The pathogenesis of psoriatic arthritis

Veale, Douglas J.; Fearon, Ursula

doi:10.1016/s0140-6736(18)30830-4

Cited by 359 publications

(270 citation statements)

References 129 publications

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“…While we examined the secretome of blood cells, one limitation of this study is that many other cell types in autoimmune arthritis are known to secrete cytokines, such as synoviocytes, fibroblasts, chondrocytes, osteoblasts/osteoclasts and epithelial cells (the latter ones in psoriatic arthritis for example), and that these cells, through their cytokine secretion, could contribute to the local pathology [23][24][25][26]. The cytokine pattern could evidently be different from the ones produced by the blood cells.…”

Section: Discussionmentioning

confidence: 99%

The use of leukocytes’ secretome to individually target biological therapy in autoimmune arthritis: a case report

Poubelle

Pagé

Longchamps

et al. 2019

Clinical & Translational Med

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Background Biological agents have allowed remarkable improvement in controlling autoimmune arthropathies, although none of the numerous biologics readily available represent a universal treatment standard. Moreover, classical and genetic predictors are currently unsatisfactory to predict individual response to a biologic, and the best treatment selection is still based on a trial-and-error approach. Here, we report a clinical case demonstrating the usefulness of examining the leukocytes’ secretome of patients. We set up and standardized a protocol that examines a patient’s immune responses to establish the secretome of the blood mononuclear leukocytes and personalize the biotherapy. Case presentation A 24-year-old woman was diagnosed with active early rheumatoid arthritis. The initial treatment regimen (prednisone, methotrexate, hydroxychloroquine, naproxen) was inefficient, as well as the anti-TNF adalimumab. The diagnosis was revised as possible rheumatoid arthritis-like psoriatic arthritis and adalimumab was replaced by abatacept (IgG1 Fc-CTLA-4) to no avail. Five years later, abatacept was replaced by the anti-IL-12/IL-23 ustekinumab with no objective control over the symptoms. The patient was thus enrolled in a prospective study based on the quantification of cytokines secreted by peripheral blood leukocytes stimulated with well-known immune activators of pattern recognition receptors and cytokine signalling. The results of this study revealed that plasma concentrations of cytokines were similar between the patient and healthy donors. In comparison to leukocytes from healthy donors, the patient’s secretome showed a unique overproduction of IL-6. The anti-IL-6 receptor tocilizumab was, therefore, administered with a rapid improvement of her active psoriatic arthritis that remained dependent on low prednisone dosage. Clinical parameters progressively returned to normal levels and her quality of life was greatly improved, despite the major delay to begin the present personalized treatment. Conclusions An efficient way to effectively treat patients with complex autoimmune arthropathies, and avoid irreversible disability, is to know their leukocytes’ secretome to identify abnormally secreted cytokines and personalize their biotherapy, as exemplified by this case report.

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Section: Discussionmentioning

confidence: 99%

The use of leukocytes’ secretome to individually target biological therapy in autoimmune arthritis: a case report

Poubelle

Pagé

Longchamps

et al. 2019

Clinical & Translational Med

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“…Hashimoto's thyroiditis (HT) is one of the most common autoimmune disorders in the general population, with a prevalence of 791.7/100 000, second only to rheumatoid arthritis (RA) . Inflammatory articular symptoms are very common in systemic autoimmune diseases but can also be present in immune‐driven organ‐specific disorders such as psoriasis, myasthenia gravis, inflammatory bowel disease and uveitis . Their presence in these different conditions does not always imply the co‐existence of a well‐defined rheumatic disease; instead, rheumatic symptoms may be just one more clinical feature of the underlying disease such as Raynaud's phenomenon and rash that are seen in various autoimmune disorders.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of undifferentiated inflammatory arthropathy in patients with Hashimoto's thyroiditis in an endocrinology clinic

et al. 2019

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Aim: Rheumatic manifestations are common in patients with Hashimoto's thyroiditis (HT).Since previous reports on the prevalence of arthritis in this disease may have a rheumatology referral bias, we sought to establish the prevalence of undifferentiated inflammatory arthropathy (UIA) in unselected HT patients as seen in an endocrinology clinic.Methods: Cross-sectional study of 92 consecutive HT patients and no definite rheumatic disease from the Endocrinology Division, Hospital Universitario de Caracas diagnosed by the presence of anti-thyroid peroxidase antibodies (n = 68) or typical ultrasonographic findings (n = 24). Undifferentiated inflammatory arthropathy was defined as combination of morning stiffness and joint pain with ≥2 characteristics of inflammatory joint pain. The study was revised and approved by the Ethics Committee of our hospital and all patients signed an informed consent form. Results:Twenty-three patients (25%; 95% CI 16-34) met the criteria for UIA. Joints most commonly affected were the knees, hands and ankles and the most common pattern was oligoarticular (82.6%). In the multivariate analysis, variables associated to the presence of UIA were the presence of myalgia (odds ratio [OR] = 19.41; 95% CI = 2.38-158.38) andRaynaud's phenomenon (OR = 4.32; 95% CI = 1.01-18.60). No association was found with demographics, duration of disease, comorbidities or thyroid function status.

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“…Ankylosing spondylitis (AS) is a systemic chronic, inflammatory disorder primarily affecting the spine and characterized by sacroiliitis and lower back pain that can result in destruction and fusion of spinal vertebrae 6 . PSOR, PsA, and AS are pathologically related conditions sharing common clinical manifestations and immunological drivers characterized by dendritic cells and helper T cells producing Th1 and Th17 cytokines including IL-23, TNF-α, IFN-γ, IL-17, and IL-22 [7][8][9] .…”

mentioning

confidence: 99%

Large-scale Analyses of Disease Biomarkers and Apremilast Pharmacodynamic Effects

Медведева

Stokes

Eisinger

et al. 2020

Sci Rep

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The pathogenesis of psoriatic arthritis

Cited by 359 publications

References 129 publications

The use of leukocytes’ secretome to individually target biological therapy in autoimmune arthritis: a case report

The use of leukocytes’ secretome to individually target biological therapy in autoimmune arthritis: a case report

Prevalence of undifferentiated inflammatory arthropathy in patients with Hashimoto's thyroiditis in an endocrinology clinic

Large-scale Analyses of Disease Biomarkers and Apremilast Pharmacodynamic Effects

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