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Patients with psoriatic arthritis have higher levels of FeNO than those with only psoriasis, which may reflect a higher prevalence of a subclinical respiratory involvement.

银屑病关节炎患者的 FeNO 水平高于单纯银屑病患者,这可能反映了亚临床呼吸系统受累的患病率较高。

  • 影响因子:2.26
  • DOI:10.1007/s10067-020-05050-2
  • 作者列表:"Damiani G","Pacifico A","Rizzi M","Santus P","Bridgewood C","Bragazzi NL","Adawi M","Watad A
  • 发表时间:2020-04-02
Abstract

BACKGROUND:Psoriatic arthritis (PsA) patients are often affected by numerous comorbidities. However, contrasting results have been reported with regard to the respiratory involvement in PsA patients. The aim of this study was to evaluate the presence of subclinical airway inflammation in non-smoking PsA patients compared to patients with only psoriasis using the fraction of exhaled nitric oxide (FeNO) as an indirect marker of airway inflammation. METHODS:The study included 164 non-smoking psoriatic patients (Psoriasis Area of Severity Index or PASI score > 10): 82 with and 82 without PsA, who underwent FeNO tests at different flow rates (30, 50, 100, 200 mL/s). PsA patients were evaluated with Disease Activity in PSoriatic Arthritis Score (DAPSA). Both study groups were compared in terms of FeNO values and its association with the PASI score. The correlations between the variables were evaluated by means of Pearson's coefficient. RESULTS:Patient with PsA had higher levels of FeNO than those with psoriasis but without arthritis (at 30 mL/s, 71.09 ± 18.40 ppb vs 66.88 ± 19.12 ppb (NS); at 50 mL/s, 36.61 ± 9.30 ppb vs 30.88 ± 9.73 ppb (p < 0.001); at 100 mL/s, 19.09 ± 4.66 ppb vs 16.63 ± 4.90 ppb (p < 0.001); and at 200 mL/s, 10.88 ± 2.53 ppb vs 9.43 ± 2.55 ppb (p < 0.001), respectively). PASI score correlated to FeNO only in psoriatic patients without arthritis. However, CASPAR index correlated with FeNO (FeNO30: r = 0.81, p < 0.001; FeNO50: r = 0.84, p < 0.001; FeNO100: r = 0.71, p < 0.001; FeNO200: r = 0.58, p < 0.001). DAPSA was also correlated with FeNO to all flows (FeNO30: r = 0.43, p < 0.001; FeNO50: r = 0.33, p < 0.001; FeNO100: r = 0.34, p < 0.001; FeNO200: r = 0.25, p < 0.001). CONCLUSIONS:PsA patients seem to have more commonly subclinical airway inflammation than those with only psoriasis. Further studies are needed to replicate these findings.Key Points• Fraction of exhaled nitric oxide (FeNO) is a useful device to detect and monitor airway inflammation not only in asthma but also in systemic inflammatory diseases such as psoriatic arthritis and psoriasis.• Clinicians should be aware to check respiratory diseases in patients with psoriatic arthritis.

摘要

背景: 银屑病关节炎 (PsA) 患者常受到多种合并症的影响。然而,关于 PsA 患者呼吸受累的对比结果已有报道。本研究的目的是使用呼出气一氧化氮 (FeNO) 分数评估非吸烟 PsA 患者与仅银屑病患者相比存在亚临床气道炎症的情况作为气道炎症的间接标志物。 方法: 研究纳入 164 例非吸烟银屑病患者 (银屑病严重程度面积指数或 PASI 评分> 10 分): 82 例伴和 82 例不伴 PsA,在不同流速 (30 、 50 、 100 、 200 mL/s) 下进行 FeNO 试验。对 PsA 患者进行银屑病关节炎疾病活动度评分 (DAPSA) 评估。比较两个研究组的 FeNO 值及其与 PASI 评分的相关性。通过 Pearson 系数评价变量之间的相关性。 结果: PsA 患者的 FeNO 水平高于银屑病但无关节炎的患者 (30 mL/s, 71.09 ± 18.40 ppb vs 66.88 ± 19.12 ppb (NS); 50 mL/s, 36.61 ± 9.30 ppb vs 30.88 ± 9.73 ppb (p <0.001); 100 mL/s 时,19.09 ± 4.66 ppb vs 16.63 ± 4.90 ppb (p <0.001); 和 200 mL/s,10.88 ± 2.53 ppb vs 9.43 ± 2.55 ppb (分别为 p <0.001)。PASI 评分仅在无关节炎的银屑病患者中与 FeNO 相关。然而,CASPAR 指数与 FeNO 相关 (FeNO30: r = 0.81,p <0.001; FeNO50: r = 0.84,p <0.001; FeNO100: r = 0.71,P <0.001; FeNO200: r = 0.58,p <0.001)。DAPSA 也与所有流量的 FeNO 相关 (FeNO30: r = 0.43,p <0.001; FeNO50: r = 0.33,p <0.001; FeNO100: R = 0.34,p <0.001; FeNO200: r = 0.25,p <0.001)。 结论: PsA 患者似乎比单纯银屑病患者有更常见的亚临床气道炎症。需要进一步的研究来复制这些发现。要点 • 呼出气一氧化氮 (FeNO) 分数是检测和监测气道炎症的有用设备,不仅在哮喘中,而且在系统性炎症性疾病如银屑病关节炎和银屑病中。• 临床医生应注意检查银屑病关节炎患者的呼吸系统疾病。

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