Jadon DR, et al. - A prospective cross-sectional comparative study is performed to affirm and figure out whether these four biomarkers are related to PsA; differentiate psoriasis cases with and without arthritis, and differentiate PsA cases with and without axial arthritis. The current study showed that the MMP-3 and M-CSF are biomarkers for the presence of arthritis in psoriatic disease, and could, therefore, be utilized to screen for PsA in psoriasis cohorts. Dkk-1 and OPG are biomarkers of axial arthritis; they could, therefore, be used to screen for the presence of axial disease in PsA cases, and help differentiate PsSpA from AS. High concentrations of Dkk-1 in AS and PsSpA compared with HC, support previous reports that Dkk-1 is dysfunctional in the spondyloarthritides.

Methods

• For this research, they conducted a prospective cross-sectional comparative two-center study.
• In this study, they enrolled 200 patients with psoriasis without arthritis (PsC), 127 with PsA without axial arthritis (pPsA), 117 with PsA with axial arthritis (psoriatic spondyloarthritis, PsSpA), 157 with ankylosing spondylitis (AS) without psoriasis, and 50 matched healthy controls (HC).
• By using ELISA, they measured serum biomarker concentrations.
• Multivariable regression and receiver operating characteristic investigations were performed.

Results

• In this study, they observed that MMP-3 concentrations were significantly higher and M-CSF significantly lower in each arthritis disease group compared with HC (p ≤0.02).
• MMP-3 concentrations were significantly higher (adjusted odds ratio, Oradj 1.02 per ng/ml increase in concentration; p = 0.0004) and M-CSF significantly lower (Oradj 0.44 per ng/ml increase; p = 0.01) in PsA (pPsA and PsSpA combined) compared with PsC.
• Dkk-1 concentrations were significantly higher (Oradj 1.22 per ng/mL increase; p = 0.01), and OPG concentrations significantly lower (Oradj 0.20 per ng/mL increase; p = 0.02) in patients with axial arthritis (PsSpA and AS combined) than in those without (pPsA).
• Furthermore, Dkk-1 concentrations were significantly higher along a spectrum of increasing axial arthritis; Dkk-1 concentrations were higher in AS compared with PsSpA (Oradj 1.18 per ng/mL increase; p = 0.02).
• Receiver operating characteristic examination demonstrated MMP-3 to be the best single biomarker for differentiating PsA from PsC (AUC 0.70 for a cut-off of 14.51 ng/mL; sensitivity 0.76, specificity 0.60).