Fat Factor Significance In Psoriatic Arthritis Bone Destruction

Background Significant bone remodeling with disordered osteoclastogenesis has been implicated in the pathogenesis of psoriatic arthritis (PsA). Psoriatic arthritis(PsA) patients have a high prevalence of the metabolic syndrome (MS). Adipokines, especially leptin and adiponectin, have recently been found involved in the development and regulation of some autoimmune diseases.Objective To examine the alternation of circulating osteoclastogenesis related cytokines (TNF-a, OPG and RANKL) and adipokines (leptin, adiponectin, resistin, chemerin, omentin) in PsA patients, and their correlation with osteoclast precurors, radiographic damage scores and disease activity index.Methods Patients with PsA (n=41), with psoriasis (n=20), and healthy controls (n=24) were studied. The arthritis activities of PsA patients were assessed by using the Psoriatic Arthritis Joint Activity Index (PsAJAI). Used the Sharp van der Heijde score and Bath Ankylosing spondylitis radiology index (BASRI) for radiographic assessments Blood samples was obtained for testing of TNF-a, osteoprotegerin (OPG), receptor activator of nuclear factor-κB ligand (RANKL) and adipokines including leptin, adiponectin, chemerin, omentin and resistin with ELISA and assessment of peripheral blood osteoclast precursors.Results Compared with controls, patients with PsA had higher TNF-a, RANKL, OCs, leptin and omentin but lower adiponectin and chemerin. Increased serum levels of TNF-a, RANKL, leptin, and omentin were positively correlated with OCs. In contrast, serum adiponectin levels were decreased in PsA and negatively correlated with OCs. TNF-a, RANKL and leptin were positively correlated PsAJAI. Only TNF-a was correlated with radiographic damage scores.Conclution Our data has shown that systemic expression of soluble mediators of osteoclastogenesis and adipokines are disordered in PsA. Certain adipokines are elevated in the circulation of patients with PsA and may contribute to pathogenesis of arthritis. Prospective studies will be of interest to determine the pluripotent effects of adipokines on osteoclastogenesis in chronic inflammatory rheumatic diseases. Future studies may lead to novel therapeutic strategies.