Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Department of Neurosurgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Int J Rheum Dis. 2020 Dec;23(12):1664-1669. doi: 10.1111/1756-185X.13997. Epub 2020 Oct 5.
Although the pathogenic mechanisms of psoriatic arthritis (PsA) are not completely clarified, evidence suggests that interleukin 17A (IL-17A)-mediated immune responses play a pivotal role in the disease. This is best underscored by the important clinical effectiveness of IL-17A inhibitors in psoriasis treatment. We aim to investigate the predictive value of IL-17A in detecting the early axial spondyloarthropic (SpA) changes in psoriatic patients.
The study enrolled 100 patients with psoriasis, classified into group 1, included 62 patients with only psoriatic skin lesions (Ps), and group 2 included 38 patients with PsA, and 100 age and gender matched healthy volunteers. All participants were subjected to general and local clinical examination, laboratory assessment including IL-17A in the serum by means of enzyme-linked immunosorbent assay, and axial joint radiological assessment.
Our study included 60 males (60%) and 40 females (40%).The positive radiological findings of early axial SpA changes were found among 30.6% of the Ps group and among 84.2% of the PsA group. There were significant differences between patients with positive magnetic resonance imaging (MRI) findings of early axial SpA and patients with negative MRI findings in both groups regarding IL-17A levels. There was a significant association between IL-17A level and early axial SpA changes in psoriatic patients with a clear cutoff point (222.5).
Our study can imply that IL-17A is a valuable, useful and low-cost biomarker in detecting early axial SpA changes in asymptomatic and nonradiographic axial SpA (nr-axial SpA) psoriatic patients that helps early management and prevent progressive axial involvement and disabilities.
虽然银屑病关节炎(PsA)的发病机制尚未完全阐明,但有证据表明白细胞介素 17A(IL-17A)介导的免疫反应在疾病中起关键作用。这在 IL-17A 抑制剂在银屑病治疗中的重要临床疗效中得到了最好的体现。我们旨在研究 IL-17A 在检测银屑病患者早期轴性脊柱关节病(SpA)变化中的预测价值。
本研究纳入了 100 例银屑病患者,分为 1 组,包括 62 例仅有银屑病皮损的患者(Ps 组)和 38 例银屑病关节炎患者(PsA 组),以及 100 例年龄和性别匹配的健康志愿者。所有参与者均接受了一般和局部临床检查、实验室评估,包括采用酶联免疫吸附试验检测血清中的 IL-17A,以及轴向关节影像学评估。
本研究共纳入 60 例男性(60%)和 40 例女性(40%)。Ps 组中有 30.6%的患者出现早期轴向 SpA 变化的阳性放射学发现,而 PsA 组中有 84.2%的患者出现阳性放射学发现。两组中,具有早期轴向 SpA 阳性 MRI 发现的患者与具有阴性 MRI 发现的患者相比,IL-17A 水平存在显著差异。在有早期轴向 SpA 变化的银屑病患者中,IL-17A 水平与早期轴向 SpA 变化之间存在显著相关性,其截断值为 222.5。
我们的研究表明,IL-17A 是一种有价值、有用且成本低廉的生物标志物,可用于检测无症状和非放射性轴向 SpA(nr-axial SpA)银屑病患者的早期轴向 SpA 变化,有助于早期管理,预防进行性轴向受累和残疾。