Abstract

Background: Psoriasis is a chronic inflammatory disease of the skin that affects the joints in up to 62% of cases. Psoriatic arthritis can present with both peripheral articular and axial skeletal manifestations. It can be diagnosed by clinical, radiological and serological parameters including serum osteoprotegerin, matrix metalloproteinase-III, C reactive protein and macrophage colony stimulating factor. Aim: Our aim was to assess the serum levels of HS-CRP, OPG, MMP-3 and M-CSF in patients with psoriasis and PsA, and to correlate them with different radiological findings. Methods: Sixty-one patients with psoriasis (including 40 patients with PsA) were subjected to clinical, radiological and serological testing. Results: Osteopenia and osteoporosis of the spine were significantly higher among patients with PsA when compared to controls (p=0.024). Serum MMP-3 was significantly higher among patients when compared to controls (p=0.005). Serum levels of HS-CRP were significantly higher in patients showing juxta-articular osteoporosis (P=0.02). Serum OPG levels were positively correlated with radiological scores (P=0.003, r=0.595) and negatively correlated with Dexa femur score (p=0.039, r=-0.434). PASI score of the patients was positively correlated to serum levels of MMP-3 and GM-CSF (p=0.032, r=0. 363 and p=0.003, r=0.485 respectively). MMP-3 levels and GM-CSF were positively correlated to each other (p=0.006, r=0.423). Conclusion: Serum levels of MMP-3, HS-CRP, GM-CSF and OPG can be used to assess the activity of arthritis among patients with PsA and should be utilized, in addition to the clinical and radiological findings, to determine the severity of the disease and can be also used to follow up patients.