Cleveland Clinic, Cleveland, Ohio.
Allegheny Health Network, Pittsburgh, Pennsylvania.
Arthritis Rheumatol. 2018 Aug;70(8):1240-1250. doi: 10.1002/art.40499. Epub 2018 Jul 8.
To compare the activity of high-density lipoprotein (HDL)-associated paraoxonase 1 (PON1) in patients with psoriasis (PsO) and patients with psoriatic arthritis (PsA), and to evaluate the association of PON1 activity with the extent of disease activity and severity of the cardiovascular disease (CVD) burden in these patients.
Serum levels of paraoxonase and arylesterase activity (both measures of PON1 function in humans) were measured in patients with PsA (n = 198, 51.0% male) and patients with PsO (n = 145, 50.3% male) who were enrolled in a longitudinal psoriatic disease biorepository. Data on PsA disease activity (using the Disease Activity Score in 28 joints [DAS28], Clinical Disease Activity Index, and painful/swollen joint counts), preexistent CVD and CVD risk factors (including diabetes, dyslipidemia, hypertension, and smoking), Framingham Risk Scores for CVD, quality of life measures, and laboratory test findings (erythrocyte sedimentation rate, C-reactive protein level, and lipid profiles) were recorded.
Serum arylesterase activities were significantly lower in patients with PsO and patients with PsA (mean ± SD 111.1 ± 25.5 μmoles/minute/ml and 124.4 ± 33.4 μmoles/minute/ml, respectively) compared to healthy controls (144.3 ± 33.4 μmoles/minute/ml) (each P < 0.001 versus healthy controls). Serum arylesterase activity decreased in parallel with increasing levels of disease activity (DAS28 scores, P = 0.012), older age (P = 0.013), higher body mass index (P = 0.042), greater incidence of metabolic syndrome (P = 0.004) and hypertension (P = 0.014), and worsening Framingham Risk Scores (P = 0.001). However, no correlation was seen between serum arylesterase activity and the extent of disease activity or CVD burden in patients with PsO. Serum paraoxonase activity trended lower both in patients with PsO and in patients with PsA (each P = 0.073 versus healthy controls). However, no association was seen between serum paraoxonase activity and the extent of disease activity or CVD burden in either of the patient cohorts.
PON1 activity is decreased in psoriatic diseases. In the PsA cohort, decreases in arylesterase activity correlated with increasing severity of joint disease and CVD burden. Arylesterase activity, as compared to paraoxonase activity, appeared to serve as a more sensitive predictor of preexisting CV risk factors in the PsA cohort. However, this correlation was not observed in the PsO population.
比较银屑病（PsO）和银屑病关节炎（PsA）患者高密度脂蛋白（HDL）相关的对氧磷酶 1（PON1）的活性，并评估 PON1 活性与这些患者疾病活动程度和心血管疾病（CVD）负担严重程度的相关性。
在纵向银屑病疾病生物库中招募了 198 名患有 PsA（51.0%为男性）和 145 名患有 PsO（50.3%为男性）的患者，测量了他们的血清对氧磷酶和芳基酯酶活性（均为人类 PON1 功能的指标）。记录了 PsA 疾病活动度（使用 28 个关节疾病活动度评分[DAS28]、临床疾病活动指数和疼痛/肿胀关节计数）、预先存在的 CVD 和 CVD 危险因素（包括糖尿病、血脂异常、高血压和吸烟）、CVD 的弗雷明汉风险评分、生活质量测量值和实验室检查结果（红细胞沉降率、C 反应蛋白水平和血脂谱）。
与健康对照组（144.3 ± 33.4 μmoles/minute/ml）相比，PsO 患者和 PsA 患者的血清芳基酯酶活性（111.1 ± 25.5 μmoles/minute/ml 和 124.4 ± 33.4 μmoles/minute/ml）显著降低（均 P < 0.001）。血清芳基酯酶活性随疾病活动度的增加而降低（DAS28 评分，P = 0.012）、年龄增大（P = 0.013）、体重指数增加（P = 0.042）、代谢综合征发生率增加（P = 0.004）、高血压发生率增加（P = 0.014）和弗雷明汉风险评分恶化（P = 0.001）。然而，在 PsO 患者中，血清芳基酯酶活性与疾病活动程度或 CVD 负担之间没有相关性。在 PsO 患者和 PsA 患者中，血清对氧磷酶活性均呈下降趋势（均 P = 0.073 与健康对照组相比）。然而，在两个患者队列中，血清对氧磷酶活性与疾病活动程度或 CVD 负担之间均无相关性。
PON1 活性在银屑病疾病中降低。在 PsA 队列中，芳基酯酶活性的降低与关节疾病和 CVD 负担的严重程度相关。与对氧磷酶活性相比，芳基酯酶活性似乎是 PsA 队列中预先存在的 CV 危险因素的更敏感预测指标。然而，在 PsO 人群中并未观察到这种相关性。
