Gao Yue, Li Xia, Liu Tao, Liu Zheng
College of Medical Laboratory Science, Guilin Medical University, No. 109, Huanchengbeier Road, Guilin, 541004, Guangxi, China.
Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
Biol Trace Elem Res. 2021 Dec;199(12):4498-4503. doi: 10.1007/s12011-021-02594-5. Epub 2021 Jan 15.
Psoriatic arthritis is a type of inflammatory arthritis that occurs in some patients with psoriasis. Clinically, low-dose methotrexate was used to treat psoriatic arthritis as a first-line agent. However, the pathogenesis of psoriatic arthritis and the mechanism of methotrexate treating psoriatic arthritis remained unclear. In recent years, a variety of side effects associated with methotrexate have been reported. In order to illuminate the role of trace/mineral elements in the pathogenesis of psoriatic arthritis and the side effect of low-dose methotrexate on blood cells and trace/mineral elements in patients with psoriatic arthritis, 37 psoriatic arthritis patients and healthy 50 people with similar age and gender were enrolled in this study. The blood cells, serum trace/mineral elements, liver function, and kidney function were determined. The results revealed that the level of serum zinc was significantly lower and copper was significantly higher in psoriatic arthritis patients in comparison with healthy control. After giving patients methotrexate intravenously (15 mg weekly), their serum zinc was significantly increased, and copper was significantly decreased with symptoms relieved. Our study provided the evidence that low zinc and high copper might be associated with the pathogenesis of psoriatic arthritis, and the possible mechanism of methotrexate treating psoriatic arthritis was through elevating zinc and reducing copper in serum. Moreover, we demonstrated that low-dose methotrexate could induce liver damage to psoriatic arthritis patients.
银屑病关节炎是一种发生于部分银屑病患者的炎性关节炎。临床上，低剂量甲氨蝶呤被用作治疗银屑病关节炎的一线药物。然而，银屑病关节炎的发病机制以及甲氨蝶呤治疗银屑病关节炎的机制仍不清楚。近年来，已报道了多种与甲氨蝶呤相关的副作用。为了阐明微量元素在银屑病关节炎发病机制中的作用以及低剂量甲氨蝶呤对银屑病关节炎患者血细胞和微量元素的副作用，本研究纳入了37例银屑病关节炎患者和50名年龄及性别相仿的健康人。检测了血细胞、血清微量元素、肝功能和肾功能。结果显示，与健康对照组相比，银屑病关节炎患者血清锌水平显著降低，铜水平显著升高。给患者静脉注射甲氨蝶呤（每周15毫克）后，随着症状缓解，他们的血清锌显著升高，铜显著降低。我们的研究提供了证据，表明低锌和高铜可能与银屑病关节炎的发病机制有关，甲氨蝶呤治疗银屑病关节炎的可能机制是通过提高血清锌水平和降低血清铜水平。此外，我们证明低剂量甲氨蝶呤可导致银屑病关节炎患者肝损伤。
