Differences in Osteoimmunological Biomarkers Predictive of Psoriatic Arthritis among a Large Italian Cohort of Psoriatic Patients
Differences in Osteoimmunological Biomarkers Predictive of Psoriatic Arthritis among a Large Italian Cohort of Psoriatic Patients
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DOI：
10.3390/ijms20225617
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发表时间：
2019-11-01
影响因子：
5.6
通讯作者：
Lombardi, Giovanni
中科院分区：
文献类型：
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作者：
Diani, Marco;Perego, Silvia;Lombardi, Giovanni
(1)背景：据文献报道，20-30%的银屑病患者随着时间的推移会演变为银屑病关节炎。目前，没有特异性生化标志物可以预测银屑病关节炎的进展或对治疗的反应。本研究旨在确定适用于临床实践的骨免疫学标记物，为评估病理状态提供定量工具，并最终为诊断提供预后支持。(2)研究方法：可溶性（血清）骨和软骨标记物定量在50例银屑病患者，50例银屑病关节炎银屑病患者，20名健康对照组通过多重和酶联免疫测定。(3)结果如下：基质金属蛋白酶（MMPs）、金属蛋白酶组织抑制剂（TIMPs）、核因子κ-B-配体受体激活剂（RANK-L）、I型前胶原N前肽（PINP）、I型胶原C-末端肽（CTx-I）、dickkopf相关蛋白1（DKK 1）和硬化素（SOST）浓度的差异将健康对照与银屑病和银屑病关节炎患者区分开来。我们发现MMP 2、MMP 12、MMP 13、TIMP 2和TIMP 4可将银屑病与接受系统治疗的银屑病关节炎患者区分开来，具有良好的诊断准确性（ROC曲线下面积（AUC）> 0.7）。然后，几丁质酶3样蛋白1（CHI 3L 1）和MMP 10区分银屑病关节炎的银屑病关节炎没有经过系统治疗，在甲病的存在下，MMP 8水平高于银屑病关节炎。然而，在这些后一种情况下，鉴定的生物标志物的诊断准确性低（0.5 < AUC < 0.7）。(4)结论.通过突出从未利用的差异，广泛的骨免疫学生物标志物面板提供了一个新的线索，银屑病和银屑病相关的关节病的诊断路径的发展。
(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.