Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Viale Bracci 1, Siena, Italy.
Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Viale Bracci 1, Siena, Italy.
Transl Res. 2022 Jan;239:18-34. doi: 10.1016/j.trsl.2021.08.001. Epub 2021 Aug 8.
The differential diagnosis of psoriatic arthritis (PsA) and rheumatoid arthritis (RA) is difficult because of the lack of diagnostic clinical signs and reliable biomarkers. This study investigated microRNAs (miRNA) and adipokines as potential additional markers to discriminate PsA from RA. The expression profile of miRNA (miR-21, miR-140, miR-146a, miR-155, miR-181b, miR-223, miR-let-7e) and inflammatory cytokines (IL-1β, IL-6, IL-17a, IL-23a, TNF-α) from peripheral blood mononuclear cells of PsA and RA patients compared to healthy controls (HC) were evaluated by real-time PCR, and serum adipokines (adiponectin, chemerin, leptin, resistin, visfatin) and cytokines by ELISA assay. Univariable binary logistic regression was used to find the association between PsA and potential predictors. The gene expression of miRNA and cytokines and the serum levels of adipokines were found significantly different in PsA and RA patients compared to HC, as well as in PsA versus RA. MiR-140 gene expression resulted up-regulated in PsA patients and reduced in RA in comparison to HC, and, for the first time, significantly higher in PsA compared with RA. Serum levels of IL-23a and leptin were significantly increased in PsA and RA populations than in HC, as well as in PsA versus RA. Furthermore, circulating TNF-α was up-regulated in PsA and RA in comparison to controls, while resulted higher in RA than in PsA. Univariable binary logistic regression analysis found the above-mentioned markers associated to PsA versus RA. Our results first demonstrated an increased expression of circulating miR-140 and serum leptin in PsA patients compared to RA, which were identified as potential additional biomarkers to discriminate PsA from RA. Since the differential diagnosis of PsA and RA poses challenges in clinical practice, our data may help to enhance the diagnostic performance of PsA in daily practice.
银屑病关节炎 (PsA) 和类风湿关节炎 (RA) 的鉴别诊断较为困难，因为缺乏诊断的临床体征和可靠的生物标志物。本研究探讨了 microRNAs (miRNA) 和脂肪因子作为潜在的附加标志物，以区分 PsA 和 RA。通过实时 PCR 评估了外周血单个核细胞中 miRNA (miR-21、miR-140、miR-146a、miR-155、miR-181b、miR-223、miR-let-7e) 和炎症细胞因子 (IL-1β、IL-6、IL-17a、IL-23a、TNF-α) 的表达谱，并通过 ELISA 检测血清脂肪因子 (脂联素、趋化素、瘦素、抵抗素、内脏脂肪素) 和细胞因子。采用单变量二项逻辑回归分析寻找 PsA 与潜在预测因子之间的关联。与 HC 相比，PsA 和 RA 患者的 miRNA 和细胞因子的基因表达以及脂肪因子的血清水平均存在显著差异，PsA 与 RA 相比也是如此。与 HC 相比，PsA 患者的 miR-140 基因表达上调，而 RA 患者下调，且首次发现 PsA 明显高于 RA。与 HC 相比，PsA 和 RA 患者的血清 IL-23a 和瘦素水平显著升高，且 PsA 高于 RA。此外，与对照组相比，PsA 和 RA 患者的循环 TNF-α 水平升高，而 RA 高于 PsA。单变量二项逻辑回归分析发现上述标志物与 PsA 与 RA 相关。我们的研究结果首次表明，与 RA 相比，PsA 患者循环 miR-140 和血清瘦素表达增加，这被确定为区分 PsA 和 RA 的潜在附加生物标志物。由于 PsA 和 RA 的鉴别诊断在临床实践中具有挑战性，我们的数据可能有助于提高 PsA 在日常实践中的诊断性能。
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