Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy.
Department of Internal Medicine, University of Verona, Piazzale A. Scuro, 37134, Verona, Italy.
Clin Rheumatol. 2017 Oct;36(10):2377-2381. doi: 10.1007/s10067-017-3734-2. Epub 2017 Jun 20.
Psoriatic Arthritis (PsA) is characterized by bone erosive damage often associated with exuberant bone formation especially in enthesial sites. Dkk-1 and sclerostin are the main inhibitors of the WNT/β-catenin signaling pathway and play a key role in the regulation of both bone formation and resorption. We performed this study in order to compare the serum levels of the WNT-pathway regulators along with bone turnover markers (BTM) and parathyroid hormone (PTH) between three different groups: one group of female patients affected by PsA, one group of female patients affected by rheumatoid arthritis (RA), and healthy female controls (HC). This is a cross-sectional study including 33 patients with PsA classified with the CASPAR criteria, 35 HC, and 28 patients with RA classified with the ACR/EULAR 2010 criteria. Intact N-propeptide of type I collagen (PINP), C-terminal telopeptide of type I collagen (CTX-I), Dickkopf-related-protein 1 (Dkk-1), sclerostin, PTH, and 25OH-vitamin D serum levels were dosed. The PsA group showed significantly lower Dkk-1 levels when compared to the HC and RA groups. Dkk-1 in the RA group was significantly higher than HC. A similar trend was documented for PTH. In the PsA group, CTX-I was found to be lower than in both the RA and HC groups. This study demonstrated for the first time that Dkk-1 levels in PsA are lower than HC, in contrast with RA, in which they are increased. These results might contribute to explain the different bone involvement of the two different diseases.
银屑病关节炎（PsA）的特征是骨侵蚀性损害，常伴有旺盛的骨形成，特别是在肌腱附着部位。DKK-1 和 Sclerostin 是 WNT/β-catenin 信号通路的主要抑制剂，在骨形成和吸收的调节中发挥关键作用。我们进行这项研究是为了比较三种不同人群（一组女性 PsA 患者、一组女性类风湿关节炎（RA）患者和健康女性对照组（HC））的 WNT 通路调节剂血清水平与骨转换标志物（BTM）和甲状旁腺激素（PTH）。这是一项横断面研究，包括 33 名符合 CASPAR 标准的女性 PsA 患者、35 名 HC 和 28 名符合 ACR/EULAR 2010 标准的女性 RA 患者。测定了 I 型胶原 N 端前肽（PINP）、I 型胶原 C 端肽（CTX-I）、Dickkopf 相关蛋白 1（Dkk-1）、Sclerostin、PTH 和 25OH-维生素 D 的血清水平。与 HC 和 RA 组相比，PsA 组的 Dkk-1 水平显著降低。RA 组的 Dkk-1 明显高于 HC。PTH 也出现了类似的趋势。在 PsA 组中，CTX-I 低于 RA 和 HC 两组。这项研究首次证明，与 RA 相比，PsA 患者的 Dkk-1 水平低于 HC，而在 RA 中，Dkk-1 水平升高。这些结果可能有助于解释两种不同疾病的不同骨骼受累。
