Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results


2008 | 3 | 3 | 245-253

Article title

Immunopathogenesis of psoriatic arthritis: Recent advances


Title variants

Languages of publication



Psoriatic Arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis. The pathophysiology of PsA includes genetic, environmental and immunologic factors. Recent studies revealed the dynamic role of the immune system in the pathogenesis of the disease. Adhesion molecules, proinflammatory cytokines, angiogenic factors and metalloproteinases appear to orchestrate the inflammatory response in PsA. This article summarizes the current immunologic findings and suggests future therapeutic and researching approaches in the field of PsA.










Physical description


1 - 9 - 2008
10 - 7 - 2008


  • First Department of Dermatology, School of Medicine, University of Athens, “A. Syngros” Hospital, Athens, 16121, Greece
  • First Department of Dermatology, School of Medicine, University of Athens, “A. Syngros” Hospital, Athens, 16121, Greece
  • First Department of Dermatology, School of Medicine, University of Athens, “A. Syngros” Hospital, Athens, 16121, Greece
  • First Department of Dermatology, School of Medicine, University of Athens, “A. Syngros” Hospital, Athens, 16121, Greece


  • [1] Moll J.M. Wright V., Psoriatic arthritis, Semin Arthritis Rheum, 1973, 3, 55–78 http://dx.doi.org/10.1016/0049-0172(73)90035-8[Crossref]
  • [2] Schon M.P. Boehncke W.H., Psoriasis, N Engl J Med, 2005, 352, 1899–912 http://dx.doi.org/10.1056/NEJMra041320[Crossref]
  • [3] Gladman D.D., Psoriatic arthritis, Rheum Dis Clin North Am, 1998, 24, 829–44, x http://dx.doi.org/10.1016/S0889-857X(05)70044-2[Crossref]
  • [4] Gladman D.D., Shuckett R., Russell M.L., Thorne J.C. Schachter R.K., Psoriatic arthritis (PSA)-an analysis of 220 patients, Q J Med, 1987, 62, 127–41
  • [5] Scarpa R., Oriente P., Pucino A., Torella M., Vignone L., Riccio A., et al., Psoriatic arthritis in psoriatic patients, Br J Rheumatol, 1984, 23, 246–50 http://dx.doi.org/10.1093/rheumatology/23.4.246[Crossref]
  • [6] Kane D., Stafford L., Bresnihan B. FitzGerald O., A classification study of clinical subsets in an inception cohort of early psoriatic peripheral arthritis-’DIP or not DIP revisited’, Rheumatology (Oxford), 2003, 42, 1469–76 http://dx.doi.org/10.1093/rheumatology/keg445[Crossref]
  • [7] Taylor W., Gladman D., Helliwell P., Marchesoni A., Mease P. Mielants H., Classification criteria for psoriatic arthritis: development of new criteria from a large international study, Arthritis Rheum, 2006, 54, 2665–73 http://dx.doi.org/10.1002/art.21972[Crossref]
  • [8] Gladman D.D., Anhorn K.A., Schachter R.K. Mervart H., HLA antigens in psoriatic arthritis, J Rheumatol, 1986, 13, 586–92
  • [9] Gonzalez S., Martinez-Borra J., Lopez-Vazquez A., Garcia-Fernandez S., Torre-Alonso J.C. Lopez-Larrea C., MICA rather than MICB, TNFA, or HLADRB1 is associated with susceptibility to psoriatic arthritis, J Rheumatol, 2002, 29, 973–8
  • [10] Cassell S. Kavanaugh A., Psoriatic arthritis: pathogenesis and novel immunomodulatory approaches to treatment, J Immune Based Ther Vaccines, 2005, 3, 6 http://dx.doi.org/10.1186/1476-8518-3-6[Crossref]
  • [11] Balding J., Kane D., Livingstone W., Mynett-Johnson L., Bresnihan B., Smith O., et al., Cytokine gene polymorphisms: association with psoriatic arthritis susceptibility and severity, Arthritis Rheum, 2003, 48, 1408–13 http://dx.doi.org/10.1002/art.10935[Crossref]
  • [12] Hohler T., Kruger A., Schneider P.M., Schopf R.E., Knop J., Rittner C., et al., A TNF-alpha promoter polymorphism is associated with juvenile onset psoriasis and psoriatic arthritis, J Invest Dermatol, 1997, 109, 562–5 http://dx.doi.org/10.1111/1523-1747.ep12337469[Crossref]
  • [13] Rahman P., Siannis F., Butt C., Farewell V., Peddle L., Pellett F., et al., TNFalpha polymorphisms and risk of psoriatic arthritis, Ann Rheum Dis, 2006, 65, 919–23 http://dx.doi.org/10.1136/ard.2005.039164[Crossref]
  • [14] Vasey F.B., Deitz C., Fenske N.A., Germain B.F. Espinoza L.R., Possible involvement of group A streptococci in the pathogenesis of psoriatic arthritis, J Rheumatol, 1982, 9, 719–22
  • [15] Njobvu P. McGill P., Psoriatic arthritis and human immunodeficiency virus infection in Zambia, J Rheumatol, 2000, 27, 1699–702
  • [16] Taglione E., Vatteroni M.L., Martini P., Galluzzo E., Lombardini F., Delle Sedie A., et al., Hepatitis C virus infection: prevalence in psoriasis and psoriatic arthritis, J Rheumatol, 1999, 26, 370–2
  • [17] Melski J.W., Bernhard J.D. Stern R.S., The Koebner (isomorphic) response in psoriasis. Associations with early age at onset and multiple previous therapies, Arch Dermatol, 1983, 119, 655–9 http://dx.doi.org/10.1001/archderm.119.8.655[Crossref]
  • [18] Langevitz P., Buskila D. Gladman D.D., Psoriatic arthritis precipitated by physical trauma, J Rheumatol, 1990, 17, 695–7
  • [19] Espinoza L.R., Vasey F.B., Espinoza C.G., Bocanegra T.S. Germain B.F., Vascular changes in psoriatic synovium. A light and electron microscopic study, Arthritis Rheum, 1982, 25, 677–84 http://dx.doi.org/10.1002/art.1780250611[Crossref]
  • [20] Reece R.J., Canete J.D., Parsons W.J., Emery P. Veale D.J., Distinct vascular patterns of early synovitis in psoriatic, reactive, and rheumatoid arthritis, Arthritis Rheum, 1999, 42, 1481–4 http://dx.doi.org/10.1002/1529-0131(199907)42:7<1481::AID-ANR23>3.0.CO;2-E[Crossref]
  • [21] Maisonpierre P.C., Suri C., Jones P.F., Bartunkova S., Wiegand S.J., Radziejewski C., et al., Angiopoietin-2, a natural antagonist for Tie2 that disrupts in vivo angiogenesis, Science, 1997, 277, 55–60 http://dx.doi.org/10.1126/science.277.5322.55[Crossref]
  • [22] Fearon U., Reece R., Smith J., Emery P. Veale D.J., Synovial cytokine and growth factor regulation of MMPs/TIMPs: implications for erosions and angiogenesis in early rheumatoid and psoriatic arthritis patients, Ann N Y Acad Sci, 1999, 878, 619–21 http://dx.doi.org/10.1111/j.1749-6632.1999.tb07743.x[Crossref]
  • [23] Fearon U., Griosios K., Fraser A., Reece R., Emery P., Jones P.F., et al., Angiopoietins, growth factors, and vascular morphology in early arthritis, J Rheumatol, 2003, 30, 260–8
  • [24] Danning C.L., Illei G.G., Hitchon C., Greer M.R., Boumpas D.T. McInnes I.B., Macrophage-derived cytokine and nuclear factor kappaB p65 expression in synovial membrane and skin of patients with psoriatic arthritis, Arthritis Rheum, 2000, 43, 1244–56 http://dx.doi.org/10.1002/1529-0131(200006)43:6<1244::AID-ANR7>3.0.CO;2-2[Crossref]
  • [25] Veale D., Yanni G., Rogers S., Barnes L., Bresnihan B. Fitzgerald O., Reduced synovial membrane macrophage numbers, ELAM-1 expression, and lining layer hyperplasia in psoriatic arthritis as compared with rheumatoid arthritis, Arthritis Rheum, 1993, 36, 893–900 http://dx.doi.org/10.1002/art.1780360705[Crossref]
  • [26] Veale D.J., Barnes L., Rogers S. FitzGerald O., Immunohistochemical markers for arthritis in psoriasis, Ann Rheum Dis, 1994, 53, 450–4 http://dx.doi.org/10.1136/ard.53.7.450[Crossref]
  • [27] Laloux L., Voisin M.C., Allain J., Martin N., Kerboull L., Chevalier X., et al., Immunohistological study of entheses in spondyloarthropathies: comparison in rheumatoid arthritis and osteoarthritis, Ann Rheum Dis, 2001, 60, 316–21 http://dx.doi.org/10.1136/ard.60.4.316[Crossref]
  • [28] Costello P., Bresnihan B., O’Farrelly C. FitzGerald O., Predominance of CD8+ T lymphocytes in psoriatic arthritis, J Rheumatol, 1999, 26, 1117–24
  • [29] Costello P.J., Winchester R.J., Curran S.A., Peterson K.S., Kane D.J., Bresnihan B., et al., Psoriatic arthritis joint fluids are characterized by CD8 and CD4 T cell clonal expansions appear antigen driven, J Immunol, 2001, 166, 2878–86
  • [30] Berman A., Espinoza L.R., Diaz J.D., Aguilar J.L., Rolando T., Vasey F.B., et al., Rheumatic manifestations of human immunodeficiency virus infection, Am J Med, 1988, 85, 59–64 http://dx.doi.org/10.1016/0002-9343(88)90503-7[Crossref]
  • [31] Espinoza L.R., Berman A., Vasey F.B., Cahalin C., Nelson R. Germain B.F., Psoriatic arthritis and acquired immunodeficiency syndrome, Arthritis Rheum, 1988, 31, 1034–40 http://dx.doi.org/10.1002/art.1780310815[Crossref]
  • [32] Espinoza L.R., Jara L.J., Espinoza C.G., Silveira L.H., Martinez-Osuna P. Seleznick M., There is an association between human immunodeficiency virus infection and spondyloarthropathies, Rheum Dis Clin North Am, 1992, 18, 257–66
  • [33] Brancato L., Itescu S., Skovron M.L., Solomon G. Winchester R., Aspects of the spectrum, prevalence and disease susceptibility determinants of Reiter’s syndrome and related disorders associated with HIV infection, Rheumatol Int, 1989, 9, 137–41
  • [34] Winchester R., Brancato L., Itescu S., Skovron M.L. Solomon G., Implications from the occurrence of Reiter’s syndrome and related disorders in association with advanced HIV infection, Scand J Rheumatol Suppl, 1988, 74, 89–93 http://dx.doi.org/10.3109/03009748809102943[Crossref]
  • [35] Tassiulas I., Duncan S.R., Centola M., Theofilopoulos A.N. Boumpas D.T., Clonal characteristics of T cell infiltrates in skin and synovium of patients with psoriatic arthritis, Hum Immunol, 1999, 60, 479–91 http://dx.doi.org/10.1016/S0198-8859(99)00034-8[Crossref]
  • [36] O’Connell P.G., Gerber L.H., Digiovanna J.J. Peck G.L., Arthritis in patients with psoriasis treated with gamma-interferon, J Rheumatol, 1992, 19, 80–2
  • [37] Sakkas L.I., Loqueman N., Bird H., Vaughan R.W., Welsh K.I. Panayi G.S., HLA class II and T cell receptor gene polymorphisms in psoriatic arthritis and psoriasis, J Rheumatol, 1990, 17, 1487–90
  • [38] Baeten D., Kruithof E., De Rycke L., Boots A.M., Mielants H., Veys E.M., et al., Infiltration of the synovial membrane with macrophage subsets and polymorphonuclear cells reflects global disease activity in spondyloarthropathy, Arthritis Res Ther, 2005, 7, R359–69 http://dx.doi.org/10.1186/ar1501[Crossref]
  • [39] Baeten D., Demetter P., Cuvelier C.A., Kruithof E., Van Damme N., De Vos M., et al., Macrophages expressing the scavenger receptor CD163: a link between immune alterations of the gut and synovial inflammation in spondyloarthropathy, J Pathol, 2002, 196, 343–50 http://dx.doi.org/10.1002/path.1044[Crossref]
  • [40] van Kuijk A.W., Reinders-Blankert P., Smeets T.J., Dijkmans B.A. Tak P.P., Detailed analysis of the cell infiltrate and the expression of mediators of synovial inflammation and joint destruction in the synovium of patients with psoriatic arthritis: implications for treatment, Ann Rheum Dis, 2006, 65, 1551–7 http://dx.doi.org/10.1136/ard.2005.050963[Crossref]
  • [41] Martin M.P., Nelson G., Lee J.H., Pellett F., Gao X., Wade J., et al., Cutting edge: susceptibility to psoriatic arthritis: influence of activating killer Ig-like receptor genes in the absence of specific HLA-C alleles, J Immunol, 2002, 169, 2818–22 [Crossref]
  • [42] Nelson G.W., Martin M.P., Gladman D., Wade J., Trowsdale J. Carrington M., Cutting edge: heterozygote advantage in autoimmune disease: hierarchy of protection/susceptibility conferred by HLA and killer Ig-like receptor combinations in psoriatic arthritis, J Immunol, 2004, 173, 4273–6
  • [43] Spadaro A., Scrivo R., Moretti T., Bernardini G., Riccieri V., Taccari E., et al., Natural killer cells and gamma/delta T cells in synovial fluid and in peripheral blood of patients with psoriatic arthritis, Clin Exp Rheumatol, 2004, 22, 389–94
  • [44] Rooney T., Murphy E., Benito M., Roux-Lombard P., FitzGerald O., Dayer J.M., et al., Synovial tissue interleukin-18 expression and the response to treatment in patients with inflammatory arthritis, Ann Rheum Dis, 2004, 63, 1393–8 http://dx.doi.org/10.1136/ard.2003.016428[Crossref]
  • [45] Reddy P., Interleukin-18: recent advances, Curr Opin Hematol, 2004, 11, 405–10 http://dx.doi.org/10.1097/01.moh.0000141926.95319.42[Crossref]
  • [46] Ritchlin C., Haas-Smith S.A., Hicks D., Cappuccio J., Osterland C.K. Looney R.J., Patterns of cytokine production in psoriatic synovium, J Rheumatol, 1998, 25, 1544–52
  • [47] Fraser A., Fearon U., Billinghurst R.C., Ionescu M., Reece R., Barwick T., et al., Turnover of type II collagen and aggrecan in cartilage matrix at the onset of inflammatory arthritis in humans: relationship to mediators of systemic and local inflammation, Arthritis Rheum, 2003, 48, 3085–95 http://dx.doi.org/10.1002/art.11331[Crossref]
  • [48] Turkiewicz A.M. Moreland L.W., Psoriatic arthritis: current concepts on pathogenesis-oriented therapeutic options, Arthritis Rheum, 2007, 56, 1051–66 http://dx.doi.org/10.1002/art.22489[Crossref]
  • [49] Lowes M.A., Bowcock A.M. Krueger J.G., Pathogenesis and therapy of psoriasis, Nature, 2007, 445, 866–73 http://dx.doi.org/10.1038/nature05663[Crossref]
  • [50] Veale D., Rogers S. Fitzgerald O., Immunolocalization of adhesion molecules in psoriatic arthritis, psoriatic and normal skin, Br J Dermatol, 1995, 132, 32–8 http://dx.doi.org/10.1111/j.1365-2133.1995.tb08621.x[Crossref]
  • [51] Carson C.W., Beall L.D., Hunder G.G., Johnson C.M. Newman W., Soluble E-selectin is increased in inflammatory synovial fluid, J Rheumatol, 1994, 21, 605–11
  • [52] Canete J.D., Pablos J.L., Sanmarti R., Mallofre C., Marsal S., Maymo J., et al., Antiangiogenic effects of anti-tumor necrosis factor alpha therapy with infliximab in psoriatic arthritis, Arthritis Rheum, 2004, 50, 1636–41 http://dx.doi.org/10.1002/art.20181[Crossref]
  • [53] Goedkoop A.Y., Kraan M.C., Picavet D.I., de Rie M.A., Teunissen M.B., Bos J.D., et al., Deactivation of endothelium and reduction in angiogenesis in psoriatic skin and synovium by low dose infliximab therapy in combination with stable methotrexate therapy: a prospective single-centre study, Arthritis Res Ther, 2004, 6, R326–34 http://dx.doi.org/10.1186/ar1182[Crossref]
  • [54] Pitzalis C., Cauli A., Pipitone N., Smith C., Barker J., Marchesoni A., et al., Cutaneous lymphocyte antigen-positive T lymphocytes preferentially migrate to the skin but not to the joint in psoriatic arthritis, Arthritis Rheum, 1996, 39, 137–45 http://dx.doi.org/10.1002/art.1780390118[Crossref]
  • [55] Odink K., Cerletti N., Bruggen J., Clerc R.G., Tarcsay L., Zwadlo G., et al., Two calcium-binding proteins in infiltrate macrophages of rheumatoid arthritis, Nature, 1987, 330, 80–2 http://dx.doi.org/10.1038/330080a0[Crossref]
  • [56] Roth J., Burwinkel F., van den Bos C., Goebeler M., Vollmer E. Sorg C., MRP8 and MRP14, S-100-like proteins associated with myeloid differentiation, are translocated to plasma membrane and intermediate filaments in a calcium-dependent manner, Blood, 1993, 82, 1875–83
  • [57] Eue I., Pietz B., Storck J., Klempt M. Sorg C., Transendothelial migration of 27E10+ human monocytes, Int Immunol, 2000, 12, 1593–604 http://dx.doi.org/10.1093/intimm/12.11.1593[Crossref]
  • [58] Frosch M., Strey A., Vogl T., Wulffraat N.M., Kuis W., Sunderkotter C., et al., Myeloid-related proteins 8 and 14 are specifically secreted during interaction of phagocytes and activated endothelium and are useful markers for monitoring disease activity in pauciarticular-onset juvenile rheumatoid arthritis, Arthritis Rheum, 2000, 43, 628–37 http://dx.doi.org/10.1002/1529-0131(200003)43:3<628::AID-ANR20>3.0.CO;2-X[Crossref]
  • [59] Kerkhoff C., Klempt M. Sorg C., Novel insights into structure and function of MRP8 (S100A8) and MRP14 (S100A9), Biochim Biophys Acta, 1998, 1448, 200–11 http://dx.doi.org/10.1016/S0167-4889(98)00144-X[Crossref]
  • [60] Kane D., Roth J., Frosch M., Vogl T., Bresnihan B. FitzGerald O., Increased perivascular synovial membrane expression of myeloid-related proteins in psoriatic arthritis, Arthritis Rheum, 2003, 48, 1676–85 http://dx.doi.org/10.1002/art.10988[Crossref]
  • [61] Boyle W.J., Simonet W.S. Lacey D.L., Osteoclast differentiation and activation, Nature, 2003, 423, 337–42 http://dx.doi.org/10.1038/nature01658[Crossref]
  • [62] Ritchlin C.T., Haas-Smith S.A., Li P., Hicks D.G. Schwarz E.M., Mechanisms of TNF-alpha-and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis, J Clin Invest, 2003, 111, 821–31 [Crossref]
  • [63] Vandooren B., Kruithof E., Yu D.T., Rihl M., Gu J., De Rycke L., et al., Involvement of matrix metalloproteinases and their inhibitors in peripheral synovitis and down-regulation by tumor necrosis factor alpha blockade in spondylarthropathy, Arthritis Rheum, 2004, 50, 2942–53 http://dx.doi.org/10.1002/art.20477[Crossref]
  • [64] O’Hara R., Murphy E.P., Whitehead A.S., FitzGerald O. Bresnihan B., Local expression of the serum amyloid A and formyl peptide receptor-like 1 genes in synovial tissue is associated with matrix metalloproteinase production in patients with inflammatory arthritis, Arthritis Rheum, 2004, 50, 1788–99 http://dx.doi.org/10.1002/art.20301[Crossref]
  • [65] Antoniou C., Stefanaki I., Stratigos A., Avgerinou G., Stavropoulos P., Potouridou I., et al., The Greek experience with efalizumab in psoriasis from a University Dermatologic Hospital, Br J Dermatol, 2007, 156 Suppl 2, 12–6 http://dx.doi.org/10.1111/j.1365-2133.2007.07764.x[Crossref]
  • [66] Dubertret L., Sterry W., Bos J.D., Chimenti S., Shumack S., Larsen C.G., et al., CLinical experience acquired with the efalizumab (Raptiva) (CLEAR) trial in patients with moderate-tosevere plaque psoriasis: results from a phase III international randomized, placebo-controlled trial, Br J Dermatol, 2006, 155, 170–81 http://dx.doi.org/10.1111/j.1365-2133.2006.07344.x[Crossref]
  • [67] van de Kerkhof P., Griffiths C.E., Christophers E., Lebwohl M. Krueger G.G., Alefacept in the treatment of psoriasis in patients for whom conventional therapies are inadequate, Dermatology, 2005, 211, 256–63 http://dx.doi.org/10.1159/000087020[Crossref]
  • [68] Mease P.J., Gladman D.D. Keystone E.C., Alefacept in combination with methotrexate for the treatment of psoriatic arthritis: results of a randomized, double-blind, placebo-controlled study, Arthritis Rheum, 2006, 54, 1638–45 http://dx.doi.org/10.1002/art.21870[Crossref]
  • [69] Papp K.A., Caro I., Leung H.M., Garovoy M. Mease P.J., Efalizumab for the treatment of psoriatic arthritis, J Cutan Med Surg, 2007, 11, 57–66 [Crossref]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.