Chia Alfred Yu Ting, Ang Gladys Wei Xin, Chan Anita Sook Yee, Chan Webber, Chong Timothy Kit Yeong, Leung Ying Ying
Duke-NUS Medical School, Singapore, Singapore.
Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre, Duke-NUS Medical School, Singapore, Singapore.
Front Med (Lausanne). 2021 Sep 16;8:737256. doi: 10.3389/fmed.2021.737256. eCollection 2021.
Psoriatic arthritis (PsA) is a chronic inflammatory disease that presents with psoriasis (PsO), peripheral and axial arthropathy. The heterogeneity of disease presentation leads to the term "psoriatic disease (PsD)" which is thought to better encompass the range of clinical manifestations. PsA is associated with several comorbidities such as cardiovascular diseases, metabolic syndrome and other extra-articular manifestations including uveitis, and inflammatory bowel disease (IBD). While novel therapeutics are being developed following advances in our understanding of the pathogenesis of the disease, the diverse combinations of PsA with its various comorbidities still pose a clinical challenge in managing patients with PsA. This article reviews our current understanding of the pathogenesis of PsA and how various pathways in the pathogenesis lead to the two comorbid extra-articular manifestations - uveitis and IBD. We also review current evidence of treatment strategies in managing patients with PsA with comorbidities of uveitis and/or IBD.
银屑病关节炎（PsA）是一种慢性炎症性疾病，表现为银屑病（PsO）、外周和中轴关节病。疾病表现的异质性导致了“银屑病性疾病（PsD）”这一术语的出现，人们认为它能更好地涵盖一系列临床表现。PsA与多种合并症相关，如心血管疾病、代谢综合征以及其他关节外表现，包括葡萄膜炎和炎症性肠病（IBD）。尽管随着我们对该疾病发病机制认识的进步，新型疗法不断涌现，但PsA与其各种合并症的多样组合在管理PsA患者方面仍构成临床挑战。本文回顾了我们目前对PsA发病机制的理解，以及发病机制中的各种途径如何导致两种合并的关节外表现——葡萄膜炎和IBD。我们还回顾了目前治疗合并葡萄膜炎和/或IBD的PsA患者的治疗策略证据。
