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转型期的银屑病关节炎:细胞因子信号传导、免疫失调与治疗创新

Psoriatic arthritis in transition: cytokine signaling, immune dysregulation, and therapeutic innovation.

作者信息

Sahu Sanjana, Jain Parag, Deshmukh Rohitas, Samal Pradeep Kumar, Satapathy Trilochan

机构信息

Department of Pharmacy, Rungta College of Pharmaceutical Sciences and Research, Bhilai, Chhattisgarh, 490024, India.

Institute of Pharmaceutical Sciences, GLA University, Mathura, India.

出版信息

Inflammopharmacology. 2025 Jul 25. doi: 10.1007/s10787-025-01865-0.

Abstract

Psoriatic arthritis (PsA) is an immune-mediated, chronic inflammatory condition characterized by a complicated interplay between genetic, immunologic, and environmental determinants. The literature search was conducted using electronic databases including PubMed, Scopus, Web of Science, and Cochrane Library for articles published between 2010 and 2025. Keywords such as "Psoriatic Arthritis," "biologic therapies," "targeted treatments," and "clinical trends" were used with Boolean operators. Presenting in up to 30% of those with psoriasis, PsA involves joint inflammation, enthesitis, dactylitis, and skin and nail lesions and is commonly accompanied by comorbid conditions such as cardiovascular disease, metabolic syndrome, and depression. This review critically reviews the epidemiology, pathophysiology, clinical manifestations, and diagnostic modalities of PsA, including the role of genetic markers (e.g., HLA-B27, IL-23R), innate and adaptive immune dysregulation, and the emerging role of microbiome and epigenetic factors. Diagnostic approaches such as CASPAR criteria, imaging techniques, and novel biomarkers are discussed. The article also indicates current and developing management strategies, including the use of DMARDs, biologics, JAK inhibitors, and non-pharmacological interventions like exercise, diet, and patient education. Early recognition, tailored therapy, and the importance of a multidisciplinary team are stressed to improve patient outcomes and quality of life. Advances in targeted therapies and biomarker research are paving the way for more precise and effective PsA management.

摘要

银屑病关节炎(PsA)是一种免疫介导的慢性炎症性疾病,其特征是遗传、免疫和环境决定因素之间复杂的相互作用。使用包括PubMed、Scopus、科学网和考克兰图书馆在内的电子数据库,检索2010年至2025年发表的文章。使用布尔运算符,将“银屑病关节炎”、“生物疗法”、“靶向治疗”和“临床趋势”等关键词进行组合检索。PsA在高达30%的银屑病患者中出现,涉及关节炎症、附着点炎、指(趾)炎以及皮肤和指甲病变,并且通常伴有心血管疾病、代谢综合征和抑郁症等合并症。本综述对PsA的流行病学、病理生理学、临床表现和诊断方式进行了批判性综述,包括遗传标志物(如HLA - B27、IL - 23R)的作用、先天性和适应性免疫失调以及微生物群和表观遗传因素的新作用。讨论了如CASPAR标准、成像技术和新型生物标志物等诊断方法。文章还指出了当前和正在发展的管理策略,包括使用改善病情抗风湿药(DMARDs)、生物制剂、JAK抑制剂以及运动、饮食和患者教育等非药物干预措施。强调早期识别、个性化治疗以及多学科团队的重要性,以改善患者预后和生活质量。靶向治疗和生物标志物研究的进展为更精确、有效的PsA管理铺平了道路。

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