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Vol. 20. Issue 1.
Pages 14-19 (January 2024)
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Vol. 20. Issue 1.
Pages 14-19 (January 2024)
Original article
DKK-1 in psoriatic arthritis: Correlation with disease activity and enthesopathy
DKK-1 en artritis psoriásica: correlación con la actividad de la enfermedad y la entesopatía
Marian Aziz Wahba Abdo Wahbaa, Nagat Mohamed El-Gazzara, Radwa Mahmoud Elsharabyb, Samar Abdalhamed Tabraa,
Corresponding author
Dr_stabra_113@yahoo.com

Corresponding author.
a Department of Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt
b Department of Clinical Pathology, Faculty of Medicine, Tanta University, Egypt
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Tables (3)
Table 1. Demographic and disease-related characteristics of the PSA patients and controls.
Table 2. Clinical, laboratory & ultrasonographic assessment of the PSA patients and controls.
Table 3. Correlation between DKK1 and age, duration of psoriasis, duration of psoriatic arthritis, SPARCC index, DAPSA, PASI, MASEI score, ESR and CRP.
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Abstract
Background

Psoriatic arthritis (PsA) is a complex inflammatory disease with varied clinical characteristics. A pathognomonic characteristic of PsA is enthesitis. Entheseal inflammation ultimately leads to the production of new bone (enthesophytes). Dickkopf-related protein-1 (DKK-1) is a wingless (Wnt) inhibitor that inhibits osteoblast function.

Objectives

Assessment of the serum level of DKK-1 and its association with disease activity and enthesopathy in PsA patients.

Methods

This observational case–control study included 50 PsA patients and 50 healthy volunteers matched for age and gender. All participants were subjected to full medical history, clinical assessment, PSA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis were determined by the Psoriasis Area and Severity Index (PASI). Ultrasonographic assessment of the entheses was done in accordance with the Madrid Sonographic Enthesitis Index (MASEI). Serum level of DKK-1 and correlation with disease activity and enthesopathy in PsA patients were assessed.

Results

There was no significant difference between patients and controls regarding age and sex. The mean value of SPARCC index, DAPSA score and PASI score were 6.74±4.58, 33.24±15.26, and 8.35±10.93, respectively. There was significant difference between patients and controls regarding the serum levels of DKK-1 and MASEI score (p<0.0001). There was a significant positive correlation between serum DKK-1 and MASEI (r: 0.43527, p: 0.00158), MASEI inflammatory (r: 0.37958, p: 0.00655), and MASEI damage (r: 0.38384, p: 0.00593).

Conclusions

Serum DKK-1 levels were elevated in PsA patients and were found to be correlated with MASEI score for enthesopathy.

Keywords:
Psoriatic arthritis
DKK-1
Enthesopathy
Disease activity
Resumen
Antecedentes

La artritis psoriásica (APs) es una enfermedad inflamatoria compleja con características clínicas variadas. Una característica patognomónica de la artritis psoriásica es la entesitis. La inflamación entesófila finalmente conduce a la producción de hueso nuevo (entesófitos). La proteína 1 relacionada con dickkopf (DKK-1) es un inhibidor sin alas (Wnt) que inhibe la función de los osteoblastos.

Objetivos

Evaluación del nivel sérico de DKK-1 y su asociación con la actividad de la enfermedad y la entesopatía en pacientes con APs.

Métodos

Este estudio observacional de casos y controles; incluyó a 50 pacientes con artritis psoriásica y 50 voluntarios sanos emparejados por edad y sexo. Todos los participantes fueron sometidos a historia clínica completa, evaluación clínica, actividad de APs utilizando la puntuación del Índice de Actividad de la Enfermedad para la Artritis Psoriásica (DAPSA), la gravedad y la extensión de la psoriasis fueron determinadas por el área de psoriasis y el índice de gravedad (PASI). La evaluación ultrasonográfica de las entesis se realizó de acuerdo con el índice de entesitis sonográfica de Madrid (MASEI). Se evaluó el nivel sérico de DKK-1 y la correlación con la actividad de la enfermedad y la entesopatía en pacientes con artritis psoriásica.

Resultados

No hubo diferencias significativas entre los pacientes y los controles con respecto a la edad y el sexo. El valor medio del índice SPARCC, la puntuación DAPSA y la puntuación PASI fueron 6,74±4,58, 33,24±15,26 y 8,35±10,93 respectivamente. Hubo diferencia significativa entre pacientes y controles con respecto a los niveles séricos de DKK-1 y la puntuación MASEI (p <0,0001). Hubo correlación positiva significativa entre DKK-1 sérico y MASEI (r: 0,43527, p = 0,00158), y daño MASEI (r: 0.38384, p = 0,00593).

Conclusiones

Los niveles séricos de DKK-1 se elevaron en pacientes con APs y se encontró que estaban correlacionados con la puntuación MASEI para la entesopatía.

Palabras clave:
Artritis psoriásica
DKK-1
Entesopatía
Actividad de la enfermedad

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