Skip to main content

Advertisement

Log in

Immunopathogenesis of psoriatic arthritis: Recent advances

  • Review Article
  • Published:
Central European Journal of Medicine

Abstract

Psoriatic Arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis. The pathophysiology of PsA includes genetic, environmental and immunologic factors. Recent studies revealed the dynamic role of the immune system in the pathogenesis of the disease. Adhesion molecules, proinflammatory cytokines, angiogenic factors and metalloproteinases appear to orchestrate the inflammatory response in PsA. This article summarizes the current immunologic findings and suggests future therapeutic and researching approaches in the field of PsA.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Moll J.M. Wright V., Psoriatic arthritis, Semin Arthritis Rheum, 1973, 3, 55–78

    Article  PubMed  CAS  Google Scholar 

  2. Schon M.P. Boehncke W.H., Psoriasis, N Engl J Med, 2005, 352, 1899–912

    Article  PubMed  CAS  Google Scholar 

  3. Gladman D.D., Psoriatic arthritis, Rheum Dis Clin North Am, 1998, 24, 829–44, x

    Article  PubMed  CAS  Google Scholar 

  4. Gladman D.D., Shuckett R., Russell M.L., Thorne J.C. Schachter R.K., Psoriatic arthritis (PSA)—an analysis of 220 patients, Q J Med, 1987, 62, 127–41

    PubMed  CAS  Google Scholar 

  5. Scarpa R., Oriente P., Pucino A., Torella M., Vignone L., Riccio A., et al., Psoriatic arthritis in psoriatic patients, Br J Rheumatol, 1984, 23, 246–50

    Article  PubMed  CAS  Google Scholar 

  6. Kane D., Stafford L., Bresnihan B. FitzGerald O., A classification study of clinical subsets in an inception cohort of early psoriatic peripheral arthritis—’DIP or not DIP revisited’, Rheumatology (Oxford), 2003, 42, 1469–76

    Article  CAS  Google Scholar 

  7. Taylor W., Gladman D., Helliwell P., Marchesoni A., Mease P. Mielants H., Classification criteria for psoriatic arthritis: development of new criteria from a large international study, Arthritis Rheum, 2006, 54, 2665–73

    Article  PubMed  Google Scholar 

  8. Gladman D.D., Anhorn K.A., Schachter R.K. Mervart H., HLA antigens in psoriatic arthritis, J Rheumatol, 1986, 13, 586–92

    PubMed  CAS  Google Scholar 

  9. Gonzalez S., Martinez-Borra J., Lopez-Vazquez A., Garcia-Fernandez S., Torre-Alonso J.C. Lopez-Larrea C., MICA rather than MICB, TNFA, or HLADRB1 is associated with susceptibility to psoriatic arthritis, J Rheumatol, 2002, 29, 973–8

    PubMed  CAS  Google Scholar 

  10. Cassell S. Kavanaugh A., Psoriatic arthritis: pathogenesis and novel immunomodulatory approaches to treatment, J Immune Based Ther Vaccines, 2005, 3, 6

    Article  PubMed  CAS  Google Scholar 

  11. Balding J., Kane D., Livingstone W., Mynett-Johnson L., Bresnihan B., Smith O., et al., Cytokine gene polymorphisms: association with psoriatic arthritis susceptibility and severity, Arthritis Rheum, 2003, 48, 1408–13

    Article  PubMed  CAS  Google Scholar 

  12. Hohler T., Kruger A., Schneider P.M., Schopf R.E., Knop J., Rittner C., et al., A TNF-alpha promoter polymorphism is associated with juvenile onset psoriasis and psoriatic arthritis, J Invest Dermatol, 1997, 109, 562–5

    Article  PubMed  CAS  Google Scholar 

  13. Rahman P., Siannis F., Butt C., Farewell V., Peddle L., Pellett F., et al., TNFalpha polymorphisms and risk of psoriatic arthritis, Ann Rheum Dis, 2006, 65, 919–23

    Article  PubMed  CAS  Google Scholar 

  14. Vasey F.B., Deitz C., Fenske N.A., Germain B.F. Espinoza L.R., Possible involvement of group A streptococci in the pathogenesis of psoriatic arthritis, J Rheumatol, 1982, 9, 719–22

    PubMed  CAS  Google Scholar 

  15. Njobvu P. McGill P., Psoriatic arthritis and human immunodeficiency virus infection in Zambia, J Rheumatol, 2000, 27, 1699–702

    PubMed  CAS  Google Scholar 

  16. Taglione E., Vatteroni M.L., Martini P., Galluzzo E., Lombardini F., Delle Sedie A., et al., Hepatitis C virus infection: prevalence in psoriasis and psoriatic arthritis, J Rheumatol, 1999, 26, 370–2

    PubMed  CAS  Google Scholar 

  17. Melski J.W., Bernhard J.D. Stern R.S., The Koebner (isomorphic) response in psoriasis. Associations with early age at onset and multiple previous therapies, Arch Dermatol, 1983, 119, 655–9

    Article  PubMed  CAS  Google Scholar 

  18. Langevitz P., Buskila D. Gladman D.D., Psoriatic arthritis precipitated by physical trauma, J Rheumatol, 1990, 17, 695–7

    PubMed  CAS  Google Scholar 

  19. Espinoza L.R., Vasey F.B., Espinoza C.G., Bocanegra T.S. Germain B.F., Vascular changes in psoriatic synovium. A light and electron microscopic study, Arthritis Rheum, 1982, 25, 677–84

    Article  PubMed  CAS  Google Scholar 

  20. Reece R.J., Canete J.D., Parsons W.J., Emery P. Veale D.J., Distinct vascular patterns of early synovitis in psoriatic, reactive, and rheumatoid arthritis, Arthritis Rheum, 1999, 42, 1481–4

    Article  PubMed  CAS  Google Scholar 

  21. Maisonpierre P.C., Suri C., Jones P.F., Bartunkova S., Wiegand S.J., Radziejewski C., et al., Angiopoietin-2, a natural antagonist for Tie2 that disrupts in vivo angiogenesis, Science, 1997, 277, 55–60

    Article  PubMed  CAS  Google Scholar 

  22. Fearon U., Reece R., Smith J., Emery P. Veale D.J., Synovial cytokine and growth factor regulation of MMPs/TIMPs: implications for erosions and angiogenesis in early rheumatoid and psoriatic arthritis patients, Ann N Y Acad Sci, 1999, 878, 619–21

    Article  PubMed  CAS  Google Scholar 

  23. Fearon U., Griosios K., Fraser A., Reece R., Emery P., Jones P.F., et al., Angiopoietins, growth factors, and vascular morphology in early arthritis, J Rheumatol, 2003, 30, 260–8

    PubMed  CAS  Google Scholar 

  24. Danning C.L., Illei G.G., Hitchon C., Greer M.R., Boumpas D.T. McInnes I.B., Macrophage-derived cytokine and nuclear factor kappaB p65 expression in synovial membrane and skin of patients with psoriatic arthritis, Arthritis Rheum, 2000, 43, 1244–56

    Article  PubMed  CAS  Google Scholar 

  25. Veale D., Yanni G., Rogers S., Barnes L., Bresnihan B. Fitzgerald O., Reduced synovial membrane macrophage numbers, ELAM-1 expression, and lining layer hyperplasia in psoriatic arthritis as compared with rheumatoid arthritis, Arthritis Rheum, 1993, 36, 893–900

    Article  PubMed  CAS  Google Scholar 

  26. Veale D.J., Barnes L., Rogers S. FitzGerald O., Immunohistochemical markers for arthritis in psoriasis, Ann Rheum Dis, 1994, 53, 450–4

    Article  PubMed  CAS  Google Scholar 

  27. Laloux L., Voisin M.C., Allain J., Martin N., Kerboull L., Chevalier X., et al., Immunohistological study of entheses in spondyloarthropathies: comparison in rheumatoid arthritis and osteoarthritis, Ann Rheum Dis, 2001, 60, 316–21

    Article  PubMed  CAS  Google Scholar 

  28. Costello P., Bresnihan B., O’Farrelly C. FitzGerald O., Predominance of CD8+ T lymphocytes in psoriatic arthritis, J Rheumatol, 1999, 26, 1117–24

    PubMed  CAS  Google Scholar 

  29. Costello P.J., Winchester R.J., Curran S.A., Peterson K.S., Kane D.J., Bresnihan B., et al., Psoriatic arthritis joint fluids are characterized by CD8 and CD4 T cell clonal expansions appear antigen driven, J Immunol, 2001, 166, 2878–86

    PubMed  CAS  Google Scholar 

  30. Berman A., Espinoza L.R., Diaz J.D., Aguilar J.L., Rolando T., Vasey F.B., et al., Rheumatic manifestations of human immunodeficiency virus infection, Am J Med, 1988, 85, 59–64

    Article  PubMed  CAS  Google Scholar 

  31. Espinoza L.R., Berman A., Vasey F.B., Cahalin C., Nelson R. Germain B.F., Psoriatic arthritis and acquired immunodeficiency syndrome, Arthritis Rheum, 1988, 31, 1034–40

    Article  PubMed  CAS  Google Scholar 

  32. Espinoza L.R., Jara L.J., Espinoza C.G., Silveira L.H., Martinez-Osuna P. Seleznick M., There is an association between human immunodeficiency virus infection and spondyloarthropathies, Rheum Dis Clin North Am, 1992, 18, 257–66

    PubMed  CAS  Google Scholar 

  33. Brancato L., Itescu S., Skovron M.L., Solomon G. Winchester R., Aspects of the spectrum, prevalence and disease susceptibility determinants of Reiter’s syndrome and related disorders associated with HIV infection, Rheumatol Int, 1989, 9, 137–41

    PubMed  CAS  Google Scholar 

  34. Winchester R., Brancato L., Itescu S., Skovron M.L. Solomon G., Implications from the occurrence of Reiter’s syndrome and related disorders in association with advanced HIV infection, Scand J Rheumatol Suppl, 1988, 74, 89–93

    Article  PubMed  CAS  Google Scholar 

  35. Tassiulas I., Duncan S.R., Centola M., Theofilopoulos A.N. Boumpas D.T., Clonal characteristics of T cell infiltrates in skin and synovium of patients with psoriatic arthritis, Hum Immunol, 1999, 60, 479–91

    Article  PubMed  CAS  Google Scholar 

  36. O’Connell P.G., Gerber L.H., Digiovanna J.J. Peck G.L., Arthritis in patients with psoriasis treated with gamma-interferon, J Rheumatol, 1992, 19, 80–2

    PubMed  CAS  Google Scholar 

  37. Sakkas L.I., Loqueman N., Bird H., Vaughan R.W., Welsh K.I. Panayi G.S., HLA class II and T cell receptor gene polymorphisms in psoriatic arthritis and psoriasis, J Rheumatol, 1990, 17, 1487–90

    PubMed  CAS  Google Scholar 

  38. Baeten D., Kruithof E., De Rycke L., Boots A.M., Mielants H., Veys E.M., et al., Infiltration of the synovial membrane with macrophage subsets and polymorphonuclear cells reflects global disease activity in spondyloarthropathy, Arthritis Res Ther, 2005, 7, R359–69

    Article  PubMed  Google Scholar 

  39. Baeten D., Demetter P., Cuvelier C.A., Kruithof E., Van Damme N., De Vos M., et al., Macrophages expressing the scavenger receptor CD163: a link between immune alterations of the gut and synovial inflammation in spondyloarthropathy, J Pathol, 2002, 196, 343–50

    Article  PubMed  CAS  Google Scholar 

  40. van Kuijk A.W., Reinders-Blankert P., Smeets T.J., Dijkmans B.A. Tak P.P., Detailed analysis of the cell infiltrate and the expression of mediators of synovial inflammation and joint destruction in the synovium of patients with psoriatic arthritis: implications for treatment, Ann Rheum Dis, 2006, 65, 1551–7

    Article  PubMed  CAS  Google Scholar 

  41. Martin M.P., Nelson G., Lee J.H., Pellett F., Gao X., Wade J., et al., Cutting edge: susceptibility to psoriatic arthritis: influence of activating killer Ig-like receptor genes in the absence of specific HLA-C alleles, J Immunol, 2002, 169, 2818–22

    PubMed  CAS  Google Scholar 

  42. Nelson G.W., Martin M.P., Gladman D., Wade J., Trowsdale J. Carrington M., Cutting edge: heterozygote advantage in autoimmune disease: hierarchy of protection/susceptibility conferred by HLA and killer Ig-like receptor combinations in psoriatic arthritis, J Immunol, 2004, 173, 4273–6

    PubMed  CAS  Google Scholar 

  43. Spadaro A., Scrivo R., Moretti T., Bernardini G., Riccieri V., Taccari E., et al., Natural killer cells and gamma/delta T cells in synovial fluid and in peripheral blood of patients with psoriatic arthritis, Clin Exp Rheumatol, 2004, 22, 389–94

    PubMed  CAS  Google Scholar 

  44. Rooney T., Murphy E., Benito M., Roux-Lombard P., FitzGerald O., Dayer J.M., et al., Synovial tissue interleukin-18 expression and the response to treatment in patients with inflammatory arthritis, Ann Rheum Dis, 2004, 63, 1393–8

    Article  PubMed  CAS  Google Scholar 

  45. Reddy P., Interleukin-18: recent advances, Curr Opin Hematol, 2004, 11, 405–10

    Article  PubMed  CAS  Google Scholar 

  46. Ritchlin C., Haas-Smith S.A., Hicks D., Cappuccio J., Osterland C.K. Looney R.J., Patterns of cytokine production in psoriatic synovium, J Rheumatol, 1998, 25, 1544–52

    PubMed  CAS  Google Scholar 

  47. Fraser A., Fearon U., Billinghurst R.C., Ionescu M., Reece R., Barwick T., et al., Turnover of type II collagen and aggrecan in cartilage matrix at the onset of inflammatory arthritis in humans: relationship to mediators of systemic and local inflammation, Arthritis Rheum, 2003, 48, 3085–95

    Article  PubMed  CAS  Google Scholar 

  48. Turkiewicz A.M. Moreland L.W., Psoriatic arthritis: current concepts on pathogenesis-oriented therapeutic options, Arthritis Rheum, 2007, 56, 1051–66

    Article  PubMed  CAS  Google Scholar 

  49. Lowes M.A., Bowcock A.M. Krueger J.G., Pathogenesis and therapy of psoriasis, Nature, 2007, 445, 866–73

    Article  PubMed  CAS  Google Scholar 

  50. Veale D., Rogers S. Fitzgerald O., Immunolocalization of adhesion molecules in psoriatic arthritis, psoriatic and normal skin, Br J Dermatol, 1995, 132, 32–8

    Article  PubMed  CAS  Google Scholar 

  51. Carson C.W., Beall L.D., Hunder G.G., Johnson C.M. Newman W., Soluble E-selectin is increased in inflammatory synovial fluid, J Rheumatol, 1994, 21, 605–11

    PubMed  CAS  Google Scholar 

  52. Canete J.D., Pablos J.L., Sanmarti R., Mallofre C., Marsal S., Maymo J., et al., Antiangiogenic effects of anti-tumor necrosis factor alpha therapy with infliximab in psoriatic arthritis, Arthritis Rheum, 2004, 50, 1636–41

    Article  PubMed  CAS  Google Scholar 

  53. Goedkoop A.Y., Kraan M.C., Picavet D.I., de Rie M.A., Teunissen M.B., Bos J.D., et al., Deactivation of endothelium and reduction in angiogenesis in psoriatic skin and synovium by low dose infliximab therapy in combination with stable methotrexate therapy: a prospective single-centre study, Arthritis Res Ther, 2004, 6, R326–34

    Article  PubMed  CAS  Google Scholar 

  54. Pitzalis C., Cauli A., Pipitone N., Smith C., Barker J., Marchesoni A., et al., Cutaneous lymphocyte antigen-positive T lymphocytes preferentially migrate to the skin but not to the joint in psoriatic arthritis, Arthritis Rheum, 1996, 39, 137–45

    Article  PubMed  CAS  Google Scholar 

  55. Odink K., Cerletti N., Bruggen J., Clerc R.G., Tarcsay L., Zwadlo G., et al., Two calcium-binding proteins in infiltrate macrophages of rheumatoid arthritis, Nature, 1987, 330, 80–2

    Article  PubMed  CAS  Google Scholar 

  56. Roth J., Burwinkel F., van den Bos C., Goebeler M., Vollmer E. Sorg C., MRP8 and MRP14, S-100-like proteins associated with myeloid differentiation, are translocated to plasma membrane and intermediate filaments in a calcium-dependent manner, Blood, 1993, 82, 1875–83

    PubMed  CAS  Google Scholar 

  57. Eue I., Pietz B., Storck J., Klempt M. Sorg C., Transendothelial migration of 27E10+ human monocytes, Int Immunol, 2000, 12, 1593–604

    Article  PubMed  CAS  Google Scholar 

  58. Frosch M., Strey A., Vogl T., Wulffraat N.M., Kuis W., Sunderkotter C., et al., Myeloid-related proteins 8 and 14 are specifically secreted during interaction of phagocytes and activated endothelium and are useful markers for monitoring disease activity in pauciarticular-onset juvenile rheumatoid arthritis, Arthritis Rheum, 2000, 43, 628–37

    Article  PubMed  CAS  Google Scholar 

  59. Kerkhoff C., Klempt M. Sorg C., Novel insights into structure and function of MRP8 (S100A8) and MRP14 (S100A9), Biochim Biophys Acta, 1998, 1448, 200–11

    Article  PubMed  CAS  Google Scholar 

  60. Kane D., Roth J., Frosch M., Vogl T., Bresnihan B. FitzGerald O., Increased perivascular synovial membrane expression of myeloid-related proteins in psoriatic arthritis, Arthritis Rheum, 2003, 48, 1676–85

    Article  PubMed  CAS  Google Scholar 

  61. Boyle W.J., Simonet W.S. Lacey D.L., Osteoclast differentiation and activation, Nature, 2003, 423, 337–42

    Article  PubMed  CAS  Google Scholar 

  62. Ritchlin C.T., Haas-Smith S.A., Li P., Hicks D.G. Schwarz E.M., Mechanisms of TNF-alpha-and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis, J Clin Invest, 2003, 111, 821–31

    PubMed  CAS  Google Scholar 

  63. Vandooren B., Kruithof E., Yu D.T., Rihl M., Gu J., De Rycke L., et al., Involvement of matrix metalloproteinases and their inhibitors in peripheral synovitis and down-regulation by tumor necrosis factor alpha blockade in spondylarthropathy, Arthritis Rheum, 2004, 50, 2942–53

    Article  PubMed  CAS  Google Scholar 

  64. O’Hara R., Murphy E.P., Whitehead A.S., FitzGerald O. Bresnihan B., Local expression of the serum amyloid A and formyl peptide receptor-like 1 genes in synovial tissue is associated with matrix metalloproteinase production in patients with inflammatory arthritis, Arthritis Rheum, 2004, 50, 1788–99

    Article  PubMed  CAS  Google Scholar 

  65. Antoniou C., Stefanaki I., Stratigos A., Avgerinou G., Stavropoulos P., Potouridou I., et al., The Greek experience with efalizumab in psoriasis from a University Dermatologic Hospital, Br J Dermatol, 2007, 156 Suppl 2, 12–6

    Article  PubMed  CAS  Google Scholar 

  66. Dubertret L., Sterry W., Bos J.D., Chimenti S., Shumack S., Larsen C.G., et al., CLinical experience acquired with the efalizumab (Raptiva) (CLEAR) trial in patients with moderate-tosevere plaque psoriasis: results from a phase III international randomized, placebo-controlled trial, Br J Dermatol, 2006, 155, 170–81

    Article  PubMed  CAS  Google Scholar 

  67. van de Kerkhof P., Griffiths C.E., Christophers E., Lebwohl M. Krueger G.G., Alefacept in the treatment of psoriasis in patients for whom conventional therapies are inadequate, Dermatology, 2005, 211, 256–63

    Article  PubMed  Google Scholar 

  68. Mease P.J., Gladman D.D. Keystone E.C., Alefacept in combination with methotrexate for the treatment of psoriatic arthritis: results of a randomized, double-blind, placebo-controlled study, Arthritis Rheum, 2006, 54, 1638–45

    Article  PubMed  CAS  Google Scholar 

  69. Papp K.A., Caro I., Leung H.M., Garovoy M. Mease P.J., Efalizumab for the treatment of psoriatic arthritis, J Cutan Med Surg, 2007, 11, 57–66

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andreas D. Katsambas.

About this article

Cite this article

Stavropoulos, P.G., Goules, A.V., Avgerinou, G. et al. Immunopathogenesis of psoriatic arthritis: Recent advances. cent.eur.j.med 3, 245–253 (2008). https://doi.org/10.2478/s11536-008-0029-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-008-0029-7

Keywords

Navigation