Differences in Osteoimmunological Biomarkers Predictive of Psoriatic Arthritis among a Large Italian Cohort of Psoriatic Patients

Abstract

(1) Background: In literature it is reported that 20–30% of psoriatic patients evolve to psoriatic arthritis over time. Currently, no specific biochemical markers can either predict progression to psoriatic arthritis or response to therapies. This study aimed to identify osteoimmunological markers applicable to clinical practice, giving a quantitative tool for evaluating pathological status and, eventually, to provide prognostic support in diagnosis. (2) Methods: Soluble (serum) bone and cartilage markers were quantified in 50 patients with only psoriasis, 50 psoriatic patients with psoriatic arthritis, and 20 healthy controls by means of multiplex and enzyme-linked immunoassays. (3) Results: Differences in the concentrations of matrix metalloproteases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), receptor activator of nuclear factor kappa-B- ligand (RANK-L), procollagen type I N propeptide (PINP), C-terminal telopeptide of type I collagen (CTx-I), dickkopf-related protein 1 (DKK1), and sclerostin (SOST) distinguished healthy controls from psoriasis and psoriatic arthritis patients. We found that MMP2, MMP12, MMP13, TIMP2, and TIMP4 distinguished psoriasis from psoriatic arthritis patients undergoing a systemic treatment, with a good diagnostic accuracy (Area under the ROC Curve (AUC) > 0.7). Then, chitinase-3-like protein 1 (CHI3L1) and MMP10 distinguished psoriasis from psoriatic arthritis not undergoing systemic therapy and, in the presence of onychopathy, MMP8 levels were higher in psoriasis than in psoriatic arthritis. However, in these latter cases, the diagnostic accuracy of the identified biomarkers was low (0.5 < AUC < 0.7). (4) Conclusions. By highlighting never exploited differences, the wide osteoimmunological biomarkers panel provides a novel clue to the development of diagnostic paths in psoriasis and psoriasis-associated arthropathic disease.

Interleukin-17A and Keratinocytes in Psoriasis

“…Genetic factors are critically involved in the development of psoriasis [12,13]. In addition to skin eruption, approximately 30% of patients with psoriasis manifest psoriatic arthritis [14][15][16][17][18][19]. Psoriasis is also significantly comorbid with other autoimmune diseases, such as bullous pemphigoid [20][21][22][23][24].…”

Assessment of Selected Matrix Metalloproteinases (MMPs) and Correlation with Cytokines in Psoriatic Patients

“…Mediators of Inflammation [15][16][17][18]. High MMP-1 and MMP-9 levels were also noticed in psoriatic patients' serum [19][20][21][22][23]. Choi et al [24] demonstrated that NB-UVB irradiation upregulated MMP-1 expression at both the mRNA and protein levels.…”

“…However, some authors recognized MMP-1 and MMP-3 as the biomarkers of PsA [25,29,[40][41][42]. Diani et al [23] observed elevation of serum MMP-1, MMP-9, and MMP-10 both in psoriatic patients and in patients with PsA.…”

A Female Psoriatic Arthritis Patient Involving the TMJ

“…The epidemiological studies in literature report around 1 to 3% of incidence with prevalence in Caucasian ethnicity [ 4 ]. About 25% of patients with psoriasis develop a rheumatological form, the PsA [ 5 , 6 ].…”

“…There are growing evidences that the phenotype of the disease is different between male and female but further studies are needed [ 10 , 13 ]. Sex differences in PsA include a more frequent axial involvement in men [ 6 ] and a predominant peripheral arthritis with higher disability scores in women [ 10 ].…”