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Serum sCD40L levels are increased in patients with psoriatic arthritis and are associated with clinical response to apremilast.
Clinical & Experimental Immunology ( IF 3.4 ) Pub Date : 2020-05-07 , DOI: 10.1111/cei.13451 V Venerito 1 , D Natuzzi 1 , R Bizzoca 1 , N Lacarpia 1 , F Cacciapaglia 1 , G Lopalco 1 , F Iannone 1
Clinical & Experimental Immunology ( IF 3.4 ) Pub Date : 2020-05-07 , DOI: 10.1111/cei.13451 V Venerito 1 , D Natuzzi 1 , R Bizzoca 1 , N Lacarpia 1 , F Cacciapaglia 1 , G Lopalco 1 , F Iannone 1
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The pathogenesis of psoriatic arthritis (PsA) involves several pathways, including the CD40/CD40L signaling which promotes the release of multiple cytokines. Transmembrane CD40L is also released in soluble form (sCD40L) and phosphodiesterase 4 (PDE4) seems to be involved in its cleavage. We aimed to investigate whether apremilast, a PDE4 inhibitor, could modify circulating levels of sCD40L in PsA patients, and the possible associations of these changes with clinical response. Consecutive PsA patients starting apremilast in routine clinical practice were prospectively observed. Disease Activity of Psoriatic Arthritis (DAPSA), Psoriasis Area Severity Index (PASI), Leeds Enthesitis Score (LEI) and serum samples were collected at baseline and at 6 months. Samples were run in a Bio‐Plex ProTM plate for sCD40L. To investigate the association of sCD40L level with DAPSA based minor response, low disease activity (LDA) and/or remission at 6 months of treatment, multivariate logistic regression models with backward selection (P < 0·05) were built. We studied 27 patients (16 of 27 women, 59·6%) with PsA and mean age [± standard deviation (s.d.)] of 58·4 ± 10 years. A significant reduction of the mean values of DAPSA, LEI and PASI was detected at 6 months. Mean serum levels of sCD40L decreased from baseline 5364 ± 2025 pg/ml to 4412 ± 2629 at 6 months (P = 0·01). Baseline DAPSA [odds ratio (OR) = 0·80, 95% confidence interval (CI) = 0·65–0·98] and sCD40L (OR = 1·001, 95% CI = 1·0001–1·0027) were independently associated with DAPSA LDA/remission at 6 months. In PsA patients, sCD40L levels decrease upon apremilast treatment and might predict short‐term clinical response to apremilast.
中文翻译：
银屑病关节炎患者的血清 sCD40L 水平升高，并且与阿普斯特的临床反应有关。
银屑病关节炎 (PsA) 的发病机制涉及多种途径，包括促进多种细胞因子释放的 CD40/CD40L 信号传导。跨膜 CD40L 也以可溶形式 (sCD40L) 释放，磷酸二酯酶 4 (PDE4) 似乎参与其裂解。我们旨在调查阿普司特（一种 PDE4 抑制剂）是否可以改变 PsA 患者中 sCD40L 的循环水平，以及这些变化与临床反应的可能关联。前瞻性观察了在常规临床实践中开始使用阿普斯特的连续 PsA 患者。在基线和 6 个月时收集银屑病关节炎的疾病活动性 (DAPSA)、银屑病面积严重程度指数 (PASI)、利兹附着点炎评分 (LEI) 和血清样本。样品在用于 sCD40L 的 Bio-Plex ProTM 板中运行。P < 0·05) 建立。我们研究了 27 名 PsA 患者（27 名女性中的 16 名，59·6%），平均年龄 [± 标准差 (sd)] 为 58·4 ± 10 岁。在 6 个月时检测到 DAPSA、LEI 和 PASI 的平均值显着降低。sCD40L 的平均血清水平在 6 个月时从基线 5364 ± 2025 pg/ml 降至 4412 ± 2629 ( P = 0·01)。基线 DAPSA [比值比 (OR) = 0·80，95% 置信区间 (CI) = 0·65–0·98] 和 sCD40L（OR = 1·001，95% CI = 1·0001-1·0027） 6 个月时与 DAPSA LDA/缓解独立相关。在 PsA 患者中，sCD40L 水平在 apremilast 治疗后降低，并可能预测对 apremilast 的短期临床反应。
更新日期：2020-05-07
中文翻译：
银屑病关节炎患者的血清 sCD40L 水平升高，并且与阿普斯特的临床反应有关。
银屑病关节炎 (PsA) 的发病机制涉及多种途径，包括促进多种细胞因子释放的 CD40/CD40L 信号传导。跨膜 CD40L 也以可溶形式 (sCD40L) 释放，磷酸二酯酶 4 (PDE4) 似乎参与其裂解。我们旨在调查阿普司特（一种 PDE4 抑制剂）是否可以改变 PsA 患者中 sCD40L 的循环水平，以及这些变化与临床反应的可能关联。前瞻性观察了在常规临床实践中开始使用阿普斯特的连续 PsA 患者。在基线和 6 个月时收集银屑病关节炎的疾病活动性 (DAPSA)、银屑病面积严重程度指数 (PASI)、利兹附着点炎评分 (LEI) 和血清样本。样品在用于 sCD40L 的 Bio-Plex ProTM 板中运行。P < 0·05) 建立。我们研究了 27 名 PsA 患者（27 名女性中的 16 名，59·6%），平均年龄 [± 标准差 (sd)] 为 58·4 ± 10 岁。在 6 个月时检测到 DAPSA、LEI 和 PASI 的平均值显着降低。sCD40L 的平均血清水平在 6 个月时从基线 5364 ± 2025 pg/ml 降至 4412 ± 2629 ( P = 0·01)。基线 DAPSA [比值比 (OR) = 0·80，95% 置信区间 (CI) = 0·65–0·98] 和 sCD40L（OR = 1·001，95% CI = 1·0001-1·0027） 6 个月时与 DAPSA LDA/缓解独立相关。在 PsA 患者中，sCD40L 水平在 apremilast 治疗后降低，并可能预测对 apremilast 的短期临床反应。
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