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Association between uveitis and psoriatic disease: a systematic review and Meta-analysis based on the evidence from cohort studies

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International Journal of Ophthalmology(English edition) 2020年第4期13卷 650-659页

作者： Chao-Ran Li Lang Chen Long-Fei Wang Bin Yan You-Ling Liang Jing Luo Department of Ophthalmology the Second Xiangya HospitalCentral South UniversityChangsha 410011Hunan ProvinceChina General Surgery Department the Third Xiangya HospitalCentral South UniversityChangsha 410008Hunan ProvinceChina Cardiovascular Department Xiangya HospitalCentral South UniversityChangsha 410008Hunan ProvinceChina

AIM: To conduct a systematic review and Meta-analysis to examine the association between uveitis and psoriatic disease, and to evaluate whether one condition predisposes individuals to the other. METHODS: We performed a comprehensive search of Pub Med and EMBASE to identify cohort studies examining the association between uveitis and psoriatic disease [psoriasis and/or psoriatic arthritis(Ps A)]. We used a random-effects model to calculate the pooled relative risks(RRs) adjusted for confounders, along with the 95% confidence intervals(CIs). RESULTS: This Meta-analysis included a total of 6 studies and a maximum of 80 178 648 participants. Compared with non-psoriatic controls, uveitis risk was significantly elevated in patients with psoriasis(RR=1.49;95%CI: 1.08-2.07), and Ps A(RR=3.16;95%CI: 2.16-4.63). Furthermore, pre-existing uveitis was associated with a significantly increased risk of psoriasis(RR=1.62;95%CI: 1.44-1.83), and Ps A(RR=4.44;95%CI: 3.52-5.60).CONCLUSION: The results of this systematic review and Meta-analysis suggest an overall positive bidirectional association between uveitis and psoriatic disease(psoriasis and Ps A), warranting increased awareness among clinicians involved in the management of these two ***, there remains a need for more detailed studies of the possible common pathogenesis of psoriatic disease and uveitis.

关键词： Meta-analysis psoriasis psoriatic arthritis risk uveitis

What have we learned about non-involved psoriatic skin from large-scale expression studies?

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World Journal of Dermatology 2014年第3期3卷 50-57页

作者： Eszter Szlavicz Kornelia Szabo Zsuzsanna Bata-Csorgo Lajos Kemeny Marta Szell Department of Dermatology and Allergology University of Szeged H-6720 Szeged Hungary Dermatological Research Group of the Hungarian Academy of Sciences University of Szeged H-6720 Szeged Hungary Department of Medical Genetics the University of Szeged H-6720 Szeged Hungary

Psoriasis is a chronic inflammatory skin disorder; its genetic background has been widely studied in recent decades. Recognition of novel factors contributing to the pathogenesis of this disorder was facilitated by potent molecular biology tools developed during the 1990 s. Large-scale gene expression studies, including differential display and microarray, have been used in experimental dermatology to a great extent; moreover, skin was one of the first organs analyzed using these methods. We performed our first comprehensive gene expression analysis in 2000. With the help of differential display and microarray, we have discovered several novel factors contributing to the inherited susceptibility for psoriasis, including the EDA+ fibronectin splice variant and PRINS. The long non-coding PRINS RNA is expressed at higher levels in non-involved skin compared to healthy and involved psoriatic epidermis and might be a factor contributing cellular stress responses and, specifically, to the development of psoriatic symptoms. This review summarizes the most important results of our large-scale gene expression studies.

关键词： Non-involved psoriatic skin Differential display cDNA microarray EDA+fibronectin isoform PRINS long non-coding RNA mRNA maturation

Genetic Factors and psoriatic Arthritis

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第3期9卷 111-120页

作者： Monica Greco Simone Negrini Chiara Schiavi Francesca Giusti Matteo Borro Francesco Puppo Giuseppe Murdaca Clinical Immunology Unit Department of Internal Medicine University of Genoa and Ospedale Policlinico San Martino Genoa Italy

psoriatic arthritis (PsA) is a complex immune-mediated disease and its pathogenesis depends both on genetic factors and environment. PsA patients may present a wide range of clinical manifestations including skin and nail abnormalities. Indeed, articular involvement is variable too. Disease development relies on a heterogeneous net made of multiple cytokines pathways which are regulated by several factors including human leucocyte antigen (HLA) expression, miRNAs, microbiome. Among genetic polymorphisms which can lead to abnormal cytokine expression, tumor necrosis factor (TNF) polymorphisms have been studied. Thus, leading to the development of new therapeutic agents. Finally, further studies on genetic factors and epigenetics will give new insights into this complex disorder. The aim of this mini-review is to provide the reader with a summary of the fundamental and most innovative aspects of genetic and epigenetic factors involved in the PsA, thus including human leucocyte antigen (HLA) expression, tumor necrosis factor (TNF) polymorphisms, micro RNAs and microbiome.

关键词： psoriatic Arthritis Psoriasis HLA Associations Genetic Heterogeneity Phenotypic Heterogeneity Epigenetics Micro RNA Microbiome TNF Polymorphisms

A Needs-Based Rheumatologist Education Program on Treating to Target in psoriatic Arthritis and Spondyloarthropathy: Insights and Challenges

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Open Journal of Rheumatology and Autoimmune Diseases 2017年第1期7卷 53-64页

作者： Janet Pope Linda Wang Paul Tingey Angela Montgomery Art Karasik Pauline Boulos Vandana Ahluwalia Maggie Larche Sara Haig Nikhil Chopra Gina Rohekar Sherry Rohekar Schulich School of Medicine & Dentistry University of Western Ontario London Canada St. Joseph’s Health Care London Canada Medical School Brisbane Australia Unit 502 Mississauga Canada Suite 202 Toronto Canada Rheumatology Division Department of Medicine Michael G. DeGroote School of Medicine McMaster University Hamilton Canada Suite 314 Brampton Canada Suite 411 London Canada

Objectives: To determine if comparative practice data and education for rheumatologists would change physician behavior for monitoring and treating psoriatic arthritis (PsA) and spondyloarthritis (SpA). Methods: Participating rheumatologists each performed a chart audit on 20 patients with PsA and SpA. Accredited education (determined by a survey and chart audits) and results of chart audits (comparing to other rheumatologists) were provided for each participant (intervention). Eight months later, a repeat chart audit by each participant was conducted on another 20 PsA and SpA patients. Changes in measurements collected, treatment given and patient characteristics pre and post intervention were analyzed. Results: Nine rheumatologists received the intervention. At baseline, most routinely monitored PsA and SpA for clinical and laboratory markers. In PsA, there was no change post-intervention in performing SJC (96%), TJC (≥91%), ESR (≥70%), CRP (≥73%), and CDAI (25%). In SpA, there were increased measurements of inflammatory markers (54% pre vs. 61% post for CRP), more NSAID use and decreased physical exam measures and HAQ but no significant changes. There were no major treatment differences pre and post intervention including NSAIDs, DMARDs and biologics. Conclusions: The rheumatologists frequently performed measurements of disease activity, did not change significantly with educational intervention so there may have been little room for improvement and many patients were already in a low disease state. Calculation of composite scores did not increase in PsA. The validity of physical exam and BASDAI as a measurement of disease activity were noted as concerns in applying a treat-to-target approach in SpA. Significance and Innovation: This study did not show a significant change in behavior for rheumatologists who had education based on care gaps and needs assessment in psoriatic arthritis and spondyloarthropathy. The rheumatologists identified that disease activity is

关键词： Education Seronegative Arthritis psoriatic Arthritis Ankylosing Spondylitis Behavioral Change Outcome Assessments

Targeting the Inflammation Culprit in Patients with Psoriasis/psoriatic Arthritis and Associated Cardiovascular Comorbidities. Is the IL-17 Inhibitor the New Kid on the Block?

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World Journal of Cardiovascular Diseases 2019年第4期9卷 267-294页

作者： Cornel Pater Biopharmaceuticals Stockholm Sweden

Despite half-century old, but comprehensive national and international guidance, evidence of clinical effectiveness and widespread agreement on management of risk factors along with sophisticated measures for primary and secondary prevention of major cardiovascular events, cardiovascular disease remains the dominant cause of death and disability world-wide. Life style changes at population-level (e.g., lower salt and saturated fat consumption or reduced/banned amount of industrially-produced trans fatty acids in specific products, etc.) or changes at individual level (e.g., targeting modifiable risk factors/life style changes affecting smoking/tobacco use, poor diet, high blood cholesterol, high blood pressure, insufficient physical activity, overweight/obesity) have reduced coronary heart disease mortality to variable extent in different countries (mostly so reported in Finland, Iceland and Sweden) at the beginning of the new century. Overall, however, cardiovascular mortality is estimated to increase in the next coming years until 2030 at a cost exceeding US $1044 billion. Several decades of status quo are also noted in the therapeutic spectrum of cardiovascular disease, mainly consisting of variations to LDL-C lowering agents, antihypertensives, anticoagulants, antiplatelets and fibrinolytics. Most of the therapeutic interventions are “tertiary” in nature (probably some 60%), meaning that treatment is instituted once the individual has developed a pathologic condition;“secondary prevention” may cover some 25%?-?30% (meant to prevent re-occurrence of the condition or occurrence of complications) while “primary prevention” is left with 10%?-?15% share (most commonly implying life style changes at individual level and rarely pharmacological intervention). For almost three decades, the so-called inflammatory hypothesis has been promoted as a reasonable pathogenetic theory behind initiation and growth of atherosclerotic plaque (Alexander RW, 1994;Ross R, 1999). With t

关键词： Psoriasis psoriatic Arthritis Cardiovascular Comorbidities Inflammation Cy-tokines IL-17

Role of leptin in the progression of psoriatic,rheumatoid and osteoarthritis

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World Journal of Rheumatology 2016年第1期6卷 9-15页

作者： Jessica Mounessa Iryna Voloshyna Amy D Glass Allison B Reiss Winthrop Research Institute and Department of Medicine Winthrop-University HospitalSUNY Stony Brook School of Medicine

Leptin,an adipokine responsible for body weight regulation,may be involved in pathological processesrelated to inflammation in joint disorders including rheumatoid arthritis(RA),osteoarthritis,and psoriatic arthritis(PsA).These arthropathies have been associated with a wide range of systemic and inflammatory con-ditions including cardiovascular disease,obesity,and metabolic *** a potent mediator of immune responses,leptin has been found in some studies to play a role in these ***,current potent biologic treatments effectively used in Ps A including ustekinumab(an interleukin 12/23 blocker) and ada-limumab(a tumor necrosis factor-alpha blocker also used in RA) have been found to increase leptin receptor expression in human *** literature review aims to further investigate the role leptin may play in the disease activity of these arthropathies.

关键词： psoriatic arthritis Rheumatoid arthritis Leptin Ustekinumab Tumor necrosis factor-alpha

The Role of Osteoclasts in psoriatic Arthritis

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International Journal of Dermatology and Venereology 2021年第4期4卷 242-247页

作者： Zhen-Zhen Wang Hong-Sheng Wang Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Hospital for Skin Diseases(Institute of Dermatology)Chinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingJiangsu 210042China Center for Global Health School of Public HealthNanjing Medical UniversityNanjingJiangsu 211166China

psoriatic arthritis (PsA) is a chronic immune-mediated inflammatory disease related to psoriasis involving bone and cartilage. It is a heterogeneous disorder with a variety of clinical manifestations, which can include peripheral arthritis, axial spondylitis, enthesitis, skin and nail disease, dactylitis, uveitis, osteitis, inflammatory bowel disease. The distinctive feature of PsA is enthesitis. The characteristic bone erosion at the bone-pannus junction in PsA is mediated by osteoclasts, which are multinucleated giant cells derived from hematopoietic stem cells. Although the pathological mechanism of osteoclasts in PsA is mainly related to the destruction of the diseased joint, the exact pathogenesis of PsA is complex and the factors involved in initiation and termination of osteoclast need to be further explored. Much attention has been paid to the importance of osteoclast in psoriasis arthritis for decades. Based on the role of osteoclasts in PsA, our review discusses the formation and characteristics of multinucleated osteoclasts in PsA, summarizes current developments in osteoclast-related pathways in PsA including classical receptor activator of nuclear factor-κB-receptor activator of nuclear factor-κB ligand-osteoprotegerin pathway and immunomodulatory factors, as well as their advances and corresponding treatment. At present, the molecular and signal pathway that interacts with osteoclasts in the pathogenesis of PSA has not been fully elucidated, therefore more detailed studies are expected in the near future.

关键词： osteoclast psoriatic arthritis bone resorption

Power Doppler ultrasonographic assessment of the ankle in patients with inflammatory rheumatic diseases

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World Journal of Orthopedics 2014年第5期5卷 574-584页

作者： Takeshi Suzuki Division of Rheumatology Mitsui Memorial Hospital

Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.

关键词： Ankle Power Doppler Ultrasound Rheumatoid arthritis psoriatic arthritis Spondyloarthritis Tenosynovitis Enthesitis

Gender medicine and psoriasis

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World Journal of Dermatology 2014年第3期3卷 36-44页

作者： Delia Colombo Nicoletta Cassano Gilberto Bellia Gino A Vena Novartis Farma Sp A 21040 Origgio Italy Dermatology and Venereology Private Practice Bari and Barletta Italy

The study of specific differences between women and men is arousing huge interests in various fields of medicine, including dermatology. The available data on gender medicine applied to common skin diseases are unfortunately still scanty. Psoriasis is a chronic immunemediated skin disease which affects 1%-3% of most populations worldwide and can involve also the joints and entheses. The pathogenesis of the disease is very complex, resulting from the interaction between genetic predisposition and several environmental triggers. The pathogenic role of sex hormones has also been hypothesized. The analysis of gender-specific differences in psoriasis seems to suggest some interesting findings, such as an earlier age of disease onset in females, a higher probability of severe disease in men, or different tendencies in care utilization, adherence to treatment, development of psychological distress, and coping strategies. Moreover, sex-related differences have been recently described in some epidemiological and clinical features among patients with psoriatic arthritis. The objective of this article is to review briefly the available evidence regarding gender differences in various aspects of psoriasis, such as epidemiology, genetics, risk factors, associated conditions, quality of life, clinical and therapeutic aspects.

关键词： Psoriasis psoriatic arthritis Gender medicine Sex differences Epidemiology Risk factors Clinical aspects Comorbidities Quality of life Therapeutic management