Synovial histopathology of psoriatic arthritis, both oligo- and polyarticular, resembles spondyloarthropathy more than it does rheumatoid arthritis.
Synovial histopathology of psoriatic arthritis, both oligo- and polyarticular, resembles spondyloarthropathy more than it does rheumatoid arthritis.
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DOI：
10.1186/ar1698
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发表时间：
2005
影响因子：
4.9
通讯作者：
De Keyser, Filip
中科院分区：
文献类型：
--
作者：
Kruithof, Elli;Baeten, Dominique;De Rycke, Leen;Vandooren, Bernard;Foell, Dirk;Roth, Johannes;Canete, Juan D;Boots, Annemieke M;Veys, Eric M;De Keyser, Filip
目前，只有很少的生物学数据表明银屑病关节炎（PsA）是否是脊柱关节病（SpA）概念的一部分，它是一个单独的疾病实体或异质性疾病组，少关节/轴型属于SpA和多关节型类似类风湿性关节炎（RA）。为了解决外周滑膜炎的问题，我们比较了PsA与强直性脊柱炎（AS）/未分化SpA（USpA）和RA的滑膜特征，并比较了少关节与多关节PsA的滑膜。滑膜活检标本来自RA、非银屑病性SpA（AS + USpA）、少关节型和多关节型PsA患者。组织学分析包括衬里层厚度、血管分布、细胞浸润、淋巴聚集体、浆细胞和中性粒细胞的检查。此外，我们还对CD 3、CD 4、CD 8、CD 20、CD 38、CD 138、CD 68、CD 163、CD 83、CD 1a、CD 146、αVβ3、E-选择素、细胞间粘附分子-1、血管细胞粘附分子-1、S100 A12、细胞内瓜氨酸化蛋白和主要组织相容性复合物（MHC）-人软骨（HC）gp 39肽复合物进行了免疫组织化学评估。SpA（PsA + AS + USpA）组与RA组比较，血管密度、中性粒细胞和CD 163+巨噬细胞计数均高于RA组（P < 0.05），而衬里层厚度和CD 83+树突状细胞计数高于RA组（P < 0.05）。在RA中，44%的样本表现出阳性染色的细胞内瓜氨酸化蛋白和46%的MHC-HC gp 39肽复合物，而没有染色的这些标记物中观察到SpA样本。我们通过对治疗和未治疗亚组进行系统分析，排除了病情缓解抗风湿药物和/或皮质类固醇治疗的影响。集中在PsA，PsA和非银屑病SpA之间没有观察到显著差异。相反，与RA相比，PsA中的血管分布（P < 0.001）和中性粒细胞增加（P = 0.010），而细胞内瓜氨酸化蛋白和MHC-HC gp 39肽复合物的染色仅在RA中观察到（均P = 0.001），表明与RA相比，在PsA和其他SpA亚型中发现了相同的鉴别特征。探索少关节和多关节PsA之间的滑膜组织病理学，没有发现显著差异。此外，细胞内瓜氨酸化蛋白和MHC-HC gp 39肽复合物，这是RA的特异性标志物，既没有oligoarticular也没有polyarticular PsA。总之，这些数据表明，滑膜组织病理学PsA，无论是少关节或多关节，类似于其他SpA亚型，而这两组可以区分RA的基础上，这些相同的滑膜功能，这表明外周滑膜炎PsA属于SpA的概念。
At present only few biological data are available to indicate whether psoriatic arthritis (PsA) is part of the spondyloarthropathy (SpA) concept, whether it is a separate disease entity or a heterogeneous disease group with oligoarticular/axial forms belonging to SpA and polyarticular forms resembling rheumatoid arthritis (RA). To address this issue with regard to peripheral synovitis, we compared the synovial characteristics of PsA with those of ankylosing spondylitis (AS)/undifferentiated SpA (USpA) and RA, and compared the synovium of oligoarticular versus polyarticular PsA. Synovial biopsies were obtained from patients with RA, nonpsoriatic SpA (AS + USpA), and oligoarticular and polyarticular PsA. The histological analysis included examination(s) of the lining layer thickness, vascularity, cellular infiltration, lymphoid aggregates, plasma cells and neutrophils. Also, we performed immunohistochemical assessments of CD3, CD4, CD8, CD20, CD38, CD138, CD68, CD163, CD83, CD1a, CD146, αVβ3, E-selectin, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, S100A12, intracellular citrullinated proteins and major histocompatibility complex (MHC)–human cartilage (HC) gp39 peptide complexes. Comparing SpA (PsA + AS + USpA) with RA, vascularity, and neutrophil and CD163+ macrophage counts were greater in SpA (P < 0.05), whereas lining layer thickness and the number of CD83+ dendritic cells were greater in RA (P < 0.05). In RA, 44% of samples exhibited positive staining for intracellular citrullinated proteins and 46% for MHC–HC gp39 peptide complexes, whereas no staining for these markers was observed in SpA samples. We excluded influences of disease-modifying antirheumatic drug and/or corticosteroid treatment by conducting systematic analyses of treated and untreated subgroups. Focusing on PsA, no significant differences were observed between PsA and nonpsoriatic SpA. In contrast, vascularity (P < 0.001) and neutrophils were increased in PsA as compared with RA (P = 0.010), whereas staining for intracellular citrullinated proteins and MHC–HC gp39 peptide complexes was exclusively observed in RA (both P = 0.001), indicating that the same discriminating features are found in PsA and other SpA subtypes compared with RA. Exploring synovial histopathology between oligoarticular and polyarticular PsA, no significant differences were noted. Moreover, intracellular citrullinated proteins and MHC–HC gp39 peptide complexes, which are specific markers for RA, were observed in neither oligoarticular nor polyarticular PsA. Taken together, these data indicate that the synovial histopathology of PsA, either oligoarticular or polyarticular, resembles that of other SpA subtypes, whereas both groups can be differentiated from RA on the basis of these same synovial features, suggesting that peripheral synovitis in PsA belongs to the SpA concept.