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Interactions of the Immune System with Skin and Bone Tissue in Psoriatic Arthritis: A Comprehensive Review

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Abstract

Cutaneous psoriasis (e.g., psoriasis vulgaris (PsV)) and psoriatic arthritis (PsA) are complex heterogeneous diseases thought to have similar pathophysiology. The soluble and cellular mediators of these closely related diseases are being elucidated through genetic approaches such as genome-wide association studies (GWAS), as well as animal and molecular models. Novel therapeutics targeting these mediators (IL-12, IL-23, IL-17, IL-17 receptor, TNF) are effective in treating both the skin and joint manifestations of psoriasis, reaffirming the shared pathophysiology of PsV and PsA. However, the molecular and cellular interactions between skin and joint disease have not been well characterized. Clearly, PsV and PsA are highly variable in terms of their clinical manifestations, and this heterogeneity can partially be explained by differences in HLA-associations (HLA-Cw*0602 versus HLA-B*27, for example). In addition, there are numerous other genetic susceptibility loci (LCE3, CARD14, NOS2, NFKBIA, PSMA6, ERAP1, TRAF3IP2, IL12RB2, IL23R, IL12B, TNIP1, TNFAIP3, TYK2) and geoepidemiologic factors that contribute to the wide variability seen in psoriasis. Herein, we review the complex interplay between the genetic, cellular, ethnic, and geographic mediators of psoriasis, focusing on the shared mechanisms of PsV and PsA.

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Authors and Affiliations

  1. Department of Dermatology, University of California, Davis, 3301 C St. Suite 1400, Sacramento, CA, 95816, USA

    Andrea Sukhov & Emanual Maverakis

  2. Department of Internal Medicine, Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California, CA, Davis, USA

    Iannis E. Adamopoulos

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  1. Andrea Sukhov
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Correspondence to Emanual Maverakis.

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This work was supported by the Burroughs Wellcome Fund and NIH 1 DP2 OD008752.

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Sukhov, A., Adamopoulos, I.E. & Maverakis, E. Interactions of the Immune System with Skin and Bone Tissue in Psoriatic Arthritis: A Comprehensive Review. Clinic Rev Allerg Immunol 51, 87–99 (2016). https://doi.org/10.1007/s12016-016-8529-8

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