Novel serum biomarkers differentiate psoriatic arthritis from psoriasis without psoriatic arthritis

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Novel serum biomarkers differentiate psoriatic arthritis from psoriasis without psoriatic arthritis
Key Take-Away: 

Psoriasis is the most persistent inflammatory skin disease that may lead to psoriatic arthritis. There is a great need to distinguish psoriatic arthritis from psoriasis without psoriatic arthritis. In this study, the potential of various serum biomarkers like CD5L, ITGΒ5, M2BP, MPO, MMP3, and CRP has been studied, and it has been deduced that the combination of serum biomarkers can be helpful in differentiating psoriatic arthritis from psoriasis without psoriatic arthritis.

There is a high prevalence of undiagnosed psoriatic arthritis (PsA) in psoriasis patients. Identifying soluble biomarkers for PsA will help in screening psoriasis patients for appropriate rheumatology referral.

ABSTRACT: 
Background: 

There is a high prevalence of undiagnosed psoriatic arthritis (PsA) in psoriasis patients. Identifying soluble biomarkers for PsA will help in screening psoriasis patients for appropriate rheumatology referral.

The study aimed to investigate whether serum levels of novel markers previously discovered by quantitative mass spectrometric (MS) analysis of synovial fluid and skin biopsies, performs better than CRP in differentiating PSA patients from those with psoriasis without PSA (PsC).

Methods: 

In this case-control study serum samples were obtained from 100 subjects with PsA, 100 with PsC, and 100 healthy controls.

Patients with PsA and PsC were group matched for age, sex, psoriasis duration and Psoriasis Area and Severity Index and were not currently receiving biologic treatment. Using ELISA, four high-priority markers (M2BP, CD5L, MPO, and ITGβ5), as well as previously established markers (MMP3 and CRP) were assayed. Data were analyzed using logistic regression. Receiver operating characteristic (ROC) curves were plotted.

Results: 

Compared to controls, CD5L, ITGβ5, M2BP, MPO, MMP3, and CRP were independently associated with PsA, while only CD5L, M2BP, and MPO were independently associated with PsC alone.

Compared to PsC, ITGβ5, M2BP, and CRP were independently associated with PSA. ROC analysis of this model shows an AUC of 0.85 (95% CI [0.80, 0.90]). The model that included CRP alone had an AUC of 0.71 (95% CI [0.64, 0.78]).

Conclusion: 

It was concluded that CD5L, ITGβ5, M2BP, MPO, MMP3, and CRP are markers for PsA. Combination of ITGβ5, M2BP, and CRP differentiate PsA from PsC and performs better than CRP alone.

Arthritis care res (Hoboken). 2017 jun 6
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