Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Tanta, Egypt.
Clin Rheumatol. 2022 Nov;41(11):3391-3399. doi: 10.1007/s10067-022-06300-1. Epub 2022 Jul 21.
OBJECTIVES: Assessment of serum levels of IL-23 in PsA patients and its correlation with depression, anxiety, and disease activity. METHODS: Eighty psoriatic arthritis (PsA) patients and eighty healthy volunteers matched for age and gender were included in this observational case-control study. All participants suspected to detailed history, clinical assessment, PsA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI), and ultrasonographic assessments of the entheses were examined according to the Madrid Sonographic Enthesitis Index (MASEI). Depression and anxiety were assessed by Hospital Anxiety and Depression Scale (HADS). Serum IL-23 was measured and correlated with disease activity, depression, and anxiety. RESULTS: There was no significant difference between patients and controls regarding demographic data. Thirty-six PsA patients (45%) had anxiety and 28 patients (35%) had depression, while in the control group, 16 persons (20%) had anxiety and 12 (15%) had depression, with significant differences between the 2 groups (p < 0.0001). There were significant differences in HADS anxiety and depression scores between patients and controls with significant positive correlations between HADS depression, anxiety scores and IL-23, DAPSA, PASI, and MASEI scores (p < 0.05). IL-23 was positively correlated with DAPSA, PASI, and HADS scores; we observed that interleukin 23, higher DAPSA, and PASI were independently associated with depression and anxiety. CONCLUSION: Serum interleukin-23 levels were elevated in PsA patients and were found to be correlated with depression, anxiety, and disease activity. Key Points • Psoriatic arthritis is a multidimensional disorder with psychiatric drawbacks. • Interleukin-23 is a proinflammatory cytokines that was correlated with depression and anxiety in PsA patients. • Interleukin-23 was correlated with disease activity in PsA. • Depression and anxiety were positively correlated with disease activity in PsA.
目的：评估银屑病关节炎（PsA）患者血清中 IL-23 的水平及其与抑郁、焦虑和疾病活动的相关性。
方法：本观察性病例对照研究纳入了 80 例银屑病关节炎患者和 80 名年龄和性别相匹配的健康志愿者。所有疑似患者均详细询问病史、临床评估、采用银屑病关节炎疾病活动指数（DAPSA）评分评估 PsA 活动度、用银屑病面积和严重程度指数（PASI）评估银屑病的严重程度和范围、根据马德里超声附着点炎指数（MASEI）对附着点进行超声评估。采用医院焦虑抑郁量表（HADS）评估抑郁和焦虑。检测血清 IL-23 并与疾病活动度、抑郁和焦虑相关联。
结果：患者和对照组在人口统计学数据方面无显著差异。36 例（45%）PsA 患者有焦虑，28 例（35%）有抑郁，而对照组中 16 人（20%）有焦虑，12 人（15%）有抑郁，两组之间存在显著差异（p<0.0001）。患者和对照组之间的 HADS 焦虑和抑郁评分存在显著差异，且 HADS 抑郁、焦虑评分与 IL-23、DAPSA、PASI 和 MASEI 评分之间存在显著正相关（p<0.05）。IL-23 与 DAPSA、PASI 和 HADS 评分呈正相关；我们观察到，白细胞介素 23、较高的 DAPSA 和 PASI 与抑郁和焦虑独立相关。
结论：银屑病关节炎患者血清白细胞介素-23 水平升高，并与抑郁、焦虑和疾病活动相关。关键点：银屑病关节炎是一种具有精神障碍的多维度疾病。白细胞介素-23 是一种促炎细胞因子，与银屑病关节炎患者的抑郁和焦虑相关。白细胞介素-23 与银屑病关节炎的疾病活动相关。抑郁和焦虑与银屑病关节炎的疾病活动呈正相关。
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