang Z, Zhang X, Sun L. A Genetic Variant rs1020760atNFKB1is Associated with Clinical Features of Psoriasis Vulgaris in a Han Chinese Population. Ann Hum Genet 2016; 80:197-202. [PMID: 27346731 DOI: 10.1111/ahg.12156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/13/2016] [Accepted: 04/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Wenjun Wang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Zhengwei Zhu
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Caihong Zhu
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Xiaodong Zheng
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Xianbo Zuo
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Gang Chen
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Fusheng Zhou
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Bo Liang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Huayang Tang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Zaixing Wang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Xuejun Zhang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
| | - Liangdan Sun
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; China
- Key Laboratory of Dermatology, Anhui Medical University; Ministry of Education; China
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20
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Helliwell PS, Ruderman EM. Natural History, Prognosis, and Socioeconomic Aspects of Psoriatic Arthritis. Rheum Dis Clin North Am 2015; 41:581-91. [DOI: 10.1016/j.rdc.2015.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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21
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Jethwa H, Bowness P. The interleukin (IL)-23/IL-17 axis in ankylosing spondylitis: new advances and potentials for treatment. Clin Exp Immunol 2015; 183:30-6. [PMID: 26080615 DOI: 10.1111/cei.12670] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 12/24/2022] Open
Abstract
Ankylosing spondylitis (AS), the most common form of spondyloarthropathy, is a chronic, progressive multi-system inflammatory disorder characteristically affecting the sacroiliac joints and axial skeleton. Although the exact mechanisms underlying the pathogenesis of AS remain to be elucidated, the presence of human leucocyte antigen (HLA)-B27 is known to markedly increase its risk of development. Current treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and tumour necrosis factor (TNF) blockers. In recent years, the interleukin (IL)-23/IL-17 pathway has been shown to have significance in the pathogenesis of AS and treatment modalities targeting this pathway have been shown to be beneficial in various other inflammatory conditions. This review provides an overview of the IL-23/IL-17 pathway in the pathogenesis of AS and summarizes new potential treatments for AS and related inflammatory diseases.
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Affiliation(s)
- H Jethwa
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - P Bowness
- Oxford University Hospitals NHS Trust, Oxford, UK.,Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, Oxford OX3 7LD, UK
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22
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Queiro R, Morante I, Cabezas I, Acasuso B. HLA-B27 and psoriatic disease: a modern view of an old relationship. Rheumatology (Oxford) 2015; 55:221-9. [PMID: 26289052 DOI: 10.1093/rheumatology/kev296] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Indexed: 12/22/2022] Open
Abstract
Psoriasis and PsA are the main phenotypes of psoriatic disease. Both conditions are highly polygenic diseases in which stochastic and environmental factors are crucial in the pathogenic process. Although the MHC region is a highly dense genetic area, most of the genetic basis of psoriatic disease within it resides in the HLA region. For decades, HLA-C*06 has been accepted as the main descriptor of the two main phenotypes of skin psoriasis. There is now compelling evidence to suggest that HLA-C*06 is only a genetic biomarker for skin involvement and not for joint involvement in psoriatic disease. The role of HLA-B*27 in the genetic aetiology of PsA has been recognized since the 1970s. Recent population case-control studies with adequate patient groups and replication cohorts, as well as confirmation studies in family pedigrees through the use of modern molecular typing methods, have reinforced the aetiological role of this allele in PsA. These studies have offered a new vision of the role of this allele in disease expression. This review contextualizes the latest findings on the role of HLA-B27 in psoriatic disease, emphasizing those aspects of particular interest for clinical practice.
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Affiliation(s)
- Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Isla Morante
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Iván Cabezas
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Belén Acasuso
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
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23
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Jadon DR, Shaddick G, Tillett W, Korendowych E, Robinson G, Waldron N, Cavill C, McHugh NJ. Psoriatic Arthritis Mutilans: Characteristics and Natural Radiographic History. J Rheumatol 2015; 42:1169-76. [DOI: 10.3899/jrheum.150083] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 02/08/2023]
Abstract
Objective.(1) To compare clinical characteristics of patients with psoriatic arthritis (PsA) with PsA mutilans (PAM) and without PAM, and (2) to determine the rate of PAM radiographic progression.Methods.A retrospective cohort study was conducted of all patients with PsA attending a teaching hospital. The most recent hand and feet radiographs were screened for PAM. Serial radiographs (earliest to most recent) were quantitatively scored for osteolysis, erosion, joint space narrowing, and osteoproliferation.Results.Out of the 610 cases, 36 PsA cases had PAM (5.9%). PAM cases were younger at diagnosis of PsA than non-PAM cases (p = 0.04), had more prevalent psoriatic nail dystrophy (OR 5.43, p < 0.001), and worse health assessment questionnaire score (1.25 vs 0.63, p < 0.04). Radiographic axial disease (OR 2.31, adjusted p = 0.03) and especially radiographic sacroiliitis (OR 2.99, adjusted p = 0.01) were more prevalent in PAM. PAM were more likely than non-PAM cases to have used a disease-modifying antirheumatic drug (DMARD; OR 16.36, p < 0.001). Out of 33 cases, 29 PAM cases had initiated a synthetic DMARD and 4/13 had initiated anti-tumor necrosis factor (anti-TNF) prior to first demonstration of PAM. A median 5 radiographs were scored for each PAM case (interquartile range 3–7). PAM progressed from monoarticular (60%) to polyarticular (80%) involvement. Osteolysis was initially rapid and progressive in the hands and feet, tapering later during disease course. Nail dystrophy predicted more severe osteolysis (p = 0.03).Conclusion.Compared with non-PAM cases, PAM cases have earlier age at PsA diagnosis, poorer function, more prevalent nail dystrophy, and more radiographic axial disease/sacroiliitis. The rate of osteolysis is higher in earlier disease, and more severe in those with nail dystrophy. DMARD and anti-TNF therapy appear not to prevent PAM occurrence.
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24
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Campuzano O, Allegue C, Fernandez A, Iglesias A, Brugada R. Determining the pathogenicity of genetic variants associated with cardiac channelopathies. Sci Rep 2015; 5:7953. [PMID: 25608792 PMCID: PMC4302303 DOI: 10.1038/srep07953] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/22/2014] [Indexed: 01/08/2023] Open
Abstract
Advancements in genetic screening have generated massive amounts of data on genetic variation; however, a lack of clear pathogenic stratification has left most variants classified as being of unknown significance. This is a critical limitation for translating genetic data into clinical practice. Genetic screening is currently recommended in the guidelines for diagnosis and treatment of cardiac channelopathies, which are major contributors to sudden cardiac death in young people. We propose to characterize the pathogenicity of genetic variants associated with cardiac channelopathies using a stratified scoring system. The development of this system was considered by using all of the tools currently available to define pathogenicity. The use of this scoring system could help clinicians to understand the limitations of genetic associations with a disease, and help them better define the role that genetics can have in their clinical routine.
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Affiliation(s)
- Oscar Campuzano
- 1] Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona (IDIBGI) and Universitat de Girona (UdG), Girona, Spain [2] Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | - Catarina Allegue
- Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona (IDIBGI) and Universitat de Girona (UdG), Girona, Spain
| | - Anna Fernandez
- Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona (IDIBGI) and Universitat de Girona (UdG), Girona, Spain
| | - Anna Iglesias
- Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona (IDIBGI) and Universitat de Girona (UdG), Girona, Spain
| | - Ramon Brugada
- 1] Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona (IDIBGI) and Universitat de Girona (UdG), Girona, Spain [2] Medical Science Department, School of Medicine, University of Girona, Girona, Spain [3] Cardiology Service, Hospital Josep Trueta, Girona, 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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Sandoval-Talamantes AK, Brito-Luna MJ, Fafutis-Morris M, Villanueva-Quintero DG, Graciano-Machuca O, Ramírez-Dueñas MG, Alvarado-Navarro A. The 3'UTR 1188A/C polymorphism of IL-12p40 is not associated with susceptibility for developing plaque psoriasis in Mestizo population from western Mexico. Immunol Lett 2014; 163:221-6. [PMID: 25447399 DOI: 10.1016/j.imlet.2014.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/29/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
Psoriasis is a chronic autoimmune inflammatory disease that affects the skin and the joints. Psoriasis is characterized by the keratinocyte proliferation, which is induced by cytokines Th1 and Th17. Patients with plaque psoriasis present a chronic inflammatory response with high levels of interleukin (IL)-12 and IL-23. Various single-nucleotide polymorphisms (SNP) have been identified in the IL12B gene, such as SNP 3' UTR 1188 A/C (SNP rs3212227), which has been associated with susceptibility to developing plaque psoriasis and with the production of IL-12 and IL-23 in individuals of different ethnic groups. In this study, we determined whether there is an association of SNP rs3212227 with the susceptibility of developing plaque psoriasis and with serum levels of IL-12 and IL-23 in Mestizo population in western Mexico. We included 112 patients with psoriasis and 112 clinical healthy individuals in the study. The frequencies of genotypes A/A, A/C, and C/C in patients with plaque psoriasis were 41, 53, and 6%, respectively, while in the control group, these were 37, 53, and 10%, respectively, without finding statistically significant differences between both groups (p>0.05). Although IL-12 and IL-23 serum levels were higher in patients than in controls, we found no significant differences. The group of patients with genotype CC presented the highest levels of IL-23 (p<0.05). These data suggest that the SNP rs3212227 phenotype is not associated with the risk of developing plaque psoriasis or with IL-12 and IL-23 levels in Mestizo population in western Mexico.
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Affiliation(s)
- Ana Karen Sandoval-Talamantes
- Centro de Investigación, Inmunología y Dermatología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México, Av. Federalismo Norte 3102, Atemajac del Valle, CP45190 Zapopan, Jalisco, Mexico.
| | - Myrian Johanna Brito-Luna
- Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaria de Salud, Jalisco, México, Av. Federalismo Norte 3102, Atemajac del Valle, CP45190 Zapopan, Jalisco, Mexico.
| | - Mary Fafutis-Morris
- Centro de Investigación, Inmunología y Dermatología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México, Av. Federalismo Norte 3102, Atemajac del Valle, CP45190 Zapopan, Jalisco, Mexico.
| | - Delfina Guadalupe Villanueva-Quintero
- Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaria de Salud, Jalisco, México, Av. Federalismo Norte 3102, Atemajac del Valle, CP45190 Zapopan, Jalisco, Mexico.
| | - Omar Graciano-Machuca
- Centro de Investigación, Inmunología y Dermatología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México, Av. Federalismo Norte 3102, Atemajac del Valle, CP45190 Zapopan, Jalisco, Mexico.
| | - María Guadalupe Ramírez-Dueñas
- Laboratorio de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México, Sierra mojada 950, Col. Independencia, CP 44340 Guadalajara, Jalisco, Mexico.
| | - Anabell Alvarado-Navarro
- Centro de Investigación, Inmunología y Dermatología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México, Av. Federalismo Norte 3102, Atemajac del Valle, CP45190 Zapopan, Jalisco, Mexico.
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Garg N, Touma Z, Ritchlin CT. GRAPPA Trainees Symposium 2012: A Report from the GRAPPA 2012 Annual Meeting. J Rheumatol 2013; 40:1413-8. [DOI: 10.3899/jrheum.130452] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Stockholm, Sweden, began with a Trainees Symposium, which included 30 dermatology and rheumatology trainees currently involved with research in psoriasis or psoriatic arthritis. The 6 oral presentations and 24 posters presented at the meeting highlight the status of current basic and clinical research performed by members and trainees of GRAPPA.
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Popa OM, Kriegova E, Popa L, Schneiderova P, Dutescu MI, Bojinca M, Bara C, Petrek M. Association study in Romanians confirms IL23A gene haplotype block rs2066808/rs11171806 as conferring risk to psoriatic arthritis. Cytokine 2013; 63:67-73. [PMID: 23673284 DOI: 10.1016/j.cyto.2013.04.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 03/09/2013] [Accepted: 04/11/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND The cytokines IL12 and IL23 have been recently implicated in the pathogenesis of psoriatic arthritis (PsA). In this study we investigated the genetic variations in the genes coding for IL12, IL23 and IL23 receptor as a plausible source of susceptibility and modification of clinical symptoms of PsA in Romanian population. METHODS Twenty five SNPs mapping to IL12A, IL12B, IL23A, IL23R and IL12RB1 genes were genotyped in 94 PsA patients and 161 healthy controls of Romanian ethnicity using the Sequenom genotyping platform. RESULTS The exonic SNP rs11171806 from IL23A gene was significantly underrepresented in patients versus controls (p=0.03, OR 0.391) and the carriers of rs11171806/rs2066808 AC haplotype had decreased risk for PsA (p=0.03). The two SNPs of the highly conserved gene IL23A are in complete LD in our population. Genetic variants of IL12B gene were associated with polyarticular subtype of PsA. No associations were found between SNPs from IL12A, IL23R and IL12RB1 genes and susceptibility to PsA and its phenotypes. CONCLUSION We confirm the previously described association of rs2066808 variant with psoriasis and PsA and we show evidence of an extended genomic region inside IL23A gene as carrier of true disease susceptibility factors. These data suggest a role for IL23 in the PsA pathogenesis in Romanians.
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Affiliation(s)
- Olivia Mihaela Popa
- Department of Immunology and Pathophysiology, Faculty of Medicine, University "Carol Davila", Bucharest, Romania; Laboratory of Immunogenomics and Immunoproteomics, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
| | - Eva Kriegova
- Laboratory of Immunogenomics and Immunoproteomics, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
| | - Luis Popa
- Molecular Biology Department, Grigore Antipa National Museum of Natural History, Bucharest, Romania.
| | - Petra Schneiderova
- Laboratory of Immunogenomics and Immunoproteomics, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
| | | | - Mihai Bojinca
- Department of Rheumatology, Faculty of Medicine, University "Carol Davila", "I.C. Cantacuzino" Hospital, Bucharest, Romania.
| | - Constantin Bara
- Department of Immunology and Pathophysiology, Faculty of Medicine, University "Carol Davila", Bucharest, Romania.
| | - Martin Petrek
- Laboratory of Immunogenomics and Immunoproteomics, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
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Abstract
Psoriatic arthritis (PsA) is the second most common inflammatory arthropathy, after rheumatoid arthritis diagnosis, in early arthritis clinics. Most patients have established psoriasis, often for years, prior to the onset of joint pain and swelling; in addition, associated features of nail disease, dactylitis, enthesitis, spondylitis or uveitis may be present. Psoriasis may not be immediately apparent, as small or patchy lesions may occur in the scalp or perineum. PsA presents as a symmetrical polyarthritis, similar to rheumatoid arthritis, or an asymmetrical oligoarthritis with a predilection for the distal interphalangeal joints. Spinal involvement is similar, although not identical, to ankylosing spondylitis. Joint damage occurs early; up to 50% of PsA patients have an 11% annual erosion rate in the first 2 years of disease duration, suggesting it is not a benign condition. There have been significant advances in our understanding of PsA pathogenesis in recent years, in the areas of genetics and molecular biology, implicating both the innate and the adaptive immune systems. This has lead to the introduction of evidence-based targeted therapy, primarily with tumour necrosis factor inhibitor (TNFi) agents. Therapy with disease-modifying anti-rheumatic drugs, such as methotrexate and leflunomide, remains the first-choice therapeutic intervention, even though there are few randomised controlled trials with these agents. In contrast, a number of successful studies of TNFi agents demonstrate excellent efficacy, in combination with methotrexate, and several novel agents are currently in development for the treatment of PsA.
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Affiliation(s)
- Douglas James Veale
- Dublin Academic Medical Centre, Centre for Arthritis and Rheumatic Diseases, St
Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
- The Conway Institute of Biomolecular and Biomedical Research, University College
Dublin, Dublin 4, Ireland
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