osteoprotegerin and Psoriasis

Introduction Severe psoriasis is a chronic systemic immune‑mediated disease associated with increased cardiovascular (CV) risk and several comorbidities. Objectives Our aim was to assess vascular indices and selected serum biomarkers of increased CV risk in patients with nonsevere psoriasis. Patients and methods The study group included 80 patients with mild or moderate psoriasis (mean [SD] psoriasis area severity index, 18.6 [10.5]), and the control group included 39 individuals matched forage and body mass index. All patients underwent a comprehensive clinical assessment with aplanation tonometry (pulse wave velocity [PWV]), and the following ultrasound indices were measured: flowmediated dilation (FMD) and carotid intima‑media thickness (IMT). Moreover, the following biomarkers were assessed in all individuals: osteoprotegerin, advanced oxidation protein products (AOPPs), visfatin, and nesfatin. Results Patients with nonsevere psoriasis had increased carotid IMT (mean [SD], 1027 [35] μm vs 587 [12] μm; P <0.05), impaired FMD (mean [SD], 16.3% [10.7%] vs 32.1% [13.7%]; P <0.001), and increased serum levels of AOPPs (mean [SD], 218.9 [44.6] μmol vs 162.1 [9.9] μmol; P <0.001) and visfatin (mean [SD], 13.1 [16.7] ng/ml vs 3.43 [1] ng/ml; P <0.001) compared with the control group. There were no significant differences in the serum levels of osteoprotegerin, nesfatin, and PWV. Oxidative stress (AOPP) was significantly associated with IMT (r = 0.3), FMD (r = -0.25), and visfatin (r = 0.6). Conclusions Our study suggests increased CV risk in patients with mild to m oderate psoriasis.

Topics: Adult; Atherosclerosis; Biomarkers; Carotid Intima-Media Thickness; Female; Humans; Male; Middle Aged; Nicotinamide Phosphoribosyltransferase; Osteoprotegerin; Oxidative Stress; Psoriasis

Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy that can be associated with focal bone erosions. Psoriasis usually precedes the psoriatic arthritis onset by an average of 10 years, but this relation is not yet fully elucidated. Pro-inflammatory cytokines, such as IL-33, OPN, IL-17, and TNF-α are involved in both psoriasis and PsA pathogenesis as well as in bone homeostasis. In this study, we have demonstrated that IL-33, OPN, IL-17, and TNF-α induced the release of a wide range of pro-osteoclastogenic factors from the skin, such as RANKL, that promote monocyte differentiation in osteoclasts. The addition of osteoprotegerin, a RANKL inhibitor, to monocyte cultures treated with supernatant from stimulated skin did not completely deplete osteoclast formation, suggesting that skin produced several additional pro-osteoclastogenic mediators, which could act in a RANKL-independent manner. Moreover, we have found that RANKL serum levels as well as osteoclast number and activity in psoriatic patients with and without arthritis, was influenced by severity of cutaneous disease. Our data demonstrate that psoriatic cutaneous inflammation contributes to bone damage.

Topics: Adult; Arthritis, Psoriatic; Bone and Bones; Bone Resorption; Cytokines; Female; Humans; Inflammation; Interleukin-17; Interleukin-33; Male; Monocytes; Osteoclasts; Osteogenesis; Osteopontin; Osteoprotegerin; Psoriasis; RANK Ligand; Tumor Necrosis Factor-alpha; Young Adult

Patients with psoriasis, in particular those with severe disease, have an increased risk of cardiovascular (CV) events compared with the general population. The aim of the present study is to determine whether correlation between asymmetric dimethylarginine (ADMA) and osteoprotegerin (OPG), two biomarkers associated with CV disease, and disease severity may exist in patients with moderate-to-severe psoriasis. We also aimed to establish if baseline serum levels of these two biomarkers could correlate with the degree of change in the clinical parameters of disease severity following the use of anti-tumor necrosis factor (TNF)-α therapy in these patients. This was a prospective study on a series of consecutive non-diabetic patients with moderate-to-severe psoriasis who completed 6 months of therapy with anti-TNF-α-adalimumab. Patients with kidney disease, hypertension or body mass index of 35 kg/m(2) or more were excluded. Metabolic and clinical evaluation was performed immediately prior to the onset of treatment and at month 6. Twenty-nine patients were assessed. Unlike OPG, a significant positive correlation between ADMA and resistin serum levels was found at the onset of adalimumab and also after 6 months of biologic therapy. We also observed a positive correlation between the percent of body surface area affected (BSA) and ADMA levels obtained before the onset of adalimumab and a negative correlation between baseline ADMA levels and a 6-month BSA change compared with baseline results. In patients with moderate-to-severe psoriasis, ADMA levels correlate with clinical markers of disease severity.

Topics: Adalimumab; Adult; Anti-Inflammatory Agents; Arginine; Biological Therapy; Biomarkers; Female; Humans; Male; Middle Aged; Osteoprotegerin; Prospective Studies; Psoriasis; Resistin; Tumor Necrosis Factor-alpha

Psoriasis is an inflammatory disease in which joints involvement may be insidious and difficult to detect. Bone and cartilage biomarkers may be helpful in screening patients with psoriasis for psoriatic arthritis (PsA).. To assess bone and cartilage serum biomarkers in psoriasis. Methods. The study was conducted in 2014 and included 61 psoriatic patients and 30 healthy individuals. In both groups, the serum concentrations of soluble receptor activator of nuclear factor-κB ligand (sRANKL), cartilage oligomeric matrix protein (COMP), osteoprotegerin (OPG), and interleukin-20 (IL-20) were examined. Severity of skin lesions was assessed by Psoriasis Area and Severity Index (PASI), body surface area (BSA), and Physician Global Assessment (PGA) scores.. The duration of psoriasis was from 1 year to 45 years. 22 patients suffered from concomitant PsA. The mean value of PASI was 23.1 ± 12.0 and BSA was 27.6 ± 20.6%. COMP, OPG, and IL-20 concentrations in psoriatic patients were significantly higher than in the control group. OPG/sRANKL ratio was significantly lower in PsA patients than in psoriatic patients without arthritis.. Results of the conducted study suggest that COMP, OPG, IL-20, and OPG/sRANKL ratio may appear useful biomarkers of bone and cartilage involvement in psoriasis.

Topics: Adult; Aged; Biomarkers; Body Surface Area; Cartilage Oligomeric Matrix Protein; Humans; Interleukins; Male; Middle Aged; Osteoprotegerin; Psoriasis; RANK Ligand; Severity of Illness Index

Patients with psoriatic arthritis (PsA) have a higher inflammatory burden and poorer quality of life compared to patients with psoriasis without PsA. Early identification of PsA may prevent joint damage progression and improve quality of life. Soluble biomarkers have the potential to be useful for screening patients with psoriasis for underlying PsA so that appropriate referral to a rheumatologist is made. Pilot studies have shown that C-reactive protein, interleukin 6, cartilage oligomeric matrix protein (COMP), Dickkopf-1, and macrophage-colony stimulating factor may differentiate PsA from psoriasis without PsA. Compared with controls, increased serum levels of receptor activator of nuclear factor-κB ligand, tumor necrosis factor superfamily member 14, matrix metalloproteinase-3 (MMP-3), and COMP are independently associated with psoriatic disease. Increased levels of high-sensitivity CRP (hsCRP), osteoprotegerin (OPG), MMP-3, and the ratio of C-propeptide of type II collagen (CPII) to collagen fragment neoepitopes Col2-3/4 C(long mono) (C2C) are independently associated with PsA. A combination of hsCRP, OPG, MMP-3, and the ratio CPII of C2C was able to distinguish patients with PsA from those with psoriasis alone in a receiver-operating characteristic curve analysis, with area under the curve 0.904. Therefore, a combination of the above biomarkers may at least have a role in screening patients with psoriasis for PsA. These findings need to be validated in prospective studies.

Topics: Arthritis, Psoriatic; Biomarkers; C-Reactive Protein; Diagnosis, Differential; Humans; Matrix Metalloproteinase 3; Osteoprotegerin; Peptide Fragments; Predictive Value of Tests; Procollagen; Prognosis; Psoriasis; ROC Curve

The most frequent extracutaneous association with psoriasis is arthritis. Because proinflammatory cytokines are increased in psoriasis, patients with this disease may be more prone to osteoporosis than the healthy individuals.. We evaluated 50 patients with psoriasis, with or without psoriatic arthritis (PsA), for the presence and degree of osteoporosis by performing dual energy x-ray absorptiometry (DEXA) and obtaining serum osteoprotegrin (OPG) levels. In addition, we correlated these results with the extent of skin and joint disease. Psoriasis area and severity index (PASI) was determined in all 50 patients with psoriasis, and total joint score (TJS) was recorded in the 16 patients who also had PsA. Results of DEXA and serum OPG were also obtained for 20 healthy individuals who served as controls.. Osteoprotegrin level was significantly increased in psoriasis patients (with or without PsA) vs. controls. However, DEXA revealed that PsA patients had a higher degree of osteoporosis in the femur neck and wrist. In PsA patients, TJS correlated positively with both disease duration and PASI but correlated negatively with Z score of the femur.. Psoriasis patients with or without arthritis may suffer from osteoporosis as evidenced by significantly increased serum OPG. Prolonged and extensive cutaneous disease is an important risk factor for the development and severity of PsA. Patients with a greater number of affected joints are at higher risk of osteoporosis.

Topics: Absorptiometry, Photon; Adult; Arthritis, Psoriatic; Female; Femur; Humans; Male; Middle Aged; Neck; Osteoporosis; Osteoprotegerin; Psoriasis; Severity of Illness Index; Wrist; Young Adult