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Psoriasis and Psoriatic Arthritis

  • Madhura Castelino
  • Steve Eyre
  • Anne Barton
Chapter

Abstract

In complex inflammatory diseases such as psoriasis vulgaris (PsV) and psoriatic arthritis (PsA), interplay between genetic and environmental factors is considered important in the pathogenesis of disease. Among the non-genetic risk factors, there is evidence for the influence of microbial elements in the pathogenesis of PsV and PsA. In both conditions, there is the potential for breach of barriers at sites of host-environment interfaces, such as the skin and mucosal surfaces of the gastrointestinal tract, due to the presence of inflammatory lesions (psoriatic plaques and gut mucosal inflammation). Such a breach could contribute to increased interaction with exogenous antigens including the microbiota and, on the background of increased susceptibility to a dysregulated immune reaction due to genetic predisposition, could result in the onset and maintenance of disease pathology. There is increasing evidence of bacterial dysbiosis in psoriatic plaques. In addition, dysbiosis similar to that observed in inflammatory bowel disease (IBD) has been reported in studies of the gut microbiota from PsV and PsA individuals. Further studies into the microbial composition and their interaction with both the host genotype and immunophenotype should help dissect the links between the skin-gut-joint axis and provide novel therapeutic targets for disease prevention and control.

Keywords

Microbiota Psoriatic arthritis Psoriasis 

Abbreviations

AMP

Antimicrobial peptide

AS

Ankylosing spondylitis

EA

Enteropathic arthritis

hBD

Human beta-defensin

HIV

Human immunodeficiency virus

HLA

Human leukocyte antigen

IBD

Inflammatory bowel disease

IL

Interleukin

PsA

Psoriatic arthritis

PsV

Psoriasis vulgaris

RA

Rheumatoid arthritis

ReA

Reactive arthritis

SpA

Spondyloarthritis

TLR

Toll-like receptor

uSpA

Undifferentiated spondyloarthritis

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Rheumatology, NIHR Manchester Musculoskeletal Biomedical Research UnitThe University of ManchesterManchesterUK
  2. 2.Division of Musculoskeletal and Dermatological SciencesThe University of ManchesterManchesterUK

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