Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugotu 8, 101, Reykjavik, Iceland.
The National University Hospital of Iceland, Reykjavík, Iceland.
Rheumatol Int. 2018 Aug;38(8):1385-1397. doi: 10.1007/s00296-017-3873-4. Epub 2017 Nov 9.
Psoriasis and psoriatic arthritis (PsA) are related inflammatory diseases with some shared genetic and environmental risk factors. It has been suggested that environmental factors, including infections, can trigger the development of PsA among psoriasis patients. The aim of this review was to systematically examine available data evaluating the effect of infections on the risk of developing PsA. A systematic search of the Cochrane Library, PubMed, Scopus, and Web of Science was conducted on March 16 2017, in accordance with the PRISMA statement. The following search terms were used along with "psoriatic arthritis": "infections", "risk", "bacteria", and "virus". Abstracts were reviewed and publications meeting the following criteria included: (1) Observational studies on psoriasis and PsA patients, including case-control, cohort, or ecologic studies and (2) presenting original data on the association between infections and PsA. The protocol for this systematic review was registered on PROSPERO (ID: 79432). Twenty-seven original studies presenting data on infections among PsA patients were included. Eight studies showed a statistically significant association between infections and PsA. In addition, seven studies reported mixed result with some statistically significant associations and five studies did not find statistically significant associations. This included studies of bacterial as well as viral pathogens and those of infections in general. The remaining seven studies lacked data to determine statistical significance. Out of all included studies, the total number of included patients was 933 PsA patients and 1611 controls. While the studies summarized did not all provide evidence supporting an association between infections and PsA certain trends emerged. The available data are inconsistent and further studies are needed to verify or refute this purported association. In particular, laryngeal infections and infections involving streptococci should be studied more carefully.
银屑病和银屑病关节炎（PsA）是相关的炎症性疾病，具有一些共同的遗传和环境危险因素。有人认为，环境因素，包括感染，可以触发银屑病患者发生 PsA。本综述的目的是系统地评估现有数据，评估感染对发生 PsA 的风险的影响。根据 PRISMA 声明，于 2017 年 3 月 16 日在 Cochrane 图书馆、PubMed、Scopus 和 Web of Science 上进行了系统搜索。使用了以下搜索词，并与“银屑病关节炎”一起使用：“感染”、“风险”、“细菌”和“病毒”。对摘要进行了审查，并纳入了符合以下标准的出版物：（1）银屑病和 PsA 患者的观察性研究，包括病例对照、队列或生态学研究；（2）提出了感染与 PsA 之间关联的原始数据。本系统评价的方案已在 PROSPERO（ID：79432）上注册。纳入了 27 项关于 PsA 患者感染的原始研究。8 项研究显示感染与 PsA 之间存在统计学显著关联。此外，7 项研究报告了混合结果，其中一些具有统计学显著关联，5 项研究未发现统计学显著关联。这包括细菌和病毒病原体的研究以及一般感染的研究。其余 7 项研究缺乏确定统计学意义的数据。在所有纳入的研究中，纳入的患者总数为 933 例 PsA 患者和 1611 例对照。虽然总结的研究没有提供支持感染与 PsA 之间存在关联的证据，但出现了一些趋势。现有数据不一致，需要进一步研究来证实或反驳这种所谓的关联。特别是，应更仔细地研究喉感染和涉及链球菌的感染。
