%0 Journal Article
%T Angiogenic and Inflammatory Properties of Psoriatic Arthritis
%A Toshiyuki Yamamoto
%J ISRN Dermatology
%D 2013
%R 10.1155/2013/630620
%X Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy associated with psoriasis and included in seronegative spondyloarthropathy. PsA has several unique characteristics different from rheumatoid arthritis (RA), such as enthesopathy, dactylitis, and abnormal bone remodeling. As compared with synovitis of RA (pannus), proliferation of PsA synovium is mild and characterized by hypervascularity and increased infiltration of polymorphonuclear leukocytes in the synovial tissues. Angiogenesis plays a crucial role in cutaneous psoriasis, and several angiogenic factors such as vascular endothelial growth factor, interleukin-8, angiopoietin, tumor necrosis factor-¦Á and transforming growth factor-¦Â, are suggested to play an important role also in the pathophysiology of PsA. Further, IL-17 has various functions such as upregulation of proinflammatory cytokines, attraction of neutrophils, stimulation of keratinocytes, endothelial cell migration, and osteoclast formation via RANKL from activated synovial fibroblasts. Thus, IL-17 may be important in angiogenesis, fibrogenesis, and osteoclastogenesis in PsA. In this paper, roles of angiogenesis in the psoriatic synovium are discussed, which may strengthen the understanding of the pathogenesis of PsA. 1. Introduction Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy in association with psoriasis. PsA is classified as one of the seronegative spondyloarthropathy characterized by joint destruction with extra-articular involvement (i.e., eye, gut, and bowel). The involved joints present swelling, redness, and deformity to the end, which are usually periphery (main involvements are distal interphalangeal joints), but sacroiliac joints are less frequently affected. In nearly 70% of patients, cutaneous lesions precede the onset of joint pain, in 20% arthropathy starts before skin manifestations, and in 10% both are contemporary. Results of laboratory examination show elevated levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) which reflect acute-phase inflammation. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibodies are usually negative. HLA-B27 is found chiefly in patients with spondylitis type PsA. Radiographic features of joint space narrowing, erosions, osteolysis, new bone formation, enthesitis, spur formation, pencil-in-cup appearance, and bamboo spine. Although, in general, patients with severe cutaneous psoriasis often complain of arthralgia, skin severity and joint lesions are not always parallel. A number of studies have suggested genetic,
%U http://www.hindawi.com/journals/isrn.dermatology/2013/630620/