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Pro-inflammatory adipokine profile in psoriatic arthritis: results from a cross-sectional study comparing PsA subset with evident cutaneous involvement and subset “sine psoriasis”

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Abstract

Objective

Adipokines have been considered in the pathogenesis of the inflammatory processes of psoriatic arthritis (PsA). The main aim of the current study is to investigate possible differences and correlations between adipokines and clinical expression in PsA patients with and without clinical evident psoriasis.

Methods

Serum levels of TNF-α, IL-6, leptin, resistin, visfatin, and ghrelin were measured in 80 consecutive PsA patients, 42 PsA patients with clinically evident psoriasis (group 1) and 38 PsA patients sine psoriasis (group 2), fulfilling the CASPAR criteria.

Results

Patients of the two groups were not significantly different for levels of TNF-α, IL-6, leptin, resistin, visfatin, and ghrelin. In the entire cohort, a positive association has been shown between leptin levels and female gender (β = 0.3, p = 0.001), BMI (β = 0.8, p < 0.0001), tender joint count (β = 0.23, p = 0.05), and patient pain-VAS score (β = 0.4, p = 0.049). In group 1, serum concentration of leptin was associated with female gender (β = 0.41, p < 0.0001) and BMI (β = 0.6, p = 0.012), whereas in group 2, a positive association was shown between leptin levels and BMI (β = 0.7, p = 0.003) and CRP (β = 0.35, p = 0.012). With regard to resistin, in the multivariate model, only the association between resistin and IL-6 was found (β = 0.33, p = 0.002). The association between resistin and IL-6 was confirmed in group 1 (β = 0.46, p = 0.004) but not in group 2.

Conclusions

Until today, the present study represents the first investigating difference in the adipokine pattern between PsA patients with psoriasis and sine psoriasis. We report a strict interplay between leptin, female gender, BMI, and inflammatory activity in overall PsA patients. In PsA patients with clinical evident psoriasis, leptin was associated with female gender and BMI, and a close association between resistin and IL-6 was found. Further, a positive association between leptin levels and BMI and CRP was found in PsA sine psoriasis patients. Further studies are also advocated for clarifying the possible role of these adipokines as laboratory findings or as disease mediators in addressing the different phenotypes of the disease.

Key Points

•Levels of TNF-α, IL-6, leptin, resistin, visfatin, and ghrelin did not differ between PsA patients with clinical evident psoriasis and PsA sine psoriasis.

•There is a strict interplay between leptin, female gender, BMI, and inflammatory activity in PsA.

•There is a close association between resistin and IL-6 in PsA patients with clinical evident psoriasis.

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Authors and Affiliations

  1. Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy

    Francesco Caso, Nicolò Girolimetto, Marco Tasso, Rosario Peluso, Antonio Del Puente, Raffaele Scarpa & Luisa Costa

  2. Translational Medical Sciences Department, School of Medicine, University Federico II of Naples, Naples, Italy

    Loredana Postiglione, Bianca Covelli, Margherita Ricciardone, Gaetano Di Spigna, Pietro Formisano & Vittoria D’Esposito

  3. Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy

    Luca Navarini, Domenico Paolo Emanuele Margiotta & Antonella Afeltra

  4. Unit of Clinical Laboratory Science, Università Campus Bio-Medico di Roma, Rome, Italy

    Massimo Ciccozzi

  5. Department of Clinical Medicine DIMED, University of Padova, Padua, Italy

    Francesca Oliviero & Leonardo Punzi

  6. Centre for Gout and Metabolic Bone and Joint Diseases, Rheumatology, SS Giovanni and Paolo Hospital, Venice, Italy

    Leonardo Punzi

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  1. Francesco Caso
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  2. Loredana Postiglione
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Corresponding author

Correspondence to Francesco Caso.

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The study was approved by the Local Ethics Committee (CE: NA 126/15), and all patients gave their informed consent.

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Caso, F., Postiglione, L., Covelli, B. et al. Pro-inflammatory adipokine profile in psoriatic arthritis: results from a cross-sectional study comparing PsA subset with evident cutaneous involvement and subset “sine psoriasis”. Clin Rheumatol 38, 2547–2552 (2019). https://doi.org/10.1007/s10067-019-04619-w

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