Classification Criteria: Peripheral Spondyloarthropathy and Psoriatic Arthritis

Taylor, William J.; Robinson, Philip C

doi:10.1007/s11926-013-0317-3

Cited by 29 publications

(25 citation statements)

References 22 publications

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“…PsA patients were diagnosed using the CASPAR criteria [16] and recruited from the Bellevue Hospital of New York University School of Medicine (Manhattan, New York). The Institutional Review Committee approved the study, and all subjects gave written informed consent.…”

Section: Patient and Control Populationsmentioning

confidence: 99%

Analysis of Programmed Death-1 in Patients with Psoriatic Arthritis

et al. 2015

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Programmed death-1 (PD-1) is an inhibitory co-receptor that is highly expressed in T lymphocytes that has been shown to downregulate inflammatory responses in several inflammatory diseases including systemic lupus erythematosus and rheumatoid arthritis. Yet, the role of PD-1 in psoriatic arthritis (PsA) has not been studied. In order to fill this gap, we measured the expression levels of PD-1 in peripheral T cells from patients with active disease. Twenty patients and fifteen age-matched healthy control subjects were recruited. The percentage of CD3(+)PD-1(+) T cells was measured by flow cytometry. Despite normal concentration of peripheral T cells, the expression levels of PD-1 were significantly higher in patients compared to healthy controls. Interestingly, among the patients, the expression levels inversely correlated with disease activity measured by disease activity scores (DAS28). PD-1 expression levels strongly correlated with the number of tender and swollen joints, but not with C-reactive protein (CRP) levels or psoriasis area and severity index (PASI). Functionally, in vitro ligation of PD-1 receptor in PsA T cells inhibited interleukin-2 (IL-2) secretion, Akt phosphorylation, and Rap1 activation. These findings suggest that PD-1 might serve as a biomarker for disease activity in PsA and highlight the need for additional studies in order to establish the role of PD-1 in PsA pathogenesis.

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Section: Patient and Control Populationsmentioning

confidence: 99%

Analysis of Programmed Death-1 in Patients with Psoriatic Arthritis

et al. 2015

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“…These criteria were designed to capture the entire spectrum of SpA, not purely axial disease. When measured against physician diagnosis as gold standard, the Amor and ESSG criteria have sensitivity and specificity of 87–90% each . These criteria have some scope to capture SpA earlier in its disease course, but their more general nature means that they are unable to identify specifically early axSpA.…”

Section: Classificationmentioning

confidence: 99%

Advances in classification, basic mechanisms and clinical science in ankylosing spondylitis and axial spondyloarthritis

Robinson

Benham

2015

Internal Medicine Journal

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The field of spondyloarthritis (SpA) has seen huge advances over the past 5 years. The classification of axial disease has been redefined by the axial SpA criteria that incorporate disease captured before radiographic damage is evident as well as established erosive sacroiliac joint disease. Our knowledge of genetics and basic immunological pathways has progressed significantly. In addition, revolutionary progress has been achieved with the availability of tumour necrosis factor inhibitors for treating patients with moderate to severe disease. In parallel, several of novel biomarkers have been identified that show significant promise for the future. Advances in magnetic resonance imaging have helped define positive disease. We have identified that T1 and short tau inversion recovery sequences are best for the diagnosis of axial SpA, and gadolinium contrast is not additive for diagnosis. Progress has been made in identifying potential agents and strategies that reduce radiographic progression. Several referral strategies aimed at appropriate identification of patients have been trialled and found to be effective. There is still substantial work ahead, but the advances of the last 5 years have made a huge and tangible difference at the clinical coalface, and we suggest that this trend will continue.

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“…By necessity, classification criteria include many features of the relevant disease, but using the clinician diagnosis as gold standard, no SpA classification criteria set has 100% specificity. Information is lacking for nr‐axSpA, but for SpA in general the specificity of different SpA classification criteria ranges from 83% to 88% . A hypothetical clinical example of the potential issue is: a 30‐year‐old patient who has Crohn's disease and mechanical back pain from a herniated disc, who is HLA‐B27‐positive and has a raised CRP from their bowel disease could be classified as nr‐axSpA (based on the ASAS criteria) when they do not in fact have nr‐axSpA.…”

Section: Resultsmentioning

confidence: 99%