Anatomical pattern of entheseal and synovial fibroblast activation in patients with psoriasis and its risk of developing psoriatic arthritis.
- Resource Type
- Academic Journal
- Authors
- Corte G; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Atzinger A; Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany.; Temiz SA; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Noversa de Sousa R; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Serviço de Medicina Interna, Hospital Pedro Hispano, Hospital Pedro Hispano, Matosinhos, Porto, Portugal.; Mutlu MY; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Schoenau V; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Raimondo MG; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Kleyer A; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Department of Rheumatology and Clinical Immunology, Charite University Hospital Berlin, Berlin, Germany.; Kuwert T; Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany.; Ramming A; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Simon D; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Department of Rheumatology and Clinical Immunology, Charite University Hospital Berlin, Berlin, Germany.; Sticherling M; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany.; Schmidkonz C; Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany.; Institute for Medical Engineering, Ostbayerische Technische Hochschule Amberg-Weiden, Amberg, Germany.; Schett G; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.; Fagni F; Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany Filippo.Fagni@uk-erlangen.de.; Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany.
- Source
- Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101662038 Publication Model: Electronic Cited Medium: Internet ISSN: 2056-5933 (Electronic) Linking ISSN: 20565933 NLM ISO Abbreviation: RMD Open Subsets: MEDLINE
- Subject
- Language
- English
Objectives: To assess the presence and anatomical distribution of activated fibroblasts in the joints and entheses of patients with psoriasis with arthralgia and to test how fibroblast activation visualised by 68 gallium-labelled fibroblast activation protein inhibitor-04 ( 68 Ga-FAPI-04)-positron emission tomography (PET)/CT correlates with clinical tenderness, musculoskeletal ultrasound findings and progression to psoriatic arthritis (PsA).
Methods: We conducted a prospective cohort study in patients with psoriasis and arthralgia who underwent clinical and ultrasound evaluation and whole-body PET/CT imaging with 68 Ga-FAPI-04. 68 Ga-FAPI-04 uptake at synovial and entheseal sites was assessed by maximal standardised uptake values (SUVmax) and PET/CT Joint Index (JI); logistic regression models were used to investigate its correlation with clinical and ultrasound findings. Survival analyses were performed on patients with at least 6 months of follow-up.
Results: 36 patients with psoriasis were enrolled. 68 Ga-FAPI-04 uptake was found in 318 (7.9%) joints and 369 (7.3%) entheses in 29 (80.6%) participants, with a mean SUVmax (SD) of 3.2 (1.8) for joints and 2.9 (1.6) for entheses. Large joints and the lower limbs were predominantly affected. A significant positive relationship was found between 68 Ga-FAPI-04-PET/CT signal intensity and the 68 tender joint count (SUVmax: p<0.001; PET/CT-JI: p<0.001) and tender entheses count (SUVmax: p<0.001; PET/CT-JI: p=0.002). No correlations were found with ultrasound findings (SUVmax: p=0.969; PET/CT-JI: p=0.720). Patients with relevant synovio-entheseal 68 Ga-FAPI-04 uptake showed a statistically significant higher risk of developing PsA (p=0.02), independent of ultrasound findings.
Conclusions: Patients with psoriasis presenting with arthralgia show localised signs of resident tissue activation in joints and entheses, which are associated with higher risk of developing PsA.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)