Calcified Tissue International

, Volume 102, Issue 5, pp 559–574 | Cite as

Altered Bone Remodeling in Psoriatic Disease: New Insights and Future Directions



Psoriatic arthritis (PsA) is an inflammatory rheumatic disorder that occurs in patients with psoriasis and predominantly affects musculoskeletal structures, skin, and nails. The etiology of PsA is not well understood but evidence supports an interplay of genetic, immunologic, and environmental factors which promote pathological bone remodeling and joint damage in PsA. Localized and systemic bone loss due to increased activity of osteoclasts is well established in PsA based on animal models and translational studies. In contrast, the mechanisms responsible for pathological bone remodeling in PsA remain enigmatic although new candidate molecules and pathways have been identified. Recent reports have revealed novel findings related to bone erosion and pathologic bone formation in PsA. Many associated risk factors and contributing molecular mechanisms have also been identified. In this review, we discuss new developments in the field, point out unresolved questions regarding the pathogenetic origins of the wide array of bone phenotypes in PsA, and discuss new directions for investigation.


Axial spondyloarthritis Bone remodeling Osteoblast Osteoclast Psoriasis Psoriatic arthritis 


Compliance with Ethical Standards

Conflict of interest

Christopher Ritchlin has research grants from Amgen, Abbvie, and UCB. He is also a consultant for Amgen, Abbvie, Boehringer Ingelheim, Celgene, Janssen, and Novartis. Ananta Paine has no conflicts of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Allergy, Immunology & Rheumatology DivisionUniversity of Rochester Medical CenterRochesterUSA

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