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Waśkiel-Burnat A, Czuwara J, Blicharz L, Olszewska M, Rudnicka L. Differential diagnosis of red scalp: the importance of trichoscopy. Clin Exp Dermatol 2024; 49:961-968. [PMID: 37935061 DOI: 10.1093/ced/llad366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
Red scalp is a common complaint that may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases to cause diffuse scalp erythema are psoriasis, seborrhoeic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases, the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis. The main trichoscopic features of psoriasis are silver-white scaling, regularly distributed dotted (glomerular) vessels or twisted red loops, and punctate haemorrhages. Yellowish-white scaling and thin arborizing vessels are typical features of seborrhoeic dermatitis. Contact dermatitis is characterized by the presence of yellow exudate and polymorphic vessels, while perifollicular scaling and erythema with the lack of follicular openings are typical findings in lichen planopilaris. In scalp dermatomyositis, tortuous and arborizing vessels with interfollicular and perifollicular pigmentation may be detected. The most characteristic features of scalp rosacea are perifollicular scaling and polygonal/arborizing vessels. This review also summarizes histological features and therapeutic options for these conditions.
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Affiliation(s)
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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2
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Singer D, Thompson-Leduc P, Ma S, Gupta D, Cheng WY, Sendhil SR, Sundar M, Hagopian E, Stempniewicz N, Duh MS, Poston S. Burden of Herpes Zoster Among Patients with Psoriatic Arthritis in the United States. PSORIASIS (AUCKLAND, N.Z.) 2024; 14:63-78. [PMID: 38939905 PMCID: PMC11208162 DOI: 10.2147/ptt.s430151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 06/29/2024]
Abstract
Purpose Patients with psoriasis (PsO) and psoriatic arthritis (PsA) are at increased risk of herpes zoster (HZ), but healthcare resource use (HRU) and costs relating to HZ in adults with PsA are unknown. We aimed to estimate the incidence of HZ among adults with PsA vs without psoriatic disease and the additional HRU and costs among patients with PsA with vs without HZ. Patients and Methods This retrospective, longitudinal, cohort study estimated HZ incidence in PsA+ vs PsO-/PsA- cohorts and HRU and medical/pharmacy costs among PsA+/HZ+ vs PsA+/HZ- cohorts comprised of adults from Optum's de-identified Clinformatics Data Mart Database during 2015-2020. For the HRU/cost analyses, index was the date of first HZ diagnosis (PsA+/HZ+ cohort) or was randomly assigned (PsA+/HZ- cohort). Generalized linear models were used for adjusted comparisons between cohorts. Results HZ incidence was higher in the PsA+ (n = 57,126) vs PsO-/PsA- (n = 23,837,237) cohort (14.85 vs 7.67 per 1000 person-years; adjusted incidence rate ratio [aIRR]: 1.23; 95% confidence interval [CI]: 1.16-1.30). Numbers of outpatient visits, emergency department visits, and inpatient admissions were significantly higher in the PsA+/HZ+ (n = 1045) vs PsA+/HZ- (n = 36,091) cohorts during the first month after HZ diagnosis (outpatient: aIRR: 1.74; 95% CI: 1.63-1.86; emergency department: 3.14; 95% CI: 2.46-4.02; inpatient: aIRR: 2.61; 95% CI: 1.89-3.61). Mean all-cause per-patient costs were significantly higher in the PsA+/HZ+ vs PsA+/HZ- cohorts during the first month after index ($6493 vs $4521; adjusted cost difference: $2012; 95% CI: $1204-$3007). HRU and costs were numerically higher in the PsA+/HZ+ cohort during the first 3 and 12 months. Conclusion These findings, which provide evidence on the increased incidence and HRU and economic burden associated with HZ among adults with PsA, could be used to inform clinical practice and decision-making.
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Affiliation(s)
- David Singer
- GSK, US Health Economics and Outcomes Research, Philadelphia, PA, USA
| | | | - Siyu Ma
- GSK, US Health Economics and Outcomes Research, Philadelphia, PA, USA
- Tufts Medical Center, Boston, MA, USA
| | - Deepshekhar Gupta
- Analysis Group, Inc., Health Economics and Outcomes Research, Menlo Park, CA, USA
| | - Wendy Y Cheng
- Analysis Group, Inc., Health Economics and Outcomes Research, Boston, MA, USA
| | - Selvam R Sendhil
- Analysis Group, Inc., Health Economics and Outcomes Research, Los Angeles, CA, USA
| | - Manasvi Sundar
- Analysis Group, Inc., Health Economics and Outcomes Research, Los Angeles, CA, USA
| | - Ella Hagopian
- Analysis Group, Inc., Health Economics and Outcomes Research, Boston, MA, USA
| | | | - Mei Sheng Duh
- Analysis Group, Inc., Health Economics and Outcomes Research, Boston, MA, USA
| | - Sara Poston
- GSK, US Health Economics and Outcomes Research, Philadelphia, PA, USA
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3
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Yi YH, Chen G, Gong S, Han LZ, Gong TL, Wang YX, Xu WH, Jin X. Injectable Temperature-Sensitive Hydrogel Loaded with IL-36Ra for the Relief of Osteoarthritis. ACS Biomater Sci Eng 2023; 9:1672-1681. [PMID: 36796355 DOI: 10.1021/acsbiomaterials.2c01144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Osteoarthritis (OA) is an inflammatory disease accompanied by synovial joint inflammation, and IL-36 plays an important role in this process. Local application of IL-36 receptor antagonist (IL-36Ra) can effectively control the inflammatory response, thereby protecting cartilage and slowing down the development of OA. However, its application is limited by the fact that it is rapidly metabolized locally. We designed and prepared a temperature-sensitive poly(lactic-co-glycolic acid)-poly(ethylene glycol)-poly(lactic-co-glycolic acid) (PLGA-PEG-PLGA) hydrogel (IL-36Ra@Gel) system carrying IL-36Ra and evaluated its basic physicochemical characteristics. The drug release curve of IL-36Ra@Gel indicated that this system could slowly release the drug over a longer period. Furthermore, degradation experiments showed that it could be largely degraded from the body within 1 month. The biocompatibility-related results showed that it had no significant effect on cell proliferation compared to the control group. In addition, the expression of MMP-13 and ADAMTS-5 was lower in IL-36Ra@Gel-treated chondrocytes than in the control group, and the opposite results appeared in aggrecan and collagen X. After 8 weeks of treatment with IL-36Ra@Gel by joint cavity injection, HE and Safranin O/Fast green staining showed that the degree of cartilage tissue destruction in the IL-36Ra@Gel-treated group was less than those in other groups. Meanwhile, the joints of mice in the IL-36Ra@Gel group had the most intact cartilage surface, the smallest thickness of cartilage erosion, and the lowest OARSI and Mankins score among all groups. Consequently, the combination of IL-36Ra and PLGA-PLEG-PLGA temperature-sensitive hydrogels can greatly improve the therapeutic effect and prolong the drug duration time, thus effectively delaying the progression of degenerative changes in OA, providing a new feasible nonsurgical treatment for OA.
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Affiliation(s)
- Yi-Hu Yi
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Guo Chen
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Song Gong
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li-Zhi Han
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Tian-Lun Gong
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yu-Xiang Wang
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wei-Hua Xu
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xin Jin
- Department of Orthopaedics, Union Hospital, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Sexton RE, Uddin MH, Bannoura S, Khan HY, Mzannar Y, Li Y, Aboukameel A, Al-Hallak MN, Al-Share B, Mohamed A, Nagasaka M, El-Rayes B, Azmi AS. Connecting the Human Microbiome and Pancreatic Cancer. Cancer Metastasis Rev 2022; 41:317-331. [PMID: 35366155 PMCID: PMC8976105 DOI: 10.1007/s10555-022-10022-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/02/2022] [Indexed: 11/02/2022]
Abstract
Pancreatic cancer is a deadly disease that is increasing in incidence throughout the world. There are no clear causal factors associated with the incidence of pancreatic cancer; however, some correlation to smoking, diabetes and alcohol has been described. Recently, a few studies have linked the human microbiome (oral and gastrointestinal tract) to pancreatic cancer development. A perturbed microbiome has been shown to alter normal cells while promoting cancer-related processes such as increased cell signaling, immune system evasion and invasion. In this article, we will review in detail the alterations within the gut and oral microbiome that have been linked to pancreatic cancer and explore the ability of other microbiomes, such as the lung and skin microbiome, to contribute to disease development. Understanding ways to identify a perturbed microbiome can result in advancements in pancreatic cancer research and allow for prevention, earlier detection and alternative treatment strategies for patients.
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Affiliation(s)
- Rachel E Sexton
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Md Hafiz Uddin
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Sahar Bannoura
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Husain Yar Khan
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Yousef Mzannar
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Yiwei Li
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Amro Aboukameel
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Mohammad Najeeb Al-Hallak
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Bayan Al-Share
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA
| | - Amr Mohamed
- UH Seidman Cancer Center, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Misako Nagasaka
- University of California, Irvine, UCI Health Chao Family Comprehensive Cancer Center, CA, Irvine, USA
| | - Bassel El-Rayes
- O'Neal Comprehensive Cancer Center, University of Alabama, AL, Tuscaloosa, USA
| | - Asfar S Azmi
- Department of Oncology, Wayne State University School of Medicine, Karmanos Cancer Institute, 4100 John R, Detroit, MI, 48201, USA.
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5
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Negi A, Rajamani K. Inflammatory Joint Disorders. CURRENT ORTHOPAEDIC PRACTICE 2022. [DOI: 10.1007/978-3-030-78529-1_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Charras A, Garau J, Hofmann SR, Carlsson E, Cereda C, Russ S, Abraham S, Hedrich CM. DNA Methylation Patterns in CD8 + T Cells Discern Psoriasis From Psoriatic Arthritis and Correlate With Cutaneous Disease Activity. Front Cell Dev Biol 2021; 9:746145. [PMID: 34746142 PMCID: PMC8567019 DOI: 10.3389/fcell.2021.746145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/16/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Psoriasis is a T cell-mediated chronic autoimmune/inflammatory disease. While some patients experience disease limited to the skin (skin psoriasis), others develop joint involvement (psoriatic arthritis; PsA). In the absence of disease- and/or outcome-specific biomarkers, and as arthritis can precede skin manifestations, diagnostic and therapeutic delays are common and contribute to disease burden and damage accrual. Objective: Altered epigenetic marks, including DNA methylation, contribute to effector T cell phenotypes and altered cytokine expression in autoimmune/inflammatory diseases. This project aimed at the identification of disease-/outcome-specific DNA methylation signatures in CD8+ T cells from patients with psoriasis and PsA as compared to healthy controls. Method: Peripheral blood CD8+ T cells from nine healthy controls, 10 psoriasis, and seven PsA patients were collected to analyze DNA methylation marks using Illumina Human Methylation EPIC BeadChips (>850,000 CpGs per sample). Bioinformatic analysis was performed using R (minfi, limma, ChAMP, and DMRcate packages). Results: DNA methylation profiles in CD8+ T cells differentiate healthy controls from psoriasis patients [397 Differentially Methylated Positions (DMPs); 9 Differentially Methylated Regions (DMRs) when ≥CpGs per DMR were considered; 2 DMRs for ≥10 CpGs]. Furthermore, patients with skin psoriasis can be discriminated from PsA patients [1,861 DMPs, 20 DMRs (≥5 CpGs per region), 4 DMRs (≥10 CpGs per region)]. Gene ontology (GO) analyses considering genes with ≥1 DMP in their promoter delivered methylation defects in skin psoriasis and PsA primarily affecting the BMP signaling pathway and endopeptidase regulator activity, respectively. GO analysis of genes associated with DMRs between skin psoriasis and PsA demonstrated an enrichment of GABAergic neuron and cortex neuron development pathways. Treatment with cytokine blockers associated with DNA methylation changes [2,372 DMPs; 1,907 DMPs within promoters, 7 DMRs (≥5 CpG per regions)] affecting transforming growth factor beta receptor and transmembrane receptor protein serine/threonine kinase signaling pathways. Lastly, a methylation score including TNF and IL-17 pathway associated DMPs inverse correlates with skin disease activity scores (PASI). Conclusion: Patients with skin psoriasis exhibit DNA methylation patterns in CD8+ T cells that allow differentiation from PsA patients and healthy individuals, and reflect clinical activity of skin disease. Thus, DNA methylation profiling promises potential as diagnostic and prognostic tool to be used for molecular patient stratification toward individualized treatment.
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Affiliation(s)
- Amandine Charras
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Jessica Garau
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Sigrun R Hofmann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Emil Carlsson
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Cristina Cereda
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Susanne Russ
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Susanne Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Christian M Hedrich
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.,Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, United Kingdom
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7
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Elias M, Zhao S, Le HT, Wang J, Neurath MF, Neufert C, Fiocchi C, Rieder F. IL-36 in chronic inflammation and fibrosis - bridging the gap? J Clin Invest 2021; 131:144336. [PMID: 33463541 DOI: 10.1172/jci144336] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IL-36 is a member of the IL-1 superfamily and consists of three agonists and one receptor antagonist (IL-36Ra). The three endogenous agonists, IL-36α, -β, and -γ, act primarily as proinflammatory cytokines, and their signaling through the IL-36 receptor (IL-36R) promotes immune cell infiltration and secretion of inflammatory and chemotactic molecules. However, IL-36 signaling also fosters secretion of profibrotic soluble mediators, suggesting a role in fibrotic disorders. IL-36 isoforms and IL-36 have been implicated in inflammatory diseases including psoriasis, arthritis, inflammatory bowel diseases, and allergic rhinitis. Moreover, IL-36 has been connected to fibrotic disorders affecting the kidney, lung, and intestines. This review summarizes the expression, cellular source, and function of IL-36 in inflammation and fibrosis in various organs, and proposes that IL-36 modulation may prove valuable in preventing or treating inflammatory and fibrotic diseases and may reveal a mechanistic link between inflammation and fibrosis.
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Affiliation(s)
- Michael Elias
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Shuai Zhao
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Hongnga T Le
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jie Wang
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Henan Key Laboratory of Immunology and Targeted Drug, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Markus F Neurath
- Department of Medicine 1 and Deutsches Zentrum Immuntherapie DZI, Universitaetsklinikum Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Clemens Neufert
- Department of Medicine 1 and Deutsches Zentrum Immuntherapie DZI, Universitaetsklinikum Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Claudio Fiocchi
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Florian Rieder
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
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8
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Gamonal SBL, Gamonal ACC, Brandão MAF, Junqueira LA, de Assis PM, Raposo NRB. Prevalence of psoriatic arthritis among patients with plaque psoriasis: a Brazilian retrospective study. SAO PAULO MED J 2021; 139:476-480. [PMID: 34378736 PMCID: PMC9632524 DOI: 10.1590/1516-3180.2020.0629.16032021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Psoriatic arthritis is the most frequent and impactful comorbidity among psoriatic patients and appears in most cases after skin disease. Dermatologists play a key role in its early diagnosis and treatment. OBJECTIVE To determine the prevalence of psoriatic arthritis and associated variables among patients with plaque psoriasis seen at a reference center for treating psoriasis. DESIGN AND SETTING Retrospective cross-sectional study conducted among 300 patients at an outpatient clinic in a university center in Juiz de Fora, MG, Brazil. METHODS Standardized records of 300 patients with plaque psoriasis were examined. Demographic data and medical variables relating to psoriasis (Psoriasis Area and Severity Index (PASI), family history, age at onset and disease progression) and psoriasis arthritis (CASPAR criteria) were evaluated. Laboratory and radiographic tests in the medical records were reviewed. RESULTS Seventy-three (24.3%) of these 300 patients with plaque psoriasis had psoriatic arthritis. Asymmetric oligoarthritis (58.9%) was the most common clinical form, followed by polyarthritis (20.5%), distal interphalangeal arthritis (15.2%) and spondyloarthritis (5.4%). Dactylitis was present in 21.9% and enthesitis in 35.6% of patients. Compared with patients without arthritis, patients with arthritis had higher average age, higher frequency of positive family history of psoriasis, longer duration of evolution and higher PASI rates. CONCLUSION Psoriatic arthritis is often underdiagnosed. Since dermatologists perform the initial approach, these professionals need to be trained to diagnose this comorbidity and treat it, together with rheumatologists.
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Affiliation(s)
- Shirley Braga Lima Gamonal
- MD, MSc, PhD. Researcher, Núcleo de Pesquisa e Inovação em Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de Fora, Juiz de Fora (MG), Brazil; Physician and Professor, Núcleo de Pesquisa em Dermatologia (NUPEDE), Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - Aloisio Carlos Couri Gamonal
- MD, MSc, PhD. Physician and Professor, Núcleo de Pesquisa em Dermatologia (NUPEDE), Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | | | - Laura Andrade Junqueira
- MSc. Pharmacist and Doctoral Student, Faculty of Pharmacy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - Pollyana Mendonça de Assis
- MSc. Pharmacist and Doctoral Student, Faculty of Pharmacy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - Nádia Rezende Barbosa Raposo
- MSc, PhD. Pharmacist and Professor, Faculty of Pharmacy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
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Reinhardt M, Garbe C, Petersen J, Augustin M, Kirsten N, Biermann MHC, Häberle B, Hagenström K. Epidemiology, Comorbidity and Risk Factors for Psoriatic Arthritis: a Health Insurance Claims Database Analysis. Acta Derm Venereol 2021; 101:adv00566. [PMID: 34263331 PMCID: PMC9425560 DOI: 10.2340/00015555-3879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Psoriatic arthritis is a frequent manifestation of psoriasis, and has a high level of impact on physical functioning, work ability and quality of life. However, there have been few studies of the epidemiology, development of and risk factors for concomitant psoriatic arthritis in patients with psoriasis. This study analysed data from a German public health insurance database of > 2 million individuals. Factors influencing the development of psoriatic arthritis were determined by descriptively analysing comorbidities and Cox regression modelling. The prevalences of psoriasis and psoriatic arthritis were 2.63% and 0.29% in adults (18+ years) and, respectively, 0.30% and 0.01% in children (0–17 years). The proportion of adult patients with incident psoriasis who developed concomitant psoriatic arthritis within five years after diagnosis of psoriasis (mean 2.3 years) was 2.6%. Cardiovascular diseases are the most frequent comorbidity in patients with psoriasis with or without concomitant psoriatic arthritis. Depression and neurosis/stress disorder were identified as indicators for the development of psoriatic arthritis.
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10
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Gottlieb AB, Merola JF. A clinical perspective on risk factors and signs of subclinical and early psoriatic arthritis among patients with psoriasis. J DERMATOL TREAT 2021; 33:1907-1915. [PMID: 34176399 DOI: 10.1080/09546634.2021.1942423] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Psoriasis is a chronic, immune-mediated disease that includes a broad spectrum of systemic manifestations, complications, and comorbidities. Approximately 20%-30% of patients with psoriasis eventually develop psoriatic arthritis, and up to half of those without psoriatic arthritis experience subclinical musculoskeletal abnormalities. Recognition of early musculoskeletal inflammatory signs in patients with psoriasis is important to understand the extent and severity of this systemic disease, assess the risk of structural joint damage, and ensure timely and effective treatment of the complete spectrum of psoriatic disease. Delayed or ineffective treatment can lead to decreased quality of life, irreversible musculoskeletal damage, and loss of function. In this review, we highlight features of subclinical or early psoriatic arthritis among patients with psoriasis of which dermatologists should be aware. Recent knowledge of features of preclinical psoriatic arthritis in patients with psoriasis is presented. We briefly discuss important risk factors, clinical features, and other characteristics of patients likely to progress from psoriasis to psoriatic arthritis that should be known by dermatologists. Screening tools commonly used in the dermatology clinic to detect psoriatic arthritis are also critically reviewed. Finally, we provide expert commentary for dermatologists concerning the treatment of patients with psoriasis and subclinical signs of early psoriatic arthritis.
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Affiliation(s)
- Alice B Gottlieb
- Mount Sinai-Beth Israel Hospital, Icahn School of Medicine at Mount Sina, New York, NY, USA
| | - Joseph F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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11
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Belman S, Walsh JA, Carroll C, Milliken M, Haaland B, Duffin KC, Krueger GG, Feng BJ. Psoriasis Characteristics for the Early Detection of Psoriatic Arthritis. J Rheumatol 2021; 48:1559-1565. [PMID: 33858978 DOI: 10.3899/jrheum.201123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Delays in the diagnosis and treatment of psoriatic arthritis (PsA) are common. These delays contribute to impairments in quality of life and joint damage. This study aims to calculate the incidence rate of PsA over time and identify clinical features that may be used for PsA prediction in patients with psoriasis (PsO). METHODS The study population for PsA incidence analysis included 1128 participants enrolled in the Utah Psoriasis Initiative between 2002 and 2014. Clinical evaluation and medical record review were performed to identify new cases of PsA after enrollment. To identify PsO features associated with PsA, the population was restricted to 627 participants who did not have PsA before PsO phenotyping and had been followed up for subsequent PsA diagnosis. We conducted Cox proportional hazard regressions to estimate the HR of PsA associated with PsO characteristics and other health-related features. RESULTS PsA incidence rate increased for > 60 years following PsO onset (trend P < 0.0001). There was a significant association between PsA and induration severity in untreated lesions (P < 0.001, HR 1.46), history of fingernail involvement (P < 0.001, HR 2.38), pustular PsO (P < 0.001, HR 3.32), fingernail involvement at enrollment (P < 0.001, HR 2.04), and Koebner phenomenon (P < 0.001, HR 1.90). Multivariate analysis yielded a model that included a history of fingernail involvement (P < 0.001, HR 2.16) and untreated induration (P < 0.001, HR 1.41). CONCLUSION Risk of PsA increases steadily for > 60 years following PsO onset. Patient-reported history of PsO characteristics has greater predictive power than physician-measured features at enrollment visits. The characteristics identified in this study provide guidance for screening for PsA risk in patients with PsO.
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Affiliation(s)
- Sophie Belman
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Jessica A Walsh
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Courtney Carroll
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Michael Milliken
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Benjamin Haaland
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Kristina C Duffin
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Gerald G Krueger
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
| | - Bing-Jian Feng
- This study was partially supported by the 2019 Discovery Research Grant and Psoriatic Arthritis Diagnostic Test Grant from the National Psoriasis Foundation, the 2018 Immunology, Inflammation, and Infectious Diseases 3i Initiative at the University of Utah, and Pfizer Inc. (grant numbers WI227108 and WI240276). The support and resources from the Center for High-Performance Computing at the University of Utah are gratefully acknowledged. The computational resources used were partially funded by the National Institutes of Health (NIH) Shared Instrumentation Grant 1S10OD021644-01A1. This project utilized REDCap at the University of Utah, supported by grant 8UL1TR000105 ( formerly UL1RR025764) from the National Center for Advancing Translational Sciences and NIH. S. Belman, MSc, School of Medicine, University of Utah, Salt Lake City, Utah, USA, and Wellcome Sanger Institute, University of Cambridge, Hinxton, UK; J.A. Walsh, MD, C. Carroll, MSc, M. Milliken, MD, MPH, K. Callis Duffin, MD, G.G. Krueger, MD, School of Medicine, University of Utah, Salt Lake City, Utah, USA; B. Haaland, PhD, B.J. Feng, PhD, School of Medicine, and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. The PERCH software, for which BJF is the inventor, has been nonexclusively licensed to Ambry Genetics Corporation for their clinical genetic testing services and research. BJF also reports funding and sponsorship to his institution on his behalf from Pfizer Inc., Regeneron Genetics Center LLC., and AstraZeneca. BH has consulted for the National Kidney Foundation and Value Analytics Labs. The remaining authors declare no potential conflicts of interest relevant to this article. Address correspondence to Dr. B.J. Feng, 30 N 1900 E, Department of Dermatology, Salt Lake City, UT 84132, USA. . Accepted for publication March 29, 2021
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Svedbom A, Mallbris L, Larsson P, Nikamo P, Wolk K, Kjellman P, Sonkoly E, Eidsmo L, Lindqvist U, Ståhle M. Long-term Outcomes and Prognosis in New-Onset Psoriasis. JAMA Dermatol 2021; 157:2778388. [PMID: 33851956 PMCID: PMC8047767 DOI: 10.1001/jamadermatol.2021.0734] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/23/2021] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Psoriasis is a heterogeneous disease. Improved understanding of prognosis and long-term outcomes in new-onset psoriasis may improve care. OBJECTIVE To describe the clinical course of psoriasis and identify possible indicators of long-term outcomes. DESIGN, SETTING, AND PARTICIPANTS The Stockholm Psoriasis Cohort was a noninterventional inception cohort study enrolling patients between 2001 and 2005. The present study was conducted from January 15, 2019, to February 5, 2021. At enrollment and 10 years, patients were examined by dermatologists and rheumatologists. Data from examinations were complemented by questionnaires, medical records, and registers. A total of 721 patients with recent-onset psoriasis (<12 months duration), 15 years or older were recruited using advertising and referrals from a broad range of health care settings. MAIN OUTCOMES AND MEASURES Disease severity and psoriatic arthritis (PsA). Recursive partitioning and regression models were implemented to identify probable indicators of long-term outcomes. RESULTS A total of 721 patients (median [interquartile range] age, 39 [27-55] years; 405 [56%] women), including 542 (75%) with plaque-onset and 174 (24%) with guttate-onset psoriasis, were enrolled. The median follow-up was 9.6 years (interquartile range, 8.8-10.4 years). The cumulative incidence of severe psoriasis at 12 years from enrollment was 21%. Among 509 patients examined clinically after 10 years, 77 of 389 patients (20%) with plaque onset and 56 of 116 (48%) with guttate onset had minimal disease activity without treatment, and 120 of 509 (24%) had PsA. Recursive partitioning identified strata with distinct risks for severe skin disease and PsA: the cumulative incidence of severe disease in patients with plaque phenotype, above-median disease activity, and scalp lesions was 52% (95% CI, 41%-64%), compared with 11% (95% CI, 8%-14%) in patients with below-median disease activity at inclusion; and 48 of 82 patients (59%) with peripheral enthesitis had PsA after 10 years compared with 37 of 304 patients (12%) without initial joint pain (P < .001). Smoking (hazard ratio, 1.70; 95% CI, 1.10-2.63) and activating genes in the interleukin-23 (IL-23) pathway (odds ratio, 1.55; 95% CI, 1.14-2.11) were also significantly associated with a severe disease course. Systemic therapy at or before enrollment was associated with a lower risk for severe disease at 10 years compared with later initiation of systemic therapy (odds ratio, 0.24; 95% CI, 0.06-0.90). CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that combinations of clinical characteristics at onset and activating genes in the IL-23 pathway are significantly associated with the clinical course of psoriasis, whereas joint pain and peripheral enthesitis may indicate the probability of PsA. Patients within those categories merit specialist referral and closer follow-up. The possibility of modifying the disease course with early systemic intervention should be tested.
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Affiliation(s)
- Axel Svedbom
- Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- ICON Clinical Research, Stockholm, Sweden
| | - Lotus Mallbris
- Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Eli Lilly, Indianapolis, Indiana
| | - Per Larsson
- Division of Rheumatology, Department of Medicine Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Nikamo
- Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Enikö Sonkoly
- Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Dermatology and Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Liv Eidsmo
- Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Dermatology and Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Ulla Lindqvist
- Department of Medical Sciences, Rheumatology, Uppsala University, Sweden
| | - Mona Ståhle
- Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Dermatology and Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
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Cintron BJ. Psoriatic Arthritis. PHYSICIAN ASSISTANT CLINICS 2021. [DOI: 10.1016/j.cpha.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Li KJ, Tsai TF, Lo Y, Wang TS. Correlation of clinical diagnosis of dactylitis by the dermatologist and ultrasonographic diagnosis by the rheumatologist in patients with psoriasis arthritis: Experience of a single clinic. DERMATOL SIN 2021. [DOI: 10.4103/ds.ds_53_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Akaishi T, Yamasaki K, Mori Y, Takahashi T, Izumiyama T, Terui H, Abe M, Takayama S, Aiba S, Ishii T. Psoriatic arthritis with skin lesions localized to the scalp: A case report. J Gen Fam Med 2020; 21:264-267. [PMID: 33304723 PMCID: PMC7689237 DOI: 10.1002/jgf2.358] [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: 02/18/2020] [Revised: 06/01/2020] [Accepted: 06/15/2020] [Indexed: 12/05/2022] Open
Abstract
A 66-year-old man with a 2-year history of suspected scalp eczema with excessive dandruff developed painful swollen joints in the extremities. Four months after developing polyarthritis and polydactylitis, eczema gradually spread to the face. He was referred to our hospital for intractable scalp and facial eczema and polyarthritis. Based on the appearance of the head and facial skin lesions, psoriasis was suspected. Treatment with apremilast (a phosphodiesterase-4-inhibitor) was initiated, which swiftly alleviated the skin lesions. The joint deformities persisted, but the pain in the joints disappeared. This case implies that psoriatic arthritis should be suspected even if psoriatic skin lesions are localized to the scalp.
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Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional MedicineTohoku University HospitalSendaiJapan
| | - Kenshi Yamasaki
- Department of DermatologyTohoku University Graduate School of MedicineSendaiJapan
| | - Yu Mori
- Department of Orthopedic SurgeryTohoku University Graduate School of MedicineSendaiJapan
| | - Toshiya Takahashi
- Department of DermatologyTohoku University Graduate School of MedicineSendaiJapan
| | - Takuya Izumiyama
- Department of Orthopedic SurgeryTohoku University Graduate School of MedicineSendaiJapan
| | - Hitoshi Terui
- Department of DermatologyTohoku University Graduate School of MedicineSendaiJapan
| | - Michiaki Abe
- Department of Education and Support for Regional MedicineTohoku University HospitalSendaiJapan
| | - Shin Takayama
- Department of Education and Support for Regional MedicineTohoku University HospitalSendaiJapan
| | - Setsuya Aiba
- Department of DermatologyTohoku University Graduate School of MedicineSendaiJapan
| | - Tadashi Ishii
- Department of Education and Support for Regional MedicineTohoku University HospitalSendaiJapan
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Abstract
Psoriasis is caused by a complex interplay among the immune system, genetic background, autoantigens, and environmental factors. Recent studies have demonstrated that patients with psoriasis have a significantly higher serum homocysteine (Hcy) level and a higher prevalence of hyperhomocysteinaemia (HHcy). Insufficiency of folic acid and vitamin B12 can be a cause of HHcy in psoriasis. Hcy may promote the immuno-inflammatory process in the pathogenesis of psoriasis by activating Th1 and Th17 cells and neutrophils, while suppressing regulatory T cells. Moreover, Hcy can drive the immuno-inflammatory process by enhancing the production of the pro-inflammatory cytokines in related to psoriasis. Hcy can induce nuclear factor kappa B activation, which is critical in the immunopathogenesis of psoriasis. There may be a link between the oxidative stress state in psoriasis and the effect of HHcy. Hydrogen sulfide (H2S) may play a protective role in the pathogenesis of psoriasis and the deficiency of H2S in psoriasis may be caused by HHcy. As the role of Hcy in the pathogenesis of psoriasis is most likely established, Hcy can be a potential therapeutic target for the treatment of psoriasis. Systemic folinate calcium, a folic acid derivative, and topical vitamin B12 have found to be effective in treating psoriasis.
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17
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A novel biomarker of MMP-cleaved prolargin is elevated in patients with psoriatic arthritis. Sci Rep 2020; 10:13541. [PMID: 32782251 PMCID: PMC7419545 DOI: 10.1038/s41598-020-70327-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022] Open
Abstract
Psoriatic arthritis (PsA) is a chronic musculoskeletal inflammatory disease found in up to 30% of psoriasis patients. Prolargin—an extracellular matrix (ECM) protein present in cartilage and tendon—has been previously shown elevated in serum of patients with psoriasis. ECM protein fragments can reflect tissue turnover and pathological changes; thus, this study aimed to develop, validate and characterize a novel biomarker PROM targeting a matrix metalloproteinase (MMP)-cleaved prolargin neo-epitope, and to evaluate it as a biomarker for PsA. A competitive ELISA was developed with a monoclonal mouse antibody; dilution- and spiking-recovery, inter- and intra-variation, and accuracy were evaluated. Serum levels were evaluated in 55 healthy individuals and 111 patients diagnosed with PsA by the CASPAR criteria. Results indicated that the PROM assay was specific for the neo-epitope. Inter- and intra- assay variations were 11% and 4%, respectively. PROM was elevated (p = 0.0003) in patients with PsA (median: 0.24, IQR: 0.19–0.31) compared to healthy controls (0.18; 0.14–0.23) at baseline. AUROC for separation of healthy controls from PsA patients was 0.674 (95% CI 0.597–0.744, P < 0.001). In conclusion, MMP-cleaved prolargin can be quantified in serum by the PROM assay and has the potential to separate patients with PsA from healthy controls.
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Rech J, Sticherling M, Stoessel D, Biermann MHC, Häberle BM, Reinhardt M. Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: results from a claims database analysis. Rheumatol Adv Pract 2020; 4:rkaa033. [PMID: 33134811 PMCID: PMC7585407 DOI: 10.1093/rap/rkaa033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/17/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Psoriasis is a systemic inflammatory disease often accompanied by comorbidities, including metabolic syndrome, cardiovascular diseases and depression. Up to 41% of psoriasis patients develop psoriatic arthritis (PsA), making it one of the most relevant manifestations. A large health claims data set was analysed to determine the rate of PsA development in psoriasis patients. Furthermore, comorbid disease profiles of psoriasis patients with or without PsA were compared, and potential risk factors for the development of PsA were identified. METHODS This was a non-interventional, retrospective analysis of anonymized insurance health claims data using a subset of the Institute of Applied Health Research Berlin (InGef) database. The primary outcome was the prevalence and incidence of diagnosed PsA among psoriasis patients in Germany. Risk factors for the development of PsA in psoriasis patients were determined by conditional logistic regression analysis. RESULTS The cumulative percentage of patients with existing psoriasis developing concomitant PsA over 4 years was 3.44%, with a mean time to diagnosis of PsA of 1.5 years. Psoriasis patients diagnosed with acute rheumatism (odds ratio: 2.93, 95% CI = 1.76, 4.86; P < 0.001) or pain in unspecific joints (odds ratio: 1.74, 95% CI = 1.01, 2.99; P = 0.047) showed an increased risk for development of PsA later on. Interestingly, fewer than half of the patients with concomitant PsA consulted a rheumatologist. CONCLUSIONS Unspecific arthritic symptoms are likely to precede PsA diagnoses and can develop soon after onset of psoriasis, with accumulating risk over time. There is a high unmet need for early rheumatological assessment of psoriasis patients.
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Affiliation(s)
- Jürgen Rech
- Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany
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Theodorakopoulou E, Dalamaga M, Katsimbri P, Boumpas DT, Papadavid E. How does the joint dermatology-rheumatology clinic benefit both patients and dermatologists? Dermatol Ther 2020; 33:e13283. [PMID: 32092214 DOI: 10.1111/dth.13283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
Abstract
Psoriasis (Pso) and psoriatic arthritis (PsA) are chronic and debilitating diseases which often develop in the same patient and are linked to a wide range of comorbid conditions. Dermatologists and rheumatologists need to cooperate in combined clinics, especially when they deal with severe, recalcitrant disease, and multiple comorbidities. The clinical and research benefits of this collaboration have been previously described to contribute to a better and more sustainable health care system. To apply a more holistic approach of patients with Pso and PsA, we established the first dual care clinic in Greece, for Pso and PsA patients, based at Attikon General University Hospital. Hereby, we describe the infrastructure and operation of a combined Pso and PsA clinic (PPAC), in the national health care system of Greece, and its impact on the management of Pso and PsA. The PPAC is a single-day joint clinic, held once a week, which consists of three dermatologists and three rheumatologists. We present the results of 185 newly diagnosed patients between December 2018 and January 2019. Mean age of onset of Pso was 34 ± 16 years old and 47 ± 12 years old for PsA. Most patients suffered from severe plaque Pso (144/185, 78%) and asymmetric oligoarticular arthritis (59/185, 32%), for which they were receiving treatment with biologic agents (105/185, 57%). Many required monitoring for hypertension (74/185, 40%), dyslipidemia (69/185, 37%), diabetes (17/185, 9%), and depression (20/185, 11%). Patients reported high levels of care satisfaction (visual analogue scale: 86 ± 11.5), using the PPAC facility, compared to different referrals between specialties. This is the first joint dermatology-rheumatology clinic in Greece, providing comprehensive care in patients with Pso and PsA. Our results support the concept of combined clinics delivering better integrated care for such patients.
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Affiliation(s)
- Elina Theodorakopoulou
- 2nd Dermatology Clinic, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Dalamaga
- 2nd Dermatology Clinic, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Pelagia Katsimbri
- 4th Department of Internal Medicine, Rheumatology Clinic, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios T Boumpas
- 4th Department of Internal Medicine, Rheumatology Clinic, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Papadavid
- 2nd Dermatology Clinic, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Medvedeva IV, Stokes ME, Eisinger D, LaBrie ST, Ai J, Trotter MWB, Schafer P, Yang R. Large-scale Analyses of Disease Biomarkers and Apremilast Pharmacodynamic Effects. Sci Rep 2020; 10:605. [PMID: 31953524 PMCID: PMC6969165 DOI: 10.1038/s41598-020-57542-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 12/12/2019] [Indexed: 01/06/2023] Open
Abstract
Finding biomarkers that provide shared link between disease severity, drug-induced pharmacodynamic effects and response status in human trials can provide number of values for patient benefits: elucidating current therapeutic mechanism-of-action, and, back-translating to fast-track development of next-generation therapeutics. Both opportunities are predicated on proactive generation of human molecular profiles that capture longitudinal trajectories before and after pharmacological intervention. Here, we present the largest plasma proteomic biomarker dataset available to-date and the corresponding analyses from placebo-controlled Phase III clinical trials of the phosphodiesterase type 4 inhibitor apremilast in psoriasis (PSOR), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) from 526 subjects overall. Using approximately 150 plasma analytes tracked across three time points, we identified IL-17A and KLK-7 as biomarkers for disease severity and apremilast pharmacodynamic effect in psoriasis patients. Combined decline rate of KLK-7, PEDF, MDC and ANGPTL4 by Week 16 represented biomarkers for the responder subgroup, shedding insights into therapeutic mechanisms. In ankylosing spondylitis patients, IL-6 and LRG-1 were identified as biomarkers with concordance to disease severity. Apremilast-induced LRG-1 increase was consistent with the overall lack of efficacy in ankylosing spondylitis. Taken together, these findings expanded the mechanistic knowledge base of apremilast and provided translational foundations to accelerate future efforts including compound differentiation, combination, and repurposing.
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Affiliation(s)
- Irina V Medvedeva
- Celgene Corporation, Informatics&Predictive Sciences, Cambridge, 02140, USA.
| | - Matthew E Stokes
- Celgene Corporation, Informatics&Predictive Sciences, Cambridge, 02140, USA
| | | | | | - Jing Ai
- Celgene Corporation, Informatics&Predictive Sciences, Cambridge, 02140, USA
| | - Matthew W B Trotter
- Celgene Corporation, Celgene Institute for Translational Research Europe (CITRE), Sevilla, 41092, Spain
| | - Peter Schafer
- Celgene Corporation, Translational Development, Summit, 07901, USA
| | - Robert Yang
- Celgene Corporation, Informatics&Predictive Sciences, Cambridge, 02140, USA
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21
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Queen D, Ediriweera C, Liu L. Function and Regulation of IL-36 Signaling in Inflammatory Diseases and Cancer Development. Front Cell Dev Biol 2019; 7:317. [PMID: 31867327 PMCID: PMC6904269 DOI: 10.3389/fcell.2019.00317] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/20/2019] [Indexed: 12/31/2022] Open
Abstract
The IL-36 subfamily of cytokines belongs to the IL-1 superfamily and consists of three pro-inflammatory agonists IL-36α, IL-36β, IL-36γ, and an IL-36 receptor (IL-36R) antagonist, IL-36Ra. These IL-36 cytokines function through a common receptor to modulate innate and adaptive immune responses. IL-36 cytokines are expressed as inactive precursors and require proteolytic processing to become fully active. Upon binding to IL-36R, IL-36 agonists augment the expression and production of inflammatory cytokines via activating signaling pathways. IL-36 is mainly expressed in epidermal, bronchial, and intestinal epithelial cells that form the barrier structures of the body and regulates the balance between pro-inflammatory and anti-inflammatory cytokine production at these tissue sites. Dysregulation of IL-36 signaling is a major etiological factor in the development of autoimmune and inflammatory diseases. Besides its critical role in inflammatory skin diseases such as psoriasis, emerging evidence suggests that aberrant IL-36 activities also promote inflammatory diseases in the lung, kidneys, and intestines, underscoring the potential of IL-36 as a therapeutic target for common inflammatory diseases. The role of IL-36 signaling in cancer development is also under investigation, with limited studies suggesting a potential anti-tumor effect. In this comprehensive review, we summarize current knowledge regarding the expression, activation, regulatory mechanisms, and biological functions of IL-36 signaling in immunity, inflammatory diseases, and cancer development.
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Affiliation(s)
- Dawn Queen
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | | | - Liang Liu
- The Hormel Institute, University of Minnesota, Austin, MN, United States
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22
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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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23
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A Review for Physician Assistants and Nurse Practitioners on the Considerations for Diagnosing and Treating Psoriatic Arthritis. Rheumatol Ther 2018; 6:5-21. [PMID: 30570707 PMCID: PMC6393269 DOI: 10.1007/s40744-018-0133-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 02/08/2023] Open
Abstract
Psoriatic arthritis (PsA) is a clinically heterogeneous form of progressive inflammatory arthritis that affects up to 30% of patients with psoriasis. The rapid rate of progression associated with PsA makes early-disease diagnosis and treatment crucial to patients' quality of life and long-term health. With the aim of providing clinical guidance to physician assistants and nurse practitioners, this article gives an overview of the different PsA clinical domains, including peripheral arthritis, axial disease, enthesitis, dactylitis, skin disease, and nail dystrophy, which should be considered as part of diagnosis and treatment strategies. The efficacy of different therapies across these PsA domains is reviewed within the context of current PsA treatment guidelines while considering more recent data on newly approved therapies for PsA.Funding: Novartis Pharmaceuticals Corp., East Hanover, NJ, USA.
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Sandikci SC, Colak S, Aydoğan Baykara R, Öktem A, Cüre E, Omma A, Kucuk A. Evaluation of restless legs syndrome and sleep disorders in patients with psoriatic arthritis. Z Rheumatol 2018; 78:987-995. [DOI: 10.1007/s00393-018-0562-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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25
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Mahmood F, Coates LC, Helliwell PS. Current concepts and unmet needs in psoriatic arthritis. Clin Rheumatol 2017; 37:297-305. [DOI: 10.1007/s10067-017-3908-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 12/31/2022]
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26
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Megna M, Gisonni P, Napolitano M, Orabona GD, Patruno C, Ayala F, Balato N. The effect of smartphone addiction on hand joints in psoriatic patients: an ultrasound-based study. J Eur Acad Dermatol Venereol 2017; 32:73-78. [PMID: 28573823 DOI: 10.1111/jdv.14380] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/10/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Distal interphalangeal (DIP) arthritis is a frequent form of psoriatic arthritis being often linked to nail psoriasis. Modern society is characterized by overuse of smartphones. Indeed, literature has recently focalized on research into smartphone addiction and health-related problems. OBJECTIVES As smartphone addiction is able to determine overuse and repeated movements of DIP joints and nails, the aim of this study was to evaluate the impact of smartphone use on hand joints of young psoriatic patients. METHODS An observational study involving four different groups such as non-smartphone-addicted (SA) psoriatic patients, SA psoriatic patients, non-SA controls and SA controls was performed. Each subject underwent an ultrasound examination of both hands by three independent and blinded to group assignment radiologists. A specific score was used to evaluate the inflammatory state of the analysed joints. RESULTS The total ultrasound score was statistically significantly higher in SA controls respect to non-SA controls (3.4 vs. 1.4; P < 0.05) as well as in SA psoriasis patients compared to non-SA psoriatic subjects (15.2 vs. 6.7; P < 0.01). Higher mean of ultrasound score was found for left hand in controls (both SA or not) and for right hand in psoriatic subjects (both SA or not), however without reaching statistical significance. CONCLUSIONS Smartphone overuse was found to be linked with higher signs of inflammation of musculoskeletal structures of hands joints in both psoriasis and controls through ultrasound examination. Therefore, smartphone overuse may be a factor which facilitate or speed up the possible development of psoriatic arthritis.
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Affiliation(s)
- M Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Gisonni
- Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University of Naples Federico II, Naples, Italy
| | - M Napolitano
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - G Dell'Aversano Orabona
- Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University of Naples Federico II, Naples, Italy
| | - C Patruno
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - F Ayala
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - N Balato
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Sharif K, Watad A, Bragazzi NL, Adawi M, Amital H, Shoenfeld Y. Coffee and autoimmunity: More than a mere hot beverage! Autoimmun Rev 2017; 16:712-721. [PMID: 28479483 DOI: 10.1016/j.autrev.2017.05.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 04/05/2017] [Indexed: 12/20/2022]
Abstract
Coffee is one of the world's most consumed beverage. In the last decades, coffee consumption has attracted a huge body of research due to its impact on health. Recent scientific evidences showed that coffee intake could be associated with decreased mortality from cardiovascular and neurological diseases, diabetes type II, as well as from endometrial and liver cancer, among others. In this review, on the basis of available data in the literature, we aimed to investigate the association between coffee intake and its influence on the immune system and the insurgence of the most relevant autoimmune diseases. While some studies reported conflicting results, general trends have been identified. Coffee consumption seems to increase the risk of developing rheumatoid arthritis (RA) and type 1 diabetes mellitus (T1DM). By contrast, coffee consumption may exert a protective role against multiple sclerosis, primary sclerosing cholangitis, and ulcerative colitis. Concerning other autoimmune diseases such as systemic lupus erythematosus, psoriasis, primary biliary cholangitis and Crohn's disease, no significant association was found. In other studies, coffee consumption was shown to influence disease course and management options. Coffee intake led to a decrease in insulin sensitivity in T1DM, in methotrexate efficacy in RA, and in levothyroxine absorption in Hashimoto's disease. Further, coffee consumption was associated with cross reactivity with gliadin antibodies in celiac patients. Data on certain autoimmune diseases like systemic sclerosis, Sjögren's syndrome, and Behçet's disease, among others, are lacking in the existent literature. As such, further research is warranted.
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Affiliation(s)
- Kassem Sharif
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abdulla Watad
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Mohammad Adawi
- Padeh and Ziv hospitals, Bar-Ilan Faculty of Medicine, Israel
| | - Howard Amital
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Raimondo A, Lembo S, Di Caprio R, Donnarumma G, Monfrecola G, Balato N, Ayala F, Balato A. Psoriatic cutaneous inflammation promotes human monocyte differentiation into active osteoclasts, facilitating bone damage. Eur J Immunol 2017; 47:1062-1074. [DOI: 10.1002/eji.201646774] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/18/2017] [Accepted: 04/05/2017] [Indexed: 01/30/2023]
Affiliation(s)
- Annunziata Raimondo
- Department of Clinical Medicine and Surgery; University of Naples Federico II; Napoli Italy
| | - Serena Lembo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”; University of Salerno; Salerno Italy
| | - Roberta Di Caprio
- Department of Clinical Medicine and Surgery; University of Naples Federico II; Napoli Italy
| | - Giovanna Donnarumma
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology; Second University of Naples; Napoli Italy
| | - Giuseppe Monfrecola
- Department of Clinical Medicine and Surgery; University of Naples Federico II; Napoli Italy
| | - Nicola Balato
- Department of Clinical Medicine and Surgery; University of Naples Federico II; Napoli Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery; University of Naples Federico II; Napoli Italy
| | - Anna Balato
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Napoli Italy
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29
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Urbancek S, Sutka R, Kmecova Z, Salkovska J, Vano I, Pecova T, Rovensky J. Screening of Patients with Psoriasis for Psoriatic Arthritis in the Slovak Republic. ACTA MEDICA MARTINIANA 2017. [DOI: 10.1515/acm-2016-0015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Global prevalence of psoriasis is ranging from 0.91 % to 8.5 % [1]. Exact numbers are missing for Slovakia. 1-5% range is the most probable while 2 % is also mentioned as an average prevalence for the European population. There is approximately 110 thousand patients suffering from psoriasis when extrapolating from total population of 5.5 million [2]. Extracutaneous manifestation is observed in 11–30 % of patients after years of solely skin symptoms presentation [3, 4, 5, 6].
Objective: To estimate prevalence of psoriatic arthritis among psoriatic patients population visiting dermatology out-patient irrelevant of the disease duration and the treatment regimen. To compare the sensitivity of both tests (ToPAS and PASE) used, evaluate possible PsA risk factors.
Methods: This was a prospective, non-interventional, epidemiological, observational study conducted using a survey administered to psoriatic patients by their dermatologists. 10–20 consequent outpatients with psoriasis in each center in 43 regional dermatology officies were screened for the presence of extra-cutaneous symptoms (i.e. joint pain, enthesitis, dactylitis, nail involvement) using questionnaire, developed specificaly for this study, and by the PASE and ToPAS questionnaires. Patients without personal history of PsA and „positivity“ of PASE and/or ToPAS were sent to the center for confirmation / exclusion of the diagnosis by applying CASPAR criteria. Outcomes were statistically processed.
Results: 177 (21.8 %) of total of 831 psoriatic patients had PsA. 9 of 177 (5.35 %) has been newly diagnosed. There was almost equal number of men (50.5 %) and women (49.5 %).
Plaque psoriasis has been most frequent type – 76.9 %. 43.2 % of PsA patients reported the onset of the disease after 40 years of life. Time interval between onset of psoriasis and PsA has been less than 10 years in 20.2 %, 10–20 years in 20.8 % and more than 20 years in 16.1 %. Most frequent co-morbidity in the study population was hypertension 23.2 %, asthma 3 % and diabetes 2.4 %. Average value of BSA and PASI was higher in PsA vs. non-PsA group: 24 vs. 20 and 10 vs 9, respectively. The sensitivity (72.6 % vs 58.9 %, P=0.01) and specificity (81.3 % vs 80.5 %) of ToPAS was higher compared to PASE.
Conclusion: 21.8 % PsA prevalence in psoriatic population in Slovakia is within the range observed in other studies. ToPAS test showed comparable results in terms of specificity, but significantly better results in terms of sensitivity and its early application should be of major importance because of the diagnostic process acceleration. The effect of an early diagnosis on the total patient outcome should be an objective of further research. This project was supported from educational grant of Pfizer Inc.
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Affiliation(s)
| | - R Sutka
- Comenius University Jessenius Faculty of Medicine and University Hospital, Department of Dermatovenerology, Martin, Slovak Republic
| | - Z Kmecova
- Rheumatology F.D. Roosevelt Hospital, Banska Bystrica
| | | | - I Vano
- Internal Medicine, University Hospital, Nitra
| | - T Pecova
- Comenius University Jessenius Faculty of Medicine and University Hospital, Department of Dermatovenerology, Martin, Slovak Republic
| | - J Rovensky
- National Institute of Rheumatic Diseases, Piešťany, Slovakia
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30
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Qu X, Zhang S, Tao L, Song Y. A meta-analysis of apremilast on psoriatic arthritis long-term assessment of clinical efficacy (PALACE). Expert Rev Clin Pharmacol 2016; 9:799-805. [PMID: 26918950 DOI: 10.1586/17512433.2016.1159130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Xiaoyu Qu
- Department of Pharmacy, The First Hospital of Jilin University, Changchun, PR China
| | - Sixi Zhang
- Department of Pharmacy, The First Hospital of Jilin University, Changchun, PR China
| | - Lina Tao
- Department of Pharmacy, The First Hospital of Jilin University, Changchun, PR China
| | - Yanqing Song
- Department of Pharmacy, The First Hospital of Jilin University, Changchun, PR China
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