Popova-Belova Stanislava Dimitrova, Geneva-Popova Mariela Gencheva, Kraev Krasimir Iliev, Popova Velichka Zaharieva
Department of Propedeutic of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Clinic of Rheumatology, University General Hospital "Sveti Georgi", 4001 Plovdiv, Bulgaria.
Department of Propedeutic of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, University General Hospital "Kaspela", 4001 Plovdiv, Bulgaria.
Diagnostics (Basel). 2023 Oct 19;13(20):3250. doi: 10.3390/diagnostics13203250.
This retrospective case-control study examined the relationship between the serum and synovial levels of cathepsin G (CatG) and cathepsin K (CatK) in patients with psoriatic arthritis (PsA) and their association with disease activity. Methods: This case-control study involved 156 PsA patients, 50 patients with gonarthrosis (GoA), and 30 healthy controls. The target parameters were measured using enzyme-linked immunosorbent assay (ELISA) kits. The serum levels of CatG and CatK were found to be significantly higher in PsA patients compared to both control groups ( < 0.001). Moreover, they could distinguish PsA patients from healthy controls with 100% accuracy. Synovial fluid CatG and CatK were positively associated with the following indicators of disease activity: the VAS (rs = 0.362, rs = 0.391); the DAPSA (rs = 0.191, rs = 0.182); and the mCPDAI (rs = 0.378, rs = 0.313). Our results suggest that serum and synovial fluid CatG and CatK levels could serve as biomarkers for PsA. In PsA patients with synovial fluid crystals, elevated synovial CatG levels demonstrated a sensitivity of 89.54% and a specificity of 86.00% in distinguishing them from PsA patients without crystals. Similarly, elevated synovial CatK levels had a sensitivity of 93.67% and a specificity of 94.34% for distinguishing PsA patients with synovial fluid crystals from those without. Furthermore, the synovial fluid levels of both CatG and CatK showed positive associations with key indicators of disease activity, including the visual analog scale (VAS) (rs = 0.362, rs = 0.391), the disease activity in psoriatic arthritis (DAPSA) (rs = 0.191, rs = 0.182), and the modified composite psoriatic disease activity index (mCPDAI) (rs = 0.378, rs = 0.313). In conclusion, our findings suggest that the serum and synovial fluid levels of CatG and CatK hold promise as potential biomarkers for assessing disease activity in psoriatic arthritis.
这项回顾性病例对照研究探讨了银屑病关节炎（PsA）患者血清和滑膜中组织蛋白酶G（CatG）及组织蛋白酶K（CatK）的水平及其与疾病活动度的关系。方法：本病例对照研究纳入了156例PsA患者、50例膝骨关节炎（GoA）患者和30名健康对照者。使用酶联免疫吸附测定（ELISA）试剂盒测量目标参数。结果发现，与两个对照组相比，PsA患者的血清CatG和CatK水平显著更高（<0.001）。此外，它们能够100%准确地区分PsA患者和健康对照者。滑液中的CatG和CatK与以下疾病活动度指标呈正相关：视觉模拟评分（VAS）（rs = 0.362，rs = 0.391）；银屑病关节炎疾病活动度评分（DAPSA）（rs = 0.191，rs = 0.182）；以及改良的银屑病综合疾病活动指数（mCPDAI）（rs = 0.378，rs = 0.313）。我们的结果表明，血清和滑液中的CatG和CatK水平可作为PsA的生物标志物。在有滑液晶体的PsA患者中，滑液CatG水平升高在区分有晶体和无晶体的PsA患者时，敏感性为89.54%，特异性为86.00%。同样，滑液CatK水平升高在区分有滑液晶体和无晶体的PsA患者时，敏感性为93.67%，特异性为94.34%。此外，滑液中CatG和CatK的水平均与疾病活动度的关键指标呈正相关，包括视觉模拟量表（VAS）（rs = 0.362，rs = 0.391）、银屑病关节炎疾病活动度（DAPSA）（rs = 0.191，rs = 0.182）以及改良的银屑病疾病活动综合指数（mCPDAI）（rs = 0.378，rs = 0.313）。总之，我们的研究结果表明，血清和滑液中CatG和CatK的水平有望成为评估银屑病关节炎疾病活动度的潜在生物标志物。
