Reumatoidalne zapalenie stawów związane z łuszczycą
Etiologia i przyczyny
Łuszczycowe zapalenie stawów (PsA) to przewlekła choroba autoimmunologiczna charakteryzująca się zapaleniem stawów i skóry, związana z nieprawidłową odpowiedzią immunologiczną, w której kluczową rolę odgrywają komórki Th17 oraz cytokiny prozapalne, takie jak TNF. Patogeneza obejmuje aktywację szlaku JAK/STAT, prowadzącą do hiperproliferacji błony maziowej i tworzenia pannus. Genetyczne predyspozycje, zwłaszcza w obrębie regionu HLA na chromosomie 6, oraz polimorfizmy w genach il23r, TNFAIP3 i PTPN22, znacząco zwiększają ryzyko rozwoju PsA. Epidemiologicznie, około 30% pacjentów z łuszczycą rozwija PsA, często po około 10 latach od pojawienia się zmian skórnych, a łuszczyca paznokci występuje u 80% chorych z PsA, stanowiąc ważny marker wczesnej diagnozy.
Reumatoidalne zapalenie stawów związane z łuszczycą – Etiologia
Reumatoidalne zapalenie stawów związane z łuszczycą (łuszczycowe zapalenie stawów, PsA) to przewlekła zapalna choroba autoimmunologiczna charakteryzująca się stanem zapalnym stawów występującym najczęściej u osób z łuszczycą skóry. Mimo intensywnych badań, dokładna przyczyna tego schorzenia pozostaje nie w pełni wyjaśniona. Patogeneza łuszczycowego zapalenia stawów obejmuje złożoną interakcję czynników genetycznych, immunologicznych i środowiskowych, prowadzących do nieprawidłowej odpowiedzi immunologicznej organizmu12.
Rola układu immunologicznego
Łuszczycowe zapalenie stawów jest chorobą autoimmunologiczną, w której układ odpornościowy błędnie atakuje zdrowe komórki i tkanki organizmu. W przypadku PsA układ immunologiczny atakuje stawy i skórę, powodując stan zapalny w stawach oraz nadprodukcję komórek skóry12. Ta nieprawidłowa odpowiedź immunologiczna prowadzi do zapalenia stawów, przyczepów ścięgien, więzadeł oraz kręgosłupa, powodując ból, sztywność i obrzęk1.
Badania wskazują, że łuszczycowe zapalenie stawów jest napędzane przez aktywację komórek T pomocniczych 17 (Th17) w połączeniu ze stanem zapalnym promowanym przez czynnik martwicy nowotworu (TNF). Potwierdza to kliniczna odpowiedź choroby na inhibitory IL-23/IL-17, takie jak ustekinumab, sekukinumab, iksekizumab i brodalumab1. Komórki T migrują do tkanki stawowej, uwalniając cytokiny zapalne, które aktywują szlak JAK/STAT, prowadząc do masywnego stanu zapalnego oraz hiperproliferacji komórek błony maziowej i tworzenia łuszczycowego pannus12.
Czynniki genetyczne
Czynniki genetyczne odgrywają istotną rolę w podatności na łuszczycowe zapalenie stawów. Około 40% pacjentów z PsA ma co najmniej jednego krewnego pierwszego stopnia z łuszczycowym zapaleniem stawów lub łuszczycą11. Wskaźnik ryzyka nawrotu dla łuszczycowego zapalenia stawów, oszacowanie dziedziczności choroby, wynosi 30-55 u krewnych pierwszego stopnia pacjentów z tym schorzeniem, podczas gdy dla łuszczycy wynosi on 8-101.
Zidentyfikowano szereg genów związanych z rozwojem łuszczycowego zapalenia stawów, a najlepiej zbadane z nich należą do rodziny genów HLA (Human Leukocyte Antigen). Region genetyczny głównego kompleksu zgodności tkankowej (MHC) w krótkim ramieniu chromosomu 6 zawiera kilka alleli lub haplotypów HLA klasy I, które są związane ze zwiększonym ryzykiem rozwoju łuszczycy i łuszczycowego zapalenia stawów1.
Do ważnych loci podatności genetycznej należą:
- Łuszczyca o wczesnym początku: HLA-Cw6, HLA-B57, HLA-DR7 i HLA-B17, przy czym wariant HLA-Cw*0602 jest silnie powiązany1
- Geny związane z PsA obejmują te w regionie HLA, zaangażowane w prezentację antygenów i rozpoznanie immunologiczne1
- Geny spoza regionu HLA odgrywają rolę w aktywacji immunologicznej i stanie zapalnym, wpływając na sygnalizację wewnątrzkomórkową, ekspresję cytokin i funkcję efektorową komórek T1
- Polimorfizmy w genach il23r (receptor IL-23), TNFAIP3 (białko A20 regulowane przez TNF) i PTPN22 (białkowa fosfataza tyrozynowa typu 22 niereceptorowego), a także SNP w locus podatności 5q311
Czynniki środowiskowe
Oprócz predyspozycji genetycznych, szereg czynników środowiskowych może odgrywać rolę w rozwoju i zaostrzeniu łuszczycowego zapalenia stawów, szczególnie u osób z genetyczną predyspozycją do choroby1.
Infekcje
Badania epidemiologiczne wykazały związek między infekcjami a rozwojem łuszczycowego zapalenia stawów. Szczególnie paciorkowcowe zapalenie gardła (angina) może wyzwalać lub zaostrzać objawy łuszczycy i łuszczycowego zapalenia stawów11. Temporalny związek między niektórymi infekcjami wirusowymi i bakteryjnymi a rozwojem lub zaostrzeniem łuszczycy i łuszczycowego zapalenia stawów sugeruje możliwą patogenną rolę wirusów i bakterii, która teoretycznie obejmuje interakcję superantygenów z autoantygenami1.
Urazy fizyczne
Urazy skóry mogą wywołać zaostrzenie zmian skórnych w łuszczycy, znane jako zjawisko Koebnera. Istnieją dowody, że uraz stawu może wywołać zaostrzenie zapalenia stawów, określane jako wewnętrzne lub głębokie zjawisko Koebnera1. Pacjenci z łuszczycą, którzy doznali urazu stawów lub kości, są bardziej narażeni na rozwój łuszczycowego zapalenia stawów w uszkodzonym stawie i innych miejscach1.
Obciążenie mechaniczne jest ważnym czynnikiem w zdrowiu i chorobach układu mięśniowo-szkieletowego. Badania wykazały, że osoby wykonujące prace wymagające powtarzalnego podnoszenia ciężkich przedmiotów są bardziej narażone na rozwój PsA1.
Otyłość i styl życia
Otyłość jest istotnym czynnikiem ryzyka rozwoju łuszczycowego zapalenia stawów. U pacjentów z PsA szanse na otyłość są wyższe niż u pacjentów z reumatoidalnym zapaleniem stawów, łuszczycą i populacją ogólną1. Nadwaga i otyłość mogą zwiększać ryzyko rozwoju łuszczycowego zapalenia stawów, szczególnie u osób, które już mają łuszczycę i/lub geny predysponujące ich do łuszczycowego zapalenia stawów1.
Palenie tytoniu jest pozytywnie związane z ryzykiem łuszczycowego zapalenia stawów w populacji ogólnej1. Badania wykazały, że palenie zwiększa ryzyko rozwoju łuszczycowego zapalenia stawów oraz wielu innych chorób autoimmunologicznych1. Kilka badań wykazało, że pacjenci z łuszczycowym zapaleniem stawów, którzy nie palą, mają mniej nasilone objawy choroby i reagują znacznie lepiej na leczenie w porównaniu z tymi, którzy palą1.
Spożycie alkoholu ma działanie prozapalne, co może nasilać objawy łuszczycowego zapalenia stawów1.
Dysbioza i mikrobiom
Dysbioza, czyli zaburzenie równowagi w składzie, dystrybucji lub aktywności metabolicznej gatunków komensalnych tworzących normalną mikroflorę barier ludzkiego ciała, może odgrywać rolę w rozwoju łuszczycowego zapalenia stawów1. Interakcja między mikrobiomem a układem immunologicznym odpowiada za wiele mechanizmów immunoregulacyjnych, a dysbioza prowadzi do zmian w przepuszczalności barier i wynikającej z tego aktywacji układu immunologicznego1.
U osób z łuszczycowym zapaleniem stawów wykazano zmieniony mikrobiom jelitowy, co może być związane ze zmianami w układzie odpornościowym1.
Stres
Stres może być czynnikiem wyzwalającym lub zaostrzającym łuszczycowe zapalenie stawów u osób z predyspozycją genetyczną1. Czynniki stresowe mogą prowadzić do zaburzenia równowagi immunologicznej i aktywować stan zapalny1.
Związek z łuszczycą
Najważniejszym czynnikiem ryzyka rozwoju łuszczycowego zapalenia stawów jest łuszczyca1. Według National Psoriasis Foundation, PsA rozwija się u około 30% osób z łuszczycą, często około 10 lat po pierwszym pojawieniu się objawów skórnych1. Łuszczyca i łuszczycowe zapalenie stawów są ze sobą powiązane, jednak dokładny związek nie jest jeszcze jasny1.
Łuszczyca paznokci występuje u 80% pacjentów z łuszczycowym zapaleniem stawów i jest ważnym narzędziem wczesnego wykrywania i leczenia łuszczycowego zapalenia stawów1. Osoby z ciężką łuszczycą są bardziej narażone na rozwój łuszczycowego zapalenia stawów niż osoby z łagodnymi objawami łuszczycy1.
Wieloczynnikowa etiologia
Podsumowując, łuszczycowe zapalenie stawów to schorzenie o złożonej, wieloczynnikowej etiologii. Predysponujące tło genetyczne w obecności czynników środowiskowych, takich jak infekcje, dysbioza mikrobioty, otyłość, stres biomechaniczny na przyczepach ścięgien („głębokie” zjawisko Koebnera) lub palenie tytoniu, może aktywować wrodzony układ odpornościowy i przyspieszać wystąpienie choroby1.
Zrozumienie wszystkich tych czynników etiologicznych jest kluczowe dla wczesnej diagnozy i skutecznego leczenia. Wczesne rozpoznanie i odpowiednie leczenie mogą spowolnić postęp łuszczycowego zapalenia stawów oraz pomóc zmniejszyć lub zapobiec trwałemu uszkodzeniu stawów1. Aktualne badania koncentrują się na lepszym zrozumieniu mechanizmów leżących u podstaw choroby, co może prowadzić do rozwoju bardziej ukierunkowanych terapii1.
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Materiały źródłowe
- #1 Psoriatic Arthritis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK547710/
Psoriatic arthritis, occurring in approximately 20% of individuals with psoriasis, is a chronic inflammatory arthritis intricately linked to psoriatic arthritis. […] The etiology and pathogenesis of psoriatic arthritis are not fully understood; they involve a complex interaction between genetic and environmental factors, resulting in immune-mediated inflammation involving the skin, joints, and other organs. Approximately 33% to 50% of patients with psoriatic arthritis have at least one first-degree relative with psoriatic arthritis or psoriasis. […] Genes related to psoriatic arthritis encompass those within the HLA region, implicated in antigen presentation and immune recognition. Additionally, non-HLA genes play a role in immune activation and inflammation, influencing intracellular signaling, cytokine expression, and T cell effector function.
- #1 Psoriatic arthritis – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076
Psoriatic arthritis occurs when your body’s immune system attacks healthy cells and tissue. The immune response causes inflammation in your joints as well as overproduction of skin cells. […] It seems likely that both genetic and environmental factors play a role in this immune system response. Many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis. Researchers have discovered certain genetic markers that appear to be associated with psoriatic arthritis. […] Physical trauma or something in the environment such as a viral or bacterial infection might trigger psoriatic arthritis in people with an inherited tendency.
- #1 Psoriatic Arthritis Symptoms & Diagnosis | NIAMShttps://www.niams.nih.gov/health-topics/psoriatic-arthritis
Psoriatic arthritis is a progressive inflammatory condition of the joints and the places where tendons and ligaments attach to bones (entheses). It happens when the immune system, for unknown reasons, becomes overactive and creates inflammation, leading to pain and swelling. […] While it is not yet clear who will develop psoriatic arthritis, obesity and having severe psoriasis appear to be associated with a higher risk of arthritis among people with psoriasis. Sometimes stressful events, trauma to the joints or bones, or infections may trigger the disease. […] Psoriatic arthritis is an immune-mediated disease, which means that your immune system overacts and causes problems. Scientists do not fully understand why changes in immune activity happen, but they know that certain factors may trigger your immune system, causing the disease. These factors include: Genes: Many people who get psoriatic arthritis have a family history of the disease, and researchers have identified some of the genes involved. Environment: Factors such as obesity, infection, injury, or stress may trigger the onset of the disease.
- #1 Psoriatic Arthritis: Practice Essentials, Background, Pathophysiology and Etiologyhttps://emedicine.medscape.com/article/2196539-overview
The following important genetic susceptibility loci have been found (although the exact mechanism of the association between HLA and psoriatic arthritis is not yet clear): Early-onset psoriasis: HLA-Cw6, HLA-B57, HLA-DR7, and HLA-B17, with HLA-Cw*0602 variant found to be highly associated. […] Involvement of immunologic mechanisms is suggested by the inflammatory process in psoriatic skin lesions and in the synovial fluid, which can be very similar to the inflammation seen in the synovial fluid in RA. […] Studies suggest that psoriatic arthritis is driven by T helper 17 (Th17) cell activation coupled with TNF-promoted inflammation. This is supported by the disease’s clinical response to IL-23/IL-17 inhibitors such as ustekinumab, secukinumab, ixekizumab, and brodalumab. […] Several environmental factors have been implicated in the pathogenesis of both psoriasis and psoriatic arthritis. The temporal relationship between certain viral and bacterial infections and the development or exacerbation of psoriasis and psoriatic arthritis suggests a possible pathogenetic role for viruses and bacteria, which is theorized to involve the interaction of superantigens with autoantigens.
- #1 New research explains mechanisms behind psoriatic arthritishttps://health.ucdavis.edu/news/headlines/new-research-explains-mechanisms-behind-psoriatic-arthritis/2024/01
A study by UC Davis Health showed how inflammatory proteins called cytokines take the brakes off synovial cell growth in joints, leading to the abnormal tissue accumulation thats associated with psoriatic arthritis. […] Psoriasis and psoriatic arthritis are two sides of the same autoimmune coin. In both cases, immune cells mostly T-cells mistakenly target healthy tissue, causing inflammation and cell overgrowth of keratinocytes in skin (psoriasis) and synovial cells in joints (psoriatic arthritis). […] In psoriatic arthritis, T-cells migrate to joint tissue, releasing inflammatory cytokines. Scientists have long known that these cytokines activate the JAK/STAT pathway, leading to massive inflammation. However, this study adds another chapter to the story, showing JAK/STAT activation also drives synovial cell hyperproliferation and pannus formation.
- #1 Patient education: Psoriatic arthritis (Beyond the Basics) – UpToDatehttps://www.uptodate.com/contents/psoriatic-arthritis-beyond-the-basics/print
Psoriatic arthritis is a type of arthritis that causes joint pain, swelling, and stiffness in some people who have a chronic skin condition called psoriasis. Researchers have not identified the exact cause of psoriatic arthritis. However, they believe that the disease develops due to a combination of genetic, immunologic, and environmental factors. Genetic factors â About 40 percent of people with psoriasis or psoriatic arthritis have family members with psoriasis or psoriatic arthritis. The likelihood of developing psoriatic arthritis if a family member has the disease is similar to that observed in psoriasis. The risk of psoriasis in an offspring has been estimated to be 41 percent if both parents are affected, 14 percent if one parent is affected, and 6 percent if one sibling is affected, compared with 2 percent when no parent or sibling was affected. Genetic researchers have identified areas on certain chromosomes that may increase the risk of developing psoriatic arthritis. Other genetic factors may contribute to the severity of disease. Immunologic factors â A variety of immune system abnormalities have been noted in people with psoriatic arthritis. For example, people who develop the condition often have higher than normal levels in their blood of certain proteins, called cytokines, which promote inflammation. Environmental factors â Exposure to certain infections may also contribute to the development of psoriatic arthritis. Some experts believe there is a link between streptococcal infection and the development of psoriasis and psoriatic arthritis, although this link has not been proven. Obesity and the severity of psoriasis are also associated with an increased chance to develop psoriatic arthritis. Psoriatic arthritis also occurs more commonly in people infected with the human immunodeficiency virus (HIV) than in the general population. Psoriasis frequently appears at sites where there is injury to the skin. This is called the Koebner phenomenon. Some patients develop arthritis in an injured joint. Indeed, physical trauma has been identified as a risk factor for developing psoriatic arthritis among people with psoriasis.
- #1 Psoriatic Arthritis: Practice Essentials, Background, Pathophysiology and Etiologyhttps://emedicine.medscape.com/article/2196539-overview
The pathogenesis of psoriatic arthritis is still not fully understood. Genetics, environmental factors, and immune-mediated inflammation play complex roles. Psoriasis and psoriatic arthritis are interrelated disorders, so it is not surprising that they have commonalities in their pathogenesis. However, the fact that some of the new biologics and targeted therapy do not control the joint disease as well as the skin lesions highlights the difference between the two disorders. […] Genetic factors play an important role in susceptibility to psoriasis and psoriatic arthritis. Approximately 40% of patients with either of those conditions have a family history of them in first-degree relatives. […] The recurrence risk ratio for psoriatic arthritis, an estimate of the heritability of the disease, is estimated at 30-55 in first-degree relatives of patients with this condition, while that for psoriasis is 8-10.
- #1 Psoriatic Arthritis: Pathogenesis and Targeted Therapieshttps://www.mdpi.com/1422-0067/24/5/4901
The genetic region of the major histocompatibility complex (MHC) in the short arm of chromosome 6 contains several alleles or haplotypes of human leukocyte antigen (HLA) class I that are associated with an increased risk for PsO and PsA and are also associated with several clinical phenotypes of the disease. […] In addition to the MHC complex, several SNPs in the il23r (IL-23 receptor), TNFAIP3 (TNF-regulated protein A20), and PTPN22 (tyrosine-protein phosphatase non-receptor type 22) genes, as well as an SNP within the 5q31 susceptibility locus, have a stronger association with PsA than with PsO. […] Dysbiosis is the imbalance in the composition, distribution, or metabolic activities of the commensal species composing the normal microflora of the human body barriers. […] The interaction between the microbiome and the immune system is responsible for many immunoregulatory mechanisms, and dysbiosis leads to alterations in barrier permeability and the consequent activation of the immune system and secretion of pro-inflammatory cytokines destabilize the junctions between epithelial cells and increase gut or skin permeability, enabling the penetration of microbes.
- #1 What Causes Psoriatic Arthritis (PsA)?https://www.psoriaticarthritisinfo.com/what-is-psoriatic-arthritis/causes
A combination of factors is believed to influence whether someone is at risk for psoriatic arthritis, including your family history and genetics, environmental factors, and how your immune system functions. […] The inflammation associated with psoriatic arthritis is caused by an abnormal response of your immune system, which is your bodys system of defense against bacteria, viruses, and other harmful substances. In psoriatic arthritis, the immune system overreacts and mistakenly attacks healthy cells and tissues in the joints as well as in the skin. […] Psoriatic arthritis tends to run in families. Researchers have found that certain genes are linked to an increased risk of developing the disease. […] Substances in the environment, or an event such as a trauma, infection (such as a streptococcal throat infection), or contracting a virus are thought to possibly trigger psoriasis and/or psoriatic arthritis in people who have a genetic predisposition.
- #1 Psoriatic Arthritis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK547710/
Some environmental factors are also suspected but have been difficult to confirm. Epidemiological studies have shown an association between streptococcal infection and recent antibiotic exposure. […] Skin trauma is known to induce flares of psoriatic skin lesions, known as the Koebner phenomenon. There is evidence that joint trauma may induce a flare of arthritis, referred to as the internal or deep Koebner phenomenon.
- #1 Psoriatic Arthritis Triggers: How to Sidestep Flare Upshttps://www.webmd.com/arthritis/psoriatic-arthritis/ss/slideshow-psoriatic-flare-triggers
Strep throat, an infection of your throat and tonsils, can spark the disease. And if you already have PsA, strep can provoke a flare-up. […] Though the cause of psoriatic arthritis is unclear, research shows that strep throat, an infection of your throat and tonsils, can spark the disease.
- #1 What are the Causes or Risk Factors of Psoriatic Arthritis? – Canadian Psoriasis Networkhttps://www.canadianpsoriasisnetwork.com/psoriatic-arthritis/psa-causes/
Although its precise causes are not yet clear, certain risk factors for psoriatic arthritis have been identified, such as: […] Psoriasis lesions often precede the joint symptoms by 10 years, on average, in 85% of patients. Some patients, however, may experience joint pain earlier than the skin symptoms. […] Approximately 40% of people with psoriatic disease have a family history of these conditions in first-degree relatives (parents, siblings or children). […] Nail psoriasis (technically referred to as psoriatic nail dystrophy) occurs in up to 80% of patients with psoriatic arthritis. The presence of nail psoriasis is an important tool for the early detection and management of psoriatic arthritis. […] Injury to the joint or bone may be a triggering event. Patients with psoriasis who sustain trauma to joints or bones are more likely to develop psoriatic arthritis in the injured joint and elsewhere.
- #1 What Causes Psoriatic Arthritis? Risk Factors and Triggers | MyPsoriasisTeamhttps://www.mypsoriasisteam.com/resources/psoriatic-arthritis-causes
Research has found that some environmental factors can play a role in the development of psoriatic arthritis. […] Studies have found that certain infections may contribute to PsA. […] Physical trauma or injuries, like scratches, can also trigger PsA. […] Research has found that people who work in jobs that involve repeated heavy lifting are more likely to develop PsA. […] Having psoriasis is the most significant risk factor for PsA. […] According to the National Psoriasis Foundation, PsA develops in about 30 percent of people with psoriasis, often around 10 years after skin symptoms first appear. […] PsA runs in families. […] This supports the assertion that genetics plays a significant role in the development of PsA. […] PsA is significantly more common in white people, according to the Arthritis Foundation. […] Additionally, research found that Pakistani populations have an even higher risk of developing PsA based on family history than their white counterparts.
- #1 Psoriatic Arthritis: Pathogenesis and Targeted Therapieshttps://www.mdpi.com/1422-0067/24/5/4901
Mechanical loading is an important factor in musculoskeletal health and disease. […] In PsA patients, a study found that the odds of obesity were higher than for patients with RA, PsO, and general population. […] Smoking has been positively associated with the risk of PsA in the general population. […] Infections function as a trigger for the immune system to develop an immune-mediated disease.
- #1 Psoriatic Arthritis Causeshttps://www.arthritis-health.com/types/psoriatic-arthritis/psoriatic-arthritis-causes
Smoking increases the risk of developing psoriatic arthritis as well as many other autoimmune diseases. […] People who are overweight and obese have an increased risk of developing psoriatic arthritis, particularly if they already have psoriasis and/or genes that predispose them to psoriatic arthritis. […] Dysbiosis increases the risk of developing psoriatic arthritis and other conditions, such as rheumatoid arthritis and irritable bowel disease. […] People who are predisposed to psoriatic arthritis may notice symptoms appear shortly after getting a viral or bacterial infection. […] In some patients, psoriatic arthritis develops in an injured joint. […] In addition to the above risk factors, psoriatic arthritis is associated with other medical conditions, such as cardiovascular diseases, chronic kidney disease, inflammation of the eyes (conjunctivitis and uveitis), mental health disorders, and certain metabolic disorders, such as type 2 diabetes. […] Having a risk factor for psoriasis does not guarantee that psoriatic arthritis will develop.
- #1 Psoriatic arthritis | NHS informhttps://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/
Psoriatic arthritis can be caused by the immune system wrongly attacking healthy tissue. Its not clear why some people with psoriasis develop psoriatic arthritis and others dont. […] An early diagnosis and the right treatment can slow down the progression of psoriatic arthritis. Treatment can also help reduce or prevent permanent damage to your joints. […] Several studies have shown that patients with psoriatic arthritis who dont smoke tend to have less severe disease and respond much better to treatment compared to those who do smoke.
- #1 Top Psoriatic Arthritis Triggershttps://www.everydayhealth.com/psoriatic-arthritis/living-with/top-psoriatic-arthritis-triggers/
The link between skin injury and psoriatic arthritis flares probably goes back to the immune systems abnormal inflammatory response, says Ogdie-Beatty. […] Several drugs that are commonly taken to treat other medical conditions can exacerbate psoriatic arthritis symptoms, says Ogdie-Beatty. […] Alcohol consumption does have a pro-inflammatory effect, says Delamo Bekele, MBBS, a clinical rheumatologist at the Mayo Clinic in Rochester, Minnesota. […] The evidence that excess weight increases the risk of developing psoriasis and that it can exacerbate symptoms of psoriatic arthritis is fairly clear, according to Bekele. […] Besides the other known health problems associated with smoking, studies indicate that a nicotine habit may cause psoriatic arthritis flares and impede the effectiveness of certain medications, specifically TNF inhibitors.
- #1 Psoriatic arthritis – treatment, causes and symptoms | healthdirecthttps://www.healthdirect.gov.au/psoriatic-arthritis
Psoriatic arthritis is a condition that affects your joints. […] The exact cause of psoriatic arthritis isn’t known. […] Many factors are thought to play a role in getting psoriatic arthritis, such as: your genes, your immune system, environmental factors like getting an infection. […] People with psoriatic arthritis have been shown to have an altered gut microbiome. This may be linked to changes in your immune system.
- #1 What Causes Psoriatic Arthritis (PsA)? | SKYRIZI® (risankizumabârzaa)https://www.skyrizi.com/psoriatic-arthritis/about-psa/what-causes-psa
The root cause of PsA is unknown. […] In people living with PsA, the immune system is triggered and becomes overactive, attacking healthy cells and tissues. This overactive response can cause inflammation in the joints. […] Theres no single answer but genes and external triggers can play a role. […] Genes and external triggers vary from person to person. What may cause your PsA to become active can be different from someone else. […] Family history of the disease […] Obesity […] Infection […] Injury […] Stress.
- #1 Get Psoriatic Arthritis Treatment Online – TeleMed2Uhttps://www.telemed2u.com/rheumatology/psoriatic-arthritis-psa
Psoriatic arthritis is a chronic inflammatory disease that affects about a third of patients who suffer from the skin condition psoriasis. […] As with many other autoimmune conditions, the cause of psoriasis and PsA is not known, however, it is believed that in genetically predisposed individuals, a trigger (stressful event – infection, physical or mental stress) causes the body’s immune system to attack healthy skin and joint tissue, causing psoriasis and inflammation arthritis. […] There are some common traits or risk factors associated with developing psoriatic arthritis. They include: […] Genetics – People with a family history of psoriatic or other arthritic conditions are very prone to developing psoriatic arthritis. It can be as high as a 40% chance of developing the condition. […] Environmental factors – There is some research contributing to the development of psoriatic arthritis to different environmental triggers. Some triggers of concern include: […] Age – Psoriatic arthritis is most common after the age of 30.
- #1 Psoriatic Arthritis Causeshttps://www.arthritis-health.com/types/psoriatic-arthritis/psoriatic-arthritis-causes
Psoriatic arthritis seems to be caused by a combination of genetic, environmental, health and lifestyle factors. Risk factors for psoriatic arthritis include: […] The most common risk factor for psoriatic arthritis is psoriasis. […] Having psoriasis is the biggest risk factor for developing psoriatic arthritis. People who have severe psoriasis are at an even greater risk of developing psoriatic arthritis than those who have mild psoriasis symptoms. […] Studies have shown that patients with close relatives with psoriasis have more than a 40% risk of developing psoriatic arthritis. […] Several genes may contribute to psoriasis and psoriatic arthritis. For example, HLA-B08, HLA-B27, HLA-B38 and HLA-B39, are linked to psoriatic arthritis. […] Psoriatic arthritis has been known to occur in patients with immune system abnormalities as well as human immunodeficiency virus (HIV).
- #1 Causes of psoriatic arthritis: Triggers and risk factorshttps://www.medicalnewstoday.com/articles/316841
Psoriatic arthritis often occurs with psoriasis. The exact cause is unclear, but it may result from faulty immune activity. Some triggers and risk factors such as an infection, may increase the risk. […] Experts do not yet know precisely why PsA occurs. […] Research suggests a link between psoriasis and PsA, although the exact link is not yet clear. PsA is far less common among people who never develop psoriasis. […] Both psoriasis and PSA seem to involve problems with the immune system. The immune cells attack healthy joint tissue, causing inflammation, swelling, and pain. […] However, it is unclear why PsA affects some people with psoriasis and not others. […] Genetic factors appear to play a role. […] Over 40% of people with PsA have a family member with the condition, and scientists have identified genetic features that appear to be linked to it.
- #1 Psoriatic Arthritis: Pathogenesis and Targeted Therapieshttps://www.mdpi.com/1422-0067/24/5/4901
Psoriatic arthritis (PsA), a heterogeneous chronic inflammatory immune-mediated disease characterized by musculoskeletal inflammation (arthritis, enthesitis, spondylitis, and dactylitis), generally occurs in patients with psoriasis. […] The pathogenesis of PsA is complex and multifaceted, with an interplay of genetic predisposition, triggering environmental factors, and activation of the innate and adaptive immune system, although autoinflammation has also been implicated. […] A predisposing genetic background in the presence of environmental factors, such as infections, microbiota (dysbiosis), obesity, biomechanical stress on the entheses (âdeepâ Koebner phenomenon) or smoking could activate the innate immune system and precipitate the onset of the disease. […] Psoriatic arthritis and PsO have a strong hereditary component.
- #1 New research explains mechanisms behind psoriatic arthritishttps://health.ucdavis.edu/news/headlines/new-research-explains-mechanisms-behind-psoriatic-arthritis/2024/01
JAK/STAT is influenced by several cytokines in psoriatic arthritis, including IL9 and IL22, ultimately leading to an increase in the number of synovial cells, Raychaudhuri explained. However, when we inhibit JAK, we can see that proliferation is reduced. These findings show that JAK plays a key role regulating synovial cell proliferation. […] From a clinical standpoint, this research showed that inhibiting JAK reduced abnormal tissue formation and the associated joint damage, revealing how JAK-inhibiting drugs could be used to moderate psoriatic arthritis. […] This study provides new insights into the role JAK plays in pannus formation, which can be so debilitating for patients with psoriatic arthritis, Raychaudhuri said. Medications can be developed to directly target the pannus.
- #2 Psoriatic arthritis – Wikipediahttps://en.wikipedia.org/wiki/Psoriatic_arthritis
Psoriatic arthritis is an inheritable polygenic disease, with many genes known or theorized to contribute to its clinical presentation (or lack thereof). […] Genetics are thought to be strongly involved in the development of psoriatic arthritis. […] Obesity and certain forms of psoriasis are thought to increase the risk. […] Health and environmental factors known to be associated with psoriatic arthritis include: Current, or history of, severe psoriasis, Disease of the finger/toenails, Obesity, Tissue trauma, or deep lesions associated with sites of trauma, Smoking, Alcohol. […] Genomic analysis has identified several genes involved in some patients, notably genes related to class I MHC including HLA-B*08, HLA-B*27, HLA-B*38, and HLA-B*39. […] Bone cells such as osteoclasts are theorized to be involved in patients with psoriatic arthritis, in contrast to most people with psoriasis whose bone cells are not significantly involved in the disease.
- #2 Psoriatic Arthritis: Symptoms and Treatmentshttps://my.clevelandclinic.org/health/diseases/13286-psoriatic-arthritis
Psoriatic arthritis is a type of arthritis. It usually affects people who have psoriasis or a biological family history of psoriasis. […] Both arthritis and psoriasis are autoimmune diseases. An autoimmune disease is the result of your immune system accidentally attacking your body instead of protecting it. Psoriatic arthritis happens when you develop psoriasis symptoms on your skin and inflammation in your joints. […] Experts arent sure what causes psoriatic arthritis. Some studies have found that people with psoriatic arthritis have similar genetic mutations. Experts cant say for certain if these changes in your genes are what cause psoriatic arthritis or if they change after you develop it. […] Around 40% of people with psoriatic arthritis have a family member that also has it. This means it might be a hereditary condition passed from biological parents to their children.
- #2 New research explains mechanisms behind psoriatic arthritishttps://health.ucdavis.edu/news/headlines/new-research-explains-mechanisms-behind-psoriatic-arthritis/2024/01
JAK/STAT is influenced by several cytokines in psoriatic arthritis, including IL9 and IL22, ultimately leading to an increase in the number of synovial cells, Raychaudhuri explained. However, when we inhibit JAK, we can see that proliferation is reduced. These findings show that JAK plays a key role regulating synovial cell proliferation. […] From a clinical standpoint, this research showed that inhibiting JAK reduced abnormal tissue formation and the associated joint damage, revealing how JAK-inhibiting drugs could be used to moderate psoriatic arthritis. […] This study provides new insights into the role JAK plays in pannus formation, which can be so debilitating for patients with psoriatic arthritis, Raychaudhuri said. Medications can be developed to directly target the pannus.