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Review
. 2020 Mar 1;59(Suppl 1):i10-i14.
doi: 10.1093/rheumatology/keaa039.

Enthesitis in psoriatic arthritis (Part 1): pathophysiology

Elizabeth G Araujo  1 , Georg Schett  1
Affiliations
Review

Enthesitis in psoriatic arthritis (Part 1): pathophysiology

Elizabeth G Araujo et al. Rheumatology (Oxford). .

Abstract

Enthesitis is a key manifestation of PsA and current knowledge supports the concept that it may be among the primary events in the development of this disease, as well as other forms of SpA. Patients with PsA seem to have a different threshold to mechanical stress, which may be genetically determined. Hence patients with psoriatic disease respond pathologically with inflammation after being exposed to physiological mechanical stress. Activation of pro-inflammatory mediators such as IL-17 and TNF-α as well as the influx of innate immune cells are key events in the development of enthesitis in PsA. Chronic entheseal inflammation is accompanied by new bone formation, leading to bony spurs in peripheral (entheseophytes) and axial (syndesmophytes) structures. This article reviews the current knowledge on the mechanisms involved in the development of enthesitis in patients with PsA.

Keywords: entheseophyte; enthesitis; interleukin 17; interleukin 23; psoriatic arthritis.

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References

    1. Schett G, Lories RJ, D’Agostino M-A. et al. Enthesitis: from pathophysiology to treatment. Nat Rev Rheumatol 2017;13:731–41. - PubMed
    1. Taylor W, Gladman D, Helliwell P. et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006;54:2665–73. - PubMed
    1. Simon D, Faustini F, Kleyer A. et al. Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis. Ann Rheum Dis 2016;75:660–6. - PubMed
    1. Watad A, Bridgewood C, Russell T. et al. The early phases of ankylosing spondylitis: emerging insights from clinical and basic science. Front Immunol 2018;9;2268. - PMC - PubMed
    1. Thomopoulos S, Genin GM, Galatz LM.. The development and morphogenesis of the tendon-to-bone insertion - what development can teach us about healing. J Musculoskelet Neuronal Interact 2010;10:35–45. - PMC - PubMed

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