Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort

Tillett, William; Charlton, Rachel; Nightingale, Alison; Snowball, Julia; Green, Amelia; Smith, Catherine; Shaddick, Gavin; McHugh, Neil

doi:10.1093/rheumatology/kex323

Cited by 76 publications

(61 citation statements)

References 15 publications

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“…Psoriatic arthritis (PsA) is characterized by sometimes treatment resistant, chronic progressive and destructive arthritis. Approximately 0.27% of patients with adult-onset psoriasis will develop PsA per year (63). Considering the inflammatory spectrum, psoriasis exhibits features of a mixed-pattern disease based on stage and phenotype specific involvement of mediators of innate and/or adaptive immune effectors.…”

Section: Epigenetic Events In the Mixed Pattern Disease Psoriasismentioning

confidence: 99%

The Role of Epigenetics in Autoimmune/Inflammatory Disease

2019

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Historically, systemic self-inflammatory conditions were classified as either autoinflammatory and caused by the innate immune system or autoimmune and driven by adaptive immune responses. However, it became clear that reality is much more complex and that autoimmune/inflammatory conditions range along an “inflammatory spectrum” with primarily autoinflammatory vs. autoimmune conditions resembling extremes at either end. Epigenetic modifications influence gene expression and alter cellular functions without modifying the genomic sequence. Methylation of CpG DNA dinucleotides and/or their hydroxymethylation, post-translational modifications to amino termini of histone proteins, and non-coding RNA expression are main epigenetic events. The pathophysiology of autoimmune/inflammatory diseases has been closely linked with disease causing gene mutations (rare) or a combination of genetic susceptibility and epigenetic modifications arising from exposure to the environment (more common). Over recent years, progress has been made in understanding molecular mechanisms involved in systemic inflammation and the contribution of innate and adaptive immune responses. Epigenetic events have been identified as (i) central pathophysiological factors in addition to genetic disease predisposition and (ii) as co-factors determining clinical pictures and outcomes in individuals with monogenic disease. Thus, a complete understanding of epigenetic contributors to autoimmune/inflammatory disease will result in approaches to predict individual disease outcomes and the introduction of effective, target-directed, and tolerable therapies. Here, we summarize recent findings that signify the importance of epigenetic modifications in autoimmune/inflammatory disorders along the inflammatory spectrum choosing three examples: the autoinflammatory bone condition chronic nonbacterial osteomyelitis (CNO), the “mixed pattern” disorder psoriasis, and the autoimmune disease systemic lupus erythematosus (SLE).

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Section: Epigenetic Events In the Mixed Pattern Disease Psoriasismentioning

confidence: 99%

The Role of Epigenetics in Autoimmune/Inflammatory Disease

2019

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“…Almost 75% of cases begin before the age of 40. PA is shown to affect 20%-30% of psoriatic patients [3,7].…”

Section: Introduction and Objectivementioning

confidence: 99%

Environmental risk factors and epigenetic alternations in psoriasis

Roszkiewicz¹,

Dopytalska²,

Szymańska³

et al. 2020

Ann Agric Environ Med.

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Introduction and objective. Psoriasis isa quite common, chronic and immune-mediated skin disorder. The prevalence of psoriasis differs in various countries, but it is said to affect 2% of the world's population in general. Psoriasis has many different clinical features but all lesions have the same characteristic: erythema, thickening and scale, although other clinical features are also connected, such as psoriatic arthritis, obesity and metabolic syndrome. All of these may lead to conditions impairing the quality of life. This review is an attempt to summarize recent data regarding environmental factors, together with epigenetic markers and processes playing an important role in psoriasis. State of knowledge. Many different environmental factors play a role in genetically predisposed patients. This is causes epigenetic alternations which may be a linking part in the whole process. Many studies have indicated a connection between psoriasis and various genes and antigens. The presence of HLA-Cw6 is common as well a strong link between its presence and the onset of psoriasis being observed. The main alternations are DNA methylation, histone's modifications and the role of microRNA. Excessive reaction is usually not present without a triggering factor. Environmental factors are mostly rated, such as drugs, life style and habits (smoking, alcohol), diet, physical trauma (skin injury provoking Koebner phenomenon), stress, microorganism and infections. Conclusions. The correlation between pathogenesis of psoriasis and environmental risk factors, together with epigenetic alternations still require more investigation. Education about diet habits, nutrition, weight loss and healthy lifestyle seems to be important during the treatment of psoriasis.

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“…In a longitudinal study in the United Kingdom, the majority of patients (82.3% and 61.3%, respectively) had psoriasis before their PsA diagnosis or within the same calendar year . The median time between diagnoses was 8 years [interquartile range (IQR) 2–15] in the collective of general practitioners and 7 years (IQR: 0–20) in the cohort of dermatologists . A similar distribution for the time interval between psoriasis and arthritis was observed in both cohorts.…”

mentioning

confidence: 64%

“…The high prevalence of undiagnosed PsA in patients with psoriasis adds to the recommendation that dermatologists need to screen all patients with psoriasis for PsA. In a longitudinal study in the United Kingdom, the majority of patients (82.3% and 61.3%, respectively) had psoriasis before their PsA diagnosis or within the same calendar year . The median time between diagnoses was 8 years [interquartile range (IQR) 2–15] in the collective of general practitioners and 7 years (IQR: 0–20) in the cohort of dermatologists .…”

mentioning

confidence: 99%