Extra-Articular Manifestations and Comorbidities in Psoriatic Disease: A Journey Into the Immunologic Crosstalk

Novelli, Lucia; Lubrano, Ennio; Venerito, Vincenzo; Perrotta, Fabio Massimo; Marando, Francesca; Curradi, Giacomo; Iannone, Florenzo

doi:10.3389/fmed.2021.737079

Cited by 20 publications

(19 citation statements)

References 153 publications

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“…6 Type 2 diabetes mellitus, cardiovascular diseases, hyperlipidemia, hypertension, and fibromyalgia have been identified as key co-morbid factors that guide the initiation and progression of PsA. 7 A few recent studies, [8][9][10] includ-ing our own earlier work, 11 have suggested a potential link between PD and PsA because both conditions share a number of remarkable traits, including bone resorption and altered bone remodeling, cell infiltration, a heightened immune response to microorganisms living on the epidermal surface of the skin or in periodontal tissues, and shared risk factors. 10,12 In fact, PD can be seen as a pertinent concern in psoriatic arthritis patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of periodontitis on oral health‐related quality of life of patients with psoriatic arthritis

Mishra,

Johnson,

Kaushal

et al. 2023

Special Care in Dentistry

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BackgroundSince oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, oral health‐related quality of life (OHRQoL) becomes an indispensable part of overall health. Previous published studies report that periodontitis (PD) and psoriatic arthritis (PsA) have a significant negative impact on OHRQoL. Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. Hence, the aim of the present study is to evaluate the OHRQoL and its impact among subjects with concurrent PsA and PD.Material and MethodsThe present study was a comparative, cross‐sectional investigation. A total of 200 participants were categorized into four groups‐ PD‐PsA (n = 50), PsA (n = 50), PD (n = 50), and healthy controls (n = 50). Demographic data and periodontal parameters—plaque index, sites with gingival bleeding, probing pocket depth, gingival recession, and clinical attachment level were recorded for all the four groups. Number of mobile teeth due to periodontitis was recorded for the PSA‐PD and PD groups. OHIP‐14 questionnaire was administered to all the four groups. Collected data was then subjected to statistical analysis.ResultsThe severity of OHIP‐14 summary scores was highest in the PsA‐PD group (18.06 ± 11.22) followed by the PD group (17.02 ± 9.99) and lowest in the healthy group (6.32 ± 5.59) (p < .0001). The scores of all the domains‐ oral pain, oral function, orofacial appearance and psychological impact were highest among the PsA‐PD group followed by the PD group (p < .0001). The combined interaction of PsA and PD on the OHRQoL was statistically significant (F = 6.33, p = .012). Results of the multiple linear regression analysis indicated that there was a moderate collective significant effect between age, past dental visit, frequency of daily tooth brushing, use of other oral hygiene aids, and OHIP‐14 (F(3,196) = 13.08, p < .001, R2 = 0.17, adjusted R2 = 0.15).ConclusionThe negative impact on OHRQoL was highest in the patients with concurrent presence of PD with PsA followed by those with PD alone. While the summary scores and dimensional scores of OHIP‐14 were insignificant when patients with PsA‐PD and PD alone were compared, these scores were significantly higher in patients with PsA‐PD than patients with PsA alone.

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Section: Discussionmentioning

confidence: 99%

Impact of periodontitis on oral health‐related quality of life of patients with psoriatic arthritis

Mishra,

Johnson,

Kaushal

et al. 2023

Special Care in Dentistry

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“…Psoriatic disease is accompanied by extracutaneous and extra-articular manifestations, as well as by a wide range of comorbidities. Compared with controls, patients with psoriatic disease have a higher incidence rate of other autoimmune diseases, cardiovascular disease, obesity/overweight, depression, anxiety, smoking, cancer, diabetes, alcohol abuse, osteoporosis, uveitis, and fatty liver disease [ 45 ]. One of the common connectors between the disease and its comorbidities is inflammation.…”

Section: Nf-κb Genetic Variants and Cardiometabolic Comorbiditymentioning

confidence: 99%

“…IL-17, one of PsA signature cytokines, promotes bone resorption via RANK ligand upregulation. Indeed, Th17 cells have been found to be highly increased in blood and tissues of patients with OP [ 45 ].…”

Section: Nf-κb Genetic Variants and Cardiometabolic Comorbiditymentioning

confidence: 99%

Genetic Variants of the NF-κB Pathway: Unraveling the Genetic Architecture of Psoriatic Disease

Queiró

Coto-Segura

González-Lara

et al. 2021

IJMS

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Psoriasis is a multifactorial genetic disease for which the genetic factors explain about 70% of disease susceptibility. Up to 30–40% of psoriasis patients develop psoriatic arthritis (PsA). However, PsA can be considered as a “disease within a disease”, since in most cases psoriasis is already present when joint complaints begin. This has made studies that attempt to unravel the genetic basis for both components of psoriatic disease enormously difficult. Psoriatic disease is also accompanied by a high burden of comorbid conditions, mainly of the cardiometabolic type. It is currently unclear whether these comorbidities and psoriatic disease have a shared genetic basis or not. The nuclear factor of kappa light chain enhancer of activated B cells (NF-κB) is a transcription factor that regulates a plethora of genes in response to infection, inflammation, and a wide variety of stimuli on several cell types. This mini-review is focused on recent findings that highlight the importance of this pathway both in the susceptibility and in the determinism of some features of psoriatic disease. We also briefly review the importance of genetic variants of this pathway as biomarkers of pharmacological response. All the above may help to better understand the etiopathogenesis of this complex entity.

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“…Moreover, extra-articular manifestations, including gastrointestinal, anterior ocular, cardiovascular, and non-psoriatic cutaneous involvement, might be found in up to 35% of patients with PsA and in up to 50% of BS patients, further complicating the differential diagnosis [2,[12][13][14]. Notably, common immunopathogenic pathways, including among others key cytokines such as tumor necrosis factor (TNF) alpha, interleukin (IL-17), IL12 and IL23, sustain articular and extra-articular manifestations in both diseases [1,6,[15][16][17]. The relationship between BS and PsA is also supported by the recent evidence that BS patients present a significantly increased risk of psoriasis, and still greater risk of PsA, being twice more vulnerable to PsA as compared to non-BS subjects [13].…”

Section: Introductionmentioning

confidence: 99%

Serum Interleukin-36 α as a Candidate Biomarker to Distinguish Behçet’s Syndrome and Psoriatic Arthritis

Bettiol,

Fagni,

Mattioli

et al. 2023

IJMS

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Behçet’s syndrome (BS) is a rare systemic vasculitis characterized by different clinical manifestations. As no specific laboratory tests exist, the diagnosis relies on clinical criteria, and the differential diagnosis with other inflammatory diseases can be challenging. Indeed, in a relatively small proportion of patients, BS symptoms include only mucocutaneous, articular, gastrointestinal, and non-typical ocular manifestations, which are frequently found also in psoriatic arthritis (PsA). We investigate the ability of serum interleukin (IL)-36α—a pro-inflammatory cytokine involved in cutaneous and articular inflammatory diseases—to differentiate BS from PsA. A cross-sectional study was performed on 90 patients with BS, 80 with PsA and 80 healthy controls. Significantly lower IL-36α concentrations were found in patients with BS as compared to PsA, although in both groups IL-36α was significantly increased compared to healthy controls. An empirical cut-off of 420.6 pg/mL displayed a specificity of 0.93, with a sensitivity of 0.70 (AUC 0.82) in discriminating PsA from BS. This cut-off displayed a good diagnostic performance also in BS patients lacking highly specific BS manifestations. Our results indicate that IL-36α might be involved in the pathogenesis of both BS and PsA, and might be a candidate biomarker to support the differential diagnosis of BS.

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Extra-Articular Manifestations and Comorbidities in Psoriatic Disease: A Journey Into the Immunologic Crosstalk

Cited by 20 publications

References 153 publications

Impact of periodontitis on oral health‐related quality of life of patients with psoriatic arthritis

Impact of periodontitis on oral health‐related quality of life of patients with psoriatic arthritis

Genetic Variants of the NF-κB Pathway: Unraveling the Genetic Architecture of Psoriatic Disease

Serum Interleukin-36 α as a Candidate Biomarker to Distinguish Behçet’s Syndrome and Psoriatic Arthritis

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