Interleukin-18, interleukin-20, and matrix metalloproteinases (MMP-1, MMP-3) as markers of psoriatic arthritis disease severity and their correlations with biomarkers of inflammation and turnover of joint cartilage

Abstract

Introduction Psoriatic arthritis (PsA) is a chronic, seronegative spondyloarthropathy characterised by joint inflammation and psoriatic skin changes. Recent data indicate that interleukin-18 (IL-18) and interleukin-20 (IL-20) may be involved in the aetiopathogenesis of PsA. Aim To evaluate the potential role of IL-18, IL-20, and matrix metalloproteinases (MMP-1, MMP-3) in the pathogenesis of PsA and their correlations with other markers of inflammation and destruction of joint cartilage, as well as clinical changes. Material and methods The study included 24 patients with PsA and 26 healthy volunteers as a control group. The concentration of IL-18 and IL-20, c-reactive protein (CRP), metalloproteinase-1 and -3 (MMP-1, MMP-3), cartilage oligomeric matrix protein (COMP), aggrecan (PG-AG), and human cartilage glycoprotein (YKL-40) in serum was determined. Clinical severity of the disease according to the BSA, PASI, and DLQI as well as tender and swollen joint count (TJC, SJC) were also evaluated. Results The concentration of IL-18 was statistically significantly higher in the serum of patients with PsA than in the control group (62.87 pg/ml vs. 16.73 pg/ml, p < 0.0049). Serum IL-20 levels in PsA patients were also higher than in the control group, but without statistical significance ( p = 0.2939). The ROC curves showed: AUC = 0.81 for IL-18, AUC = 0.75 for IL-20, AUC = 0.96 for COMP, and AUC = 0.89 for MMP-3. Conclusions IL-18 and IL-20 as well as MMP-3 and COMP may be sensitive markers in the diagnosis of PsA.

Serum Biomarkers of Inflammation and Turnover of Joint Cartilage Can Help Differentiate Psoriatic Arthritis (PsA) Patients from Osteoarthritis (OA) Patients

“…Our earlier studies confirm the important role these biomarkers play in the etiopathogenesis of both OA and PsA [ 15 , 16 , 17 ]. Our previous observations in OA patients indicate that IL-18 potentially mediates mainly in intra-articular processes and is responsible for the destruction of joint cartilage.…”

“…The concentration of biomarkers responsible for inflammation and destruction of joint cartilage were analysed in the serum of PsA patients, OA patients, and the control group of healthy individuals (HC): interleukin 6 (IL-6), interleukin 18 (IL-18), interleukin 20 (IL-20), matrix metalloproteinases 1 and 3 (MMP-1, MMP-3), cartilage oligomeric matrix protein (COMP), human cartilage glycoprotein (YKL-40), and aggrecan (PG-AG). Our earlier studies and the others confirm the important role these biomarkers may play in the etiopathogenesis of both OA and PsA [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Determination of the clinical stage of disease expressed on a Kellgren-Lawrence scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Index of Severity for Osteoarthritis of the Knee (Lequesne index) for OA patients and Body Surface Area score (BSA), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and the number of painful (TJC) and swollen joints (SJC) for PsA patients was also conducted [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

“…The homogeneity of the studied groups indicates that, in case of scanty and uncharacteristic clinical symptoms, the differentiation between the two diseases does not always have to be clear and simple. Our observations, also from previous publications, indicate that the activity of inflammatory processes and destruction of the articular cartilage may be similar in both groups of patients [ 15 , 16 ] and selective consideration of their activity does not allow for differentiation between the two diseases. Only the multivariate logistic regression analysis of the studied biomarkers allowed us to indicate those that distinguish OA from PsA ( Table 2 ).…”

“…Those observations have also shown that IL-20, but also COMP, YKL-40, and MMP-3, may be a sensitive marker in the diagnosis of osteoarthritis [ 16 ]. In turn, our previous studies among patients with PsA indicate the important role of IL-18, COMP, and MMP-3 in the etiopathogenesis of PsA and that these biomarkers may be a sensitive marker of this disease [ 15 , 17 ].…”

The influence of tumour necrosis factor α inhibitors treatment – etanercept on serum concentration of biomarkers of inflammation and cartilage turnover in psoriatic arthritis patients

“…Early diagnosis and effective treatment protect patients from complications and severe consequences of the musculoskeletal system. In order to understand the exact etiopathogenesis of this disease, its early detection and effective treatment, various biomarkers specific to this disease are investigated [1,[4][5][6][7][8]. According to the National Institutes of Health Biomarkers Definitions Working Group, a biomarker is "a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic intervention" [9].…”