Skip to main content

Advertisement

SpringerLink
Log in

The Conundrum of Psoriatic Arthritis: a Pathogenetic and Clinical Pattern at the Midpoint of Autoinflammation and Autoimmunity

  • Published:
Clinical Reviews in Allergy & Immunology Aims and scope Submit manuscript

Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory condition characterized by psoriasis, synovitis, enthesitis, spondylitis, and the possible association with other extra-articular manifestations and comorbidities. It is a multifaceted and systemic disorder sustained by complex pathogenesis, combining aspects of autoinflammation and autoimmunity. Features of PsA autoinflammation include the role of biomechanical stress in the onset and/or exacerbation of the disease; the evidence of involvement of the innate immune response mediators in the skin, peripheral blood and synovial tissue; an equal gender distribution; the clinical course which may encounter periods of prolonged remission and overlapping features with autoinflammatory syndromes. Conversely, the role of autoimmunity is evoked by the association with class I major histocompatibility complex alleles, the polyarticular pattern of the disease which sometimes resembles rheumatoid arthritis and the presence of serum autoantibodies. Genetics also provide important insights into the pathogenesis of PsA, particularly related to class I HLA being associated with psoriasis and PsA. In this review, we provide a comprehensive review of the pathogenesis, genetics and clinical features of PsA that endorse the mixed nature of a disorder at the crossroads of autoinflammation and autoimmunity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ritchlin CT (2005) Pathogenesis of psoriatic arthritis. Curr Opin Rheumatol 17:406–412

    Article  PubMed  Google Scholar 

  2. Gladman DD, Antoni C, Mease P, Clegg DO, Nash P (2005) Psoriatic arthritis: epidemiology, clinical features, course and outcome. Ann Rheum Dis 64:14–17

    Google Scholar 

  3. Scarpa R, Ayala F, Caporaso N, Olivieri I (2006) Psoriasis, psoriatic arthritis, or psoriatic disease? J Rheumatol 33:210–212

    PubMed  Google Scholar 

  4. Rahmati S, Li Q, Rahman P, Chandran V (2021) Insights into the pathogenesis of psoriatic arthritis from genetic studies. Semin Immunopathol 43:221–234

    Article  CAS  PubMed  Google Scholar 

  5. Lubrano E, Scriffignano S, Perrotta FM (2019) Psoriatic arthritis, psoriatic disease, or psoriatic syndrome? J Rheumatol 46:1428–1430

    Article  PubMed  Google Scholar 

  6. Scarpa R (2020) Psoriatic syndrome or psoriatic disease? J Rheumatol 47:941

    Article  PubMed  Google Scholar 

  7. McGonagle D, McDermott MF (2006) A proposed classification of the immunological diseases. PLoS Med 3:e297

  8. Matzinger P (1994) Tolerance, danger, and the extended family. Annu Rev Immunol 12:991–1045

    Article  CAS  PubMed  Google Scholar 

  9. Hile G, Kahlenberg JM, Gudjonsson JE (2020) Recent genetic advances in innate immunity of psoriatic arthritis. Clin Immunol 214:108405

  10. Morhenn VB (1997) Langerhans cells may trigger the psoriatic disease process via production of nitric oxide. Immunol Today 18:433–436

    Article  CAS  PubMed  Google Scholar 

  11. Sun L, Liu W, Zhang L (2019) The role of toll-like receptors in skin host defense, psoriasis, and atopic dermatitis. J Immunol Res 2019:1824624

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hsieh J, Kadavath S, Efthimiou P (2014) Can traumatic injury trigger psoriatic arthritis? A review of the literature. Clin Rheumatol 33:601–608

    Article  PubMed  Google Scholar 

  13. Dürr UHN, Sudheendra US, Ramamoorthy A (2006) LL-37, the only human member of the cathelicidin family of antimicrobial peptides. Biochim Biophys Acta 1758:1408–1425

    Article  PubMed  Google Scholar 

  14. Conrad C, Gilliet M (2018) Psoriasis: from pathogenesis to targeted therapies. Clin Rev Allergy Immunol 54:102–113

    Article  CAS  PubMed  Google Scholar 

  15. Xiao C, Luo Y, Zhang C et al (2020) Negative regulation of dendritic cell activation in psoriasis mediated via CD100-plexin-B2. J Pathol 250:409–419

    Article  CAS  PubMed  Google Scholar 

  16. Lories RJ, de Vlam K (2012) Is psoriatic arthritis a result of abnormalities in acquired or innate immunity? Curr Rheumatol Rep 14:375–382

    Article  CAS  PubMed  Google Scholar 

  17. Benjamin M, McGonagle D (2009) The enthesis organ concept and its relevance to the spondyloarthropathies. Adv Exp Med Biol 649:57–70

    Article  PubMed  Google Scholar 

  18. McGonagle D, Lories RJU, Tan AL, Benjamin M (2007) The concept of a “synovio-entheseal complex” and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum 56:2482–2491

    Article  PubMed  Google Scholar 

  19. McGonagle D (2009) Enthesitis: an autoinflammatory lesion linking nail and joint involvement in psoriatic disease. J Eur Acad Dermatol Venereol 23(Suppl 1):9–13

    Article  CAS  PubMed  Google Scholar 

  20. McGonagle D, Ash Z, Dickie L, McDermott M, Aydin SZ (2011) The early phase of psoriatic arthritis. Ann Rheum Dis 70(Suppl 1):i71–i76

    Article  CAS  PubMed  Google Scholar 

  21. Kehl AS, Corr M, Weisman MH (2016) Review: enthesitis: new insights into pathogenesis, diagnostic modalities, and treatment. Arthritis Rheumatol 68:312–322

    Article  PubMed  PubMed Central  Google Scholar 

  22. Benham H, Rehaume LM, Hasnain SZ et al (2014) Interleukin-23 mediates the intestinal response to microbial β-1,3-glucan and the development of spondyloarthritis pathology in SKG mice. Arthritis Rheumatol 66:1755–1767

    Article  CAS  PubMed  Google Scholar 

  23. Ruutu M, Thomas G, Steck R et al (2012) β-Glucan triggers spondylarthritis and Crohn’s disease-like ileitis in SKG mice. Arthritis Rheum 64:2211–2222

    Article  CAS  PubMed  Google Scholar 

  24. Reinhardt A, Yevsa T, Worbs T et al (2016) Interleukin-23–dependent γ/δ T cells produce interleukin-17 and accumulate in the enthesis, aortic valve, and ciliary body in mice. Arthritis Rheumatol 68:2476–2486

    Article  CAS  PubMed  Google Scholar 

  25. Thorarensen SM, Lu N, Ogdie A, Gelfand JM, Choi HK, Love TJ (2017) Physical trauma recorded in primary care is associated with the onset of psoriatic arthritis among patients with psoriasis. Ann Rheum Dis 76:521–525

    Article  PubMed  Google Scholar 

  26. Tan AL, Benjamin M, Toumi H et al (2007) The relationship between the extensor tendon enthesis and the nail in distal interphalangeal joint disease in psoriatic arthritis - a high-resolution MRI and histological study. Rheumatology (Oxford) 46:253–256

    Article  CAS  PubMed  Google Scholar 

  27. Wang A, Bai YP (2020) Dendritic cells: the driver of psoriasis. J Dermatol 47:104–113

    Article  CAS  PubMed  Google Scholar 

  28. Ramirez VP, Gurevich I, Aneskievich BJ (2012) Emerging roles for TNIP1 in regulating post-receptor signaling. Cytokine Growth Factor Rev 23:109–118

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Jiang Y, Wang W, Zheng X, Jin H (2020) Immune regulation of TNFAIP3 in psoriasis through its association with Th1 and Th17 cell differentiation and p38 activation. J Immunol Res 21:5980190

    Google Scholar 

  30. Stuart PE, Nair RP, Tsoi LC et al (2015) Genome-wide association analysis of psoriatic arthritis and cutaneous psoriasis reveals differences in their genetic architecture. Am J Hum Genet 97:816–836

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Jiang X, Tian H, Fan Y et al (2012) Expression of tumor necrosis factor alpha-induced protein 3 mRNA in peripheral blood mononuclear cells negatively correlates with disease severity in psoriasis vulgaris. Clin Vaccine Immunol 19:1938–1942

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Herster F, Bittner Z, Archer NK et al (2020) Neutrophil extracellular trap-associated RNA and LL37 enable self-amplifying inflammation in psoriasis. Nat Commun 11:105

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kaplan MJ, Radic M (2012) Neutrophil extracellular traps: double-edged swords of innate immunity. J Immunol 189:2689–2695

    Article  CAS  PubMed  Google Scholar 

  34. Chiang CC, Cheng WJ, Korinek M, Lin CY, Hwang TL (2019) Neutrophils in psoriasis Front Immunol 10:2376

    Article  CAS  PubMed  Google Scholar 

  35. Hagert C, Sareila O, Kelkka T, Jalkanen S, Holmdahl R (2018) The macrophage mannose receptor regulate mannan-induced psoriasis, psoriatic arthritis, and rheumatoid arthritis-like disease models. Front Immunol 9:114

    Article  PubMed  PubMed Central  Google Scholar 

  36. Zhong J, Scholz T, Yau ACY et al (2018) Mannan-induced Nos2 in macrophages enhances IL-17-driven psoriatic arthritis by innate lymphocytes. Sci Adv 4:eaas9864

  37. Lowes MA, Chamian F, Abello MV et al (2005) Increase in TNF-alpha and inducible nitric oxide synthase-expressing dendritic cells in psoriasis and reduction with efalizumab (anti-CD11a). Proc Natl Acad Sci USA 102:19057–19062

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Bowes J, Budu-Aggrey A, Huffmeier U et al (2015) Dense genotyping of immune-related susceptibility loci reveals new insights into the genetics of psoriatic arthritis. Nat Commun 6:6046

    Article  CAS  PubMed  Google Scholar 

  39. Fuentes-Duculan J, Bonifacio KM, Hawkes J et al (2017) Autoantigens ADAMTSL5 and LL-37 are significantly upregulated in active psoriasis and associated with dendritic cells and macrophages. Exp Dermatol 26:1075–1082

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Ritchlin CT, Colbert RA, Gladman DD (2017) Psoriatic arthritis. N Engl J Med 376:957–970

    Article  PubMed  Google Scholar 

  41. Carrasco S, Neves FS, Fonseca MH et al (2011) Toll-like receptor (TLR) 2 is upregulated on peripheral blood monocytes of patients with psoriatic arthritis: a role for a Gram-positive inflammatory trigger? Clin Exp Rheumatol 29:958–962

    PubMed  Google Scholar 

  42. Garcia-Rodriguez S, Arias-Santiago S, Perandrés-López R et al (2013) Increased gene expression of Toll-like receptor 4 on peripheral blood mononuclear cells in patients with psoriasis. J Eur Acad Dermatol Venereol 27:242–250

    Article  CAS  PubMed  Google Scholar 

  43. Oliveira-Toré CF, Moraes AG, Martinez GF et al (2019) Genetic polymorphisms of toll-like receptors 2 and 9 as susceptibility factors for the development of ankylosing spondylitis and psoriatic arthritis. J Immunol Res 2019:1492092

    Article  PubMed  PubMed Central  Google Scholar 

  44. Spadaro A, Scrivo R, Moretti T et al (2004) Natural killer cells and γ/δ T cells in synovial fluid and in peripheral blood of patients with psoriatic arthritis. Clin Exp Rheumatol 22:389–394

    CAS  PubMed  Google Scholar 

  45. Scrivo R, Conigliaro P, Riccieri V et al (2014) Distribution of interleukin-10 family cytokines in serum and synovial fluid of patients with inflammatory arthritis reveals different contribution to systemic and joint inflammation. Clin Exp Immunol 179:300–308

    Article  Google Scholar 

  46. Cannavò SF, Bertino L, Di Salvo E, Papaianni V, Ventura-Spagnolo E, Gangemi S (2019) Possible roles of IL-33 in the innate-adaptive immune crosstalk of psoriasis pathogenesis. Mediators Inflamm 2019:7158014

    Article  PubMed  PubMed Central  Google Scholar 

  47. Generali E, Bose T, Selmi C, Voncken JW, Damoiseaux J (2018) Nature versus nurture in the spectrum of rheumatic diseases: classification of spondyloarthritis as autoimmune or autoinflammatory. Autoimmun Rev 17:935–941

    Article  CAS  PubMed  Google Scholar 

  48. Queiro R, Gonzalez S, Lopez-Larrea C et al (2006) HLA-C locus alleles may modulate the clinical expression of psoriatic arthritis. Arthritis Res Ther 8:R185

    Article  PubMed  PubMed Central  Google Scholar 

  49. Rahmati S, Tsoi L, O’Rielly D, Chandran V, Rahman P (2020) Complexities in genetics of psoriatic arthritis. Curr Rheumatol Rep 22:10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Chandran V, Schentag CT, Brockbank JE et al (2009) Familial aggregation of psoriatic arthritis. Ann Rheum Dis 68:664–667

    Article  CAS  PubMed  Google Scholar 

  51. FitzGerald O, Haroon M, Giles JT, Winchester R (2015) Concepts of pathogenesis in psoriatic arthritis: genotype determines clinical phenotype. Arthritis Res Ther 17:115

    Article  PubMed  PubMed Central  Google Scholar 

  52. Wiśniewski A, Matusiak L, Szczerkowska-Dobosz A, Nowak I, Kuśnierczyk P (2018) HLA-C*06:02-independent, gender-related association of PSORS1C3 and PSORS1C1/CDSN single-nucleotide polymorphisms with risk and severity of psoriasis. Mol Genet Genomics 293:957–966

    Article  PubMed  PubMed Central  Google Scholar 

  53. Rendon A, Schäkel K (2019) Psoriasis pathogenesis and treatment. Int J Mol Sci 20:1475

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Dand N, Duckworth M, Baudry D et al (2019) HLA-C*06:02 genotype is a predictive biomarker of biologic treatment response in psoriasis. J Allergy Clin Immunol 143:2120–2130

    Article  CAS  PubMed  Google Scholar 

  55. Fitzgerald O, Winchester R (2014) Editorial: emerging evidence for critical involvement of the interleukin-17 pathway in both psoriasis and psoriatic arthritis. Arthritis Rheumatol 66:1077–1080

    Article  CAS  PubMed  Google Scholar 

  56. Fife DJ, Waller JM, Jeffes EW, Koo JYM (2007) Unraveling the paradoxes of HIV-associated psoriasis: a review of T-cell subsets and cytokine profiles. Dermatol Online J 13:4

    PubMed  Google Scholar 

  57. Queirós N, Torres T (2018) HIV-associated psoriasis. Actas Dermosifiliogr 109:303–311

    Article  PubMed  Google Scholar 

  58. Nititham J, Gupta R, Zeng X et al (2017) Psoriasis risk SNPs and their association with HIV-1 control. Hum Immunol 78:179–184

    Article  CAS  PubMed  Google Scholar 

  59. Castillo RL, Racaza GZ, Roa FD (2014) Ostraceous and inverse psoriasis with psoriatic arthritis as the presenting features of advanced HIV infection. Singapore Med J 55:e60-63

    Article  PubMed  PubMed Central  Google Scholar 

  60. Lawson E, Walker-Bone K (2012) The changing spectrum of rheumatic disease in HIV infection. Br Med Bull 103:203–221

    Article  CAS  PubMed  Google Scholar 

  61. Aboulafia DM, Bundow D, Wilske K, Ochs UI (2000) Etanercept for the treatment of human immunodeficiency virus-associated arthritis. Mayo Clin Proc 75:1093–1098

    Article  CAS  PubMed  Google Scholar 

  62. Blauvelt A, Chiricozzi A (2018) The immunologic role of IL-17 in psoriasis and psoriatic arthritis pathogenesis. Clinic Rev Allergy Immunol 55:379–390

    Article  CAS  Google Scholar 

  63. Yuan Y, Qiu J, Lin Z-T et al (2019) Identification of novel autoantibodies associated with psoriatic arthritis. Arthritis Rheumatol 71:941–951

    Article  CAS  PubMed  Google Scholar 

  64. Spadaro A, Riccieri V, Scrivo R, Alessandri C, Valesini G (2007) Anti-cyclic citrullinated peptide antibody determination in synovial fluid of psoriatic arthritis. Clin Exp Rheumatol 25:599–604

    CAS  PubMed  Google Scholar 

  65. Menon B, Gullick NJ, Walter GJ et al (2014) Interleukin-17+CD8+ T cells are enriched in the joints of patients with psoriatic arthritis and correlate with disease activity and joint damage progression. Arthritis Rheumatol 66:1272–1281

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Scotti L, Franchi M, Marchesoni A, Corrao G (2018) Prevalence and incidence of psoriatic arthritis: a systematic review and meta-analysis. Semin Arthritis Rheum 48:28–34

    Article  PubMed  Google Scholar 

  67. Veale DJ, Fearon U (2018) The pathogenesis of psoriatic arthritis. Lancet 391:2273–2284

    Article  CAS  PubMed  Google Scholar 

  68. Olivieri I, Padula A, D’Angelo S, Scarpa R (2008) Role of trauma in psoriatic arthritis. J Rheumatol 35:2085–2087

    Article  PubMed  Google Scholar 

  69. Tönük Ş, Yorgancıoğlu ZR (2019) Biomechanical factors in psoriatic disease: defective repair exertion as a potential cause. hypothesis presentation and literature review. ACR Open Rheumatol 1:452–461

    Article  PubMed  PubMed Central  Google Scholar 

  70. Buckley WR, Raleigh RL (1959) Psoriasis with acro-osteolysis. N Engl J Med 261:539–541

    Article  CAS  PubMed  Google Scholar 

  71. Ng J, Tan AL, McGonagle D (2015) Unifocal psoriatic arthritis development in identical twins following site specific injury: evidence supporting biomechanical triggering events in genetically susceptible hosts. Ann Rheum Dis 74:948–949

    Article  PubMed  Google Scholar 

  72. Langevitz P, Buskila D, Gladman DD (1990) Psoriatic arthritis precipitated by physical trauma. J Rheumatol 17:695–697

    CAS  PubMed  Google Scholar 

  73. Eder L, Law T, Chandran V et al (2011) Association between environmental factors and onset of psoriatic arthritis in patients with psoriasis. Arthritis Care Res (Hoboken) 63:1091–1097

    Article  PubMed  Google Scholar 

  74. Pattison E, Harrison BJ, Griffiths CE, Silman AJ, Bruce IN (2008) Environmental risk factors for the development of psoriatic arthritis: results from a case-control study. Ann Rheum Dis 67:672–676

    Article  CAS  PubMed  Google Scholar 

  75. Love TJ, Zhu Y, Zhang Y et al (2012) Obesity and the risk of psoriatic arthritis: a population-based study. Ann Rheum Dis 71:1273–1277

    Article  PubMed  Google Scholar 

  76. Punzi L, Pianon M, Rizzi E, Rossini P, Todesco S (1997) Prevalence of post-traumatic psoriatic rheumatism. Presse Med 26:420

    CAS  PubMed  Google Scholar 

  77. Scarpa R, Del Puente A, di Girolamo C, della Valle G, Lubrano E, Oriente P (1992) Interplay between environmental factors, articular involvement, and HLA-B27 in patients with psoriatic arthritis. Ann Rheum Dis 51:78–79

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Simon D, Faustini F, Kleyer A et al (2016) Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis. Ann Rheum Dis 75:660–666

    Article  CAS  PubMed  Google Scholar 

  79. Salvarani C, Cantini F, Olivieri I et al (1997) Isolated peripheral enthesitis and/or dactylitis: a subset of psoriatic arthritis. J Rheumatol 24:1106–1110

    CAS  PubMed  Google Scholar 

  80. Padula A, Belsito F, Barozzi L et al (1999) Isolated tenosynovitis associated with psoriasis triggered by physical injury. Clin Exp Rheumatol 17:103–104

    CAS  PubMed  Google Scholar 

  81. Cantini F, Niccoli L, Nannini C, Kaloudi O, Bertoni M, Cassarà E (2010) Psoriatic arthritis: a systematic review. Int J Rheum Dis 13:300–317

    Article  PubMed  Google Scholar 

  82. Cantini F, Niccoli L, Nannini C et al (2008) Frequency and duration of clinical remission in patients with peripheral psoriatic arthritis requiring second-line drugs. Rheumatology (Oxford) 47:872–876

    Article  CAS  PubMed  Google Scholar 

  83. Olivieri I, Scarano E, Gigliotti P, Giasi V, Padula A (2006) Successful treatment of juvenile-onset HLA-B27-associated severe and refractory heel thesitis with adalimumab documented by magnetic resonance imaging. Rheumatology (Oxford) 45:1315–1317

    Article  CAS  PubMed  Google Scholar 

  84. Olivieri I, Scarano E, Padula A, D’Angelo S, Cantini F (2007) Switching tumor necrosis factor alpha inhibitors in HLA-B27-associated severe heel enthesitis. Arthritis Rheum 57:1572–1574

    Article  PubMed  Google Scholar 

  85. Olivieri I, Giasi V, Scarano E, Gigliotti P, D’Angelo S, Padula A (2009) A brief course of anti-TNF-alpha therapy can cure recurrent episodes of HLA-B27-associated severe and refractory heel enthesitis. Clin Exp Rheumatol 27:1057; author reply 1058

  86. Haroon M, Fitzgerald O (2012) Pathogenetic overview of psoriatic disease. J Rheumatol Suppl 89:7–10

    Article  PubMed  Google Scholar 

  87. McGonagle D, Gibbon W, Emery P (1998) Classification of inflammatory arthritis by enthesitis. Lancet 352:1137–1140

    Article  CAS  PubMed  Google Scholar 

  88. Jacques P, Lambrecht S, Verheugen E et al (2014) Proof of concept: enthesitis and new bone formation in spondyloarthritis are driven by mechanical strain and stromal cells. Ann Rheum Dis 73:437–445

    Article  PubMed  Google Scholar 

  89. Bridgewood C, Watad A, Cuthbert RJ, McGonagle D (2018) Spondyloarthritis: new insights into clinical aspects, translational immunology and therapeutics. Curr Opin Rheumatol 30:526–532

    Article  CAS  PubMed  Google Scholar 

  90. Firestein GS, Gabriel SE, McInnes IB, O'Dell JR (2017) Kelley and Firestein’s Textbook of Rheumatology. Tenth edition

  91. McGonagle D, Tan AL (2015) The enthesis in psoriatic arthritis. Clin Exp Rheumatol 33(5 Suppl 93):S36-39

    PubMed  Google Scholar 

  92. Perrotta FM, Astorri D, Zappia M, Reginelli A, Brunese L, Lubrano E (2016) An ultrasonographic study of enthesis in early psoriatic arthritis patients naive to traditional and biologic DMARDs treatment. Rheumatol Int 36:1579–1583

    Article  PubMed  Google Scholar 

  93. Rizzo A, Ferrante A, Guggino G, Ciccia F (2017) Gut inflammation in spondyloarthritis. Best Pract Res Clin Rheumatol 31:863–876

    Article  PubMed  Google Scholar 

  94. Li WQ, Han JL, Chan AT, Qureshi AA (2013) Psoriasis, psoriatic arthritis and increased risk of incident Crohn’s disease in US women. Ann Rheum Dis 72:1200–1205

    Article  PubMed  Google Scholar 

  95. Charlton R, Green A, Shaddick G et al (2018) Risk of uveitis and inflammatory bowel disease in people with psoriatic arthritis: a population-based cohort study. Ann Rheum Dis 77:277–280

    Article  PubMed  Google Scholar 

  96. Sibley CH (2016) Autoinflammation and HLA-B27: beyond antigen presentation. Ocul Immunol Inflamm 24:460–469

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. Rehaume LM, Matigian N, Mehdi AM et al (2019) IL-23 favours outgrowth of spondyloarthritis-associated pathobionts and suppresses host support for homeostatic microbiota. Ann Rheum Dis 78:494–503

    Article  CAS  PubMed  Google Scholar 

  98. Rossini M, Epis OM, Tinazzi I, Grembiale RD, Iagnocco A (2020) Role of the IL-23 pathway in the pathogenesis and treatment of enthesitis in psoriatic arthritis. Expert Opin Biol Ther 20:787–798

    Article  CAS  PubMed  Google Scholar 

  99. Rosenbaum JT, Kim HW (2013) Innate immune signals in autoimmune and autoinflammatory uveitis. Int Rev Immunol 32:68–75

    Article  CAS  PubMed  Google Scholar 

  100. Huhtinen M, Repo H, Laasila K et al (2002) Systemic inflammation and innate immune response in patients with previous anterior uveitis. Br J Ophthalmol 86:412–417

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. Fotiadou C, Lazaridou E (2019) Psoriasis and uveitis: links and risks. Psoriasis (Auckl) 9:91–96

    CAS  PubMed  Google Scholar 

  102. Abbouda A, Abicca I, Fabiani C (2017) Psoriasis and psoriatic arthritis-related uveitis: different ophthalmological manifestations and ocular inflammation features. Semin Ophthalmol 32:715–720

    Article  PubMed  Google Scholar 

  103. Vinkel C, Thomsen SF (2017) Autoinflammatory syndromes associated with hidradenitis suppurativa and/or acne. Int J Dermatol 56:811–818

    Article  CAS  PubMed  Google Scholar 

  104. De Vita V, McGonagle D (2018) Hidradenitis suppurativa as an autoinflammatory keratinization disease. J Allergy Clin Immunol 141:1953

    Article  PubMed  Google Scholar 

  105. Gadelha RL, Paiva RDSR, Palitot EB, Costa JEFD (2020) PsAPASH: a rare and recent autoinflammatory syndrome associated with hidradenitis suppurativa. An Bras Dermatol 95:203–206

    Article  PubMed  PubMed Central  Google Scholar 

  106. Liu S, Tang M, Cao Y, Li C (2020) Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: review and update. Ther Adv Musculoskelet Dis 12:1759720X20912865

  107. Olivieri I, Giasi V, D’Angelo S, Palazzi C, Padula A (2014) The SAPHO syndrome. In: Zouboulis C, Katsambas A, Kligman A, eds. Pathogenesis and treatment of acne and rosacea: Springer-Verlag Berlin Heidelberg Springer:579–584

  108. Aksentijevich I, Masters SL, Ferguson PJ et al (2009) An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist. N Engl J Med 360:2426–2437

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Lubrano E, Mesina F, Caporali R (2018) Clinical remission in rheumatoid arthritis and psoriatic arthritis. Clin Exp Rheumatol 36:900–910

    PubMed  Google Scholar 

  110. Gracey E, Burssens A, Cambré I et al (2020) Tendon and ligament mechanical loading in the pathogenesis of inflammatory arthritis. Nat Rev Rheumatol 16:193–207

    Article  PubMed  PubMed Central  Google Scholar 

  111. Lubrano E, Parsons WJ, Perrotta FM (2016) Assessment of response to treatment, remission, and minimal disease activity in axial psoriatic arthritis treated with tumor necrosis factor inhibitors. J Rheumatol 43:918–923

    Article  PubMed  Google Scholar 

  112. Moll JM, Haslock I, Macrae IF, Wright V (1974) Associations between ankylosing spondylitis, psoriatic arthritis, Reiter’s disease, the intestinal arthropathies, and Behcet’s syndrome. Medicine (Baltimore) 53:343–364

    Article  CAS  PubMed  Google Scholar 

  113. Conigliaro P, Triggianese P, Perricone C et al (2014) Restoration of peripheral blood natural killer and B cell levels in patients affected by rheumatoid and psoriatic arthritis during etanercept treatment. Clin Exp Immunol 177:234–243

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  114. Cañete JD, Santiago B, Cantaert T et al (2007) Ectopic lymphoid neogenesis in psoriatic arthritis. Ann Rheum Dis 66:720–726

    Article  PubMed  PubMed Central  Google Scholar 

  115. Dolcino M, Lunardi C, Ottria A, Tinazzi E, Patuzzo G, Puccetti A (2014) Crossreactive autoantibodies directed against cutaneous and joint antigens are present in psoriatic arthritis. PLoS One 16:e115424

  116. Chimenti MS, Caso F, Alivernini S et al (2019) Amplifying the concept of psoriatic arthritis: the role of autoimmunity in systemic psoriatic disease. Autoimmun Rev 18:565–575

    Article  CAS  PubMed  Google Scholar 

  117. Pasquetti P, Morozzi G, Galeazzi M (2009) Very low prevalence of anti-CCP antibodies in rheumatoid factor-negative psoriatic polyarthritis. Rheumatology (Oxford) 48:315–316

    Article  CAS  PubMed  Google Scholar 

  118. Perez-Alamino R, Garcia-Valladares I, Cuchacovich R, Iglesias-Gamarra A, Espinoza LR (2014) Are anti-CCP antibodies in psoriatic arthritis patients a biomarker of erosive disease? Rheumatol Int 34:1211–1216

    Article  CAS  PubMed  Google Scholar 

  119. Behrens F, Koehm M, Thaçi D et al (2016) Anti-citrullinated protein antibodies are linked to erosive disease in an observational study of patients with psoriatic arthritis. Rheumatology (Oxford) 55:1791–1795

    Article  CAS  PubMed  Google Scholar 

  120. Popescu C, Zofotă S, Bojincă V, Ionescu R (2013) Anti-cyclic citrullinated peptide antibodies in psoriatic arthritis–cross-sectional study and literature review. J Med Life 6:376–382

    CAS  PubMed  PubMed Central  Google Scholar 

  121. Chimenti MS, Triggianese P, Nuccetelli M et al (2015) Auto-reactions, autoimmunity and psoriatic arthritis. Autoimmun Rev 14:1142–1146

    Article  CAS  PubMed  Google Scholar 

  122. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheumatol 54:2665–2673

    Article  Google Scholar 

  123. Johnson SR, Schentag CT, Gladman DD (2005) Autoantibodies in biological agent naive patients with psoriatic arthritis. Ann Rheum Dis 64:770–772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  124. Reeves WH, Fisher DE, Wisniewolski R, Gottlieb AB, Chiorazzi N (1986) Psoriasis and Raynaud’s phenomenon associated with autoantibodies to U1 and U2 small nuclear ribonucleoproteins. N Engl J Med 315:105–111

    Article  CAS  PubMed  Google Scholar 

  125. Reeves W (1991) Autoimmune mechanisms in psoriasis. Semin Dermatol 10:217–224

    CAS  PubMed  Google Scholar 

  126. Frasca L, Palazzo R, Chimenti MS et al (2018) Anti-LL37 antibodies are present in psoriatic arthritis (PsA) patients: new biomarkers in PsA. Front Immunol 9:1936

    Article  PubMed  PubMed Central  Google Scholar 

  127. Guarneri C, Aguennouz M, Guarneri F, Polito F, Benvenga S, Cannavò SP (2018) Autoimmunity to heterogeneous nuclear ribonucleoprotein A1 in psoriatic patients and correlation with disease severity. J Dtsch Dermatol Ges 16:1103–1107

    PubMed  Google Scholar 

  128. Breedveld FC, Dayer JM (2000) Leflunomide: mode of action in the treatment of rheumatoid arthritis. Ann Rheum Dis 59:841–849

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  129. Cutolo M, Seriolo B, Pizzorni C, Craviotto C, Sulli A (2002) Methotrexate in psoriatic arthritis. Clin Exp Rheumatol 20(6 Suppl 28):S76-80

    CAS  PubMed  Google Scholar 

  130. Salvarani C, Macchioni P, Olivieri I et al (2001) A comparison of cyclosporine, sulfasalazine, and symptomatic therapy in the treatment of psoriatic arthritis. J Rheumatol 28:2274–2282

    CAS  PubMed  Google Scholar 

  131. Salvarani C, Olivieri I, Cantini F, Macchioni L, Boiardi L (1998) Psoriatic arthritis. Curr Opin Rheumatol 10:299–305

    Article  CAS  PubMed  Google Scholar 

  132. Gossec L, Baraliakos X, Kerschbaumer A et al (2020) EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 79:700–712

    Article  PubMed  Google Scholar 

  133. Coates LC, Kavanaugh A, Mease PJ et al (2016) Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol 68:1060–1071

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Rossana Scrivo and Salvatore D’Angelo are equal contributors.

Authors and Affiliations

  1. Rheumatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy

    Rossana Scrivo, Chiara Castellani & Fabrizio Conti

  2. Rheumatology Institute of Lucania (IReL) - Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna Delle Grazie Hospital of Matera, Potenza, Italy

    Salvatore D’Angelo & Antonio Carriero

  3. Dipartimento Di Medicina E Scienze Della Salute, Università Degli Studi del Molise, Campobasso, Italy

    Antonio Carriero, Fabio Massimo Perrotta & Ennio Lubrano

  4. Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, MI, Italy

    Matteo Vecellio & Carlo Selmi

  5. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Center, Oxford, UK

    Matteo Vecellio

  6. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy

    Carlo Selmi

Authors
  1. Rossana Scrivo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Salvatore D’Angelo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antonio Carriero
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chiara Castellani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fabio Massimo Perrotta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fabrizio Conti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matteo Vecellio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Carlo Selmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ennio Lubrano
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Informed Consent

Not applicable.

Research Involving Human Participants and/or Animals

Not applicable.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Scrivo, R., D’Angelo, S., Carriero, A. et al. The Conundrum of Psoriatic Arthritis: a Pathogenetic and Clinical Pattern at the Midpoint of Autoinflammation and Autoimmunity. Clinic Rev Allerg Immunol 65, 72–85 (2023). https://doi.org/10.1007/s12016-021-08914-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12016-021-08914-w

Keywords

Search

Navigation