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Clinical Rheumatology

, Volume 37, Issue 4, pp 859–868 | Cite as

Psoriatic arthritis: tissue-directed inflammation?

  • Giacomo Cafaro
  • Iain B. McInnes
Review Article

Abstract

The clinical picture of psoriatic arthritis (PsA) is heterogeneous, potentially involving numerous organs and tissues, such as skin and joint. From a clinical point of view, discrete tissue PsA features develop and respond to treatments apparently independently. The pathogenic events occurring in the various tissues are only partially understood. Although the vast majority of known genetic predisposing factors are shared between patients with skin psoriasis (PSO) and those affected by PsA, some tissue-specific variants have been identified. Furthermore, current data suggest that the TNF pathway and IL-23/Th17 pathways may be differentially activated in distinct tissue sites. In this review, we briefly describe current knowledge on the pathogenesis of PsA in terms of genetic predisposition, environmental factors and immunology, advancing our hypothesis to explain why a common immunologic process can express itself with significant differences in various tissues.

Keywords

Genetics Microbiota Pathogenesis Psoriasis Psoriatic arthritis 

Notes

Compliance with ethical standards

The manuscript does not contain clinical studies or patient data.

Conflict of interest

IBM has received honoraria or research funding from Novartis, Lilly, Celgene, Janssen, Abbvie, BMS, UCB and Pfizer all of whom are developing or have medicines involved in the treatment of psoriatic arthritis.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Rheumatology Unit, Department of MedicineUniversity of PerugiaPerugiaItaly
  2. 2.Institute of Infection Immunity and Inflammation, College of MVLSUniversity of GlasgowGlasgowUK

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