Rheumatology Advance Access originally published online on March 30, 2006
Rheumatology 2006 45(10):1218-1222; doi:10.1093/rheumatology/kel108
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Tumour necrosis factor-related apoptosis-inducing ligand and osteoprotegerin serum levels in psoriatic arthritis
Department of Internal Medicine, Philipps-University, Marburg, 1Medical Clinic C, City Hospital, Ludwigshafen and 2Kerckhoff Clinic and Foundation, Department of Rheumatology, Clinical Immunology and Osteology, University of Giessen, Bad Nauheim, Germany.
Correspondence to: Lorenz C. Hofbauer, MD, Department of Internal Medicine, Philipps-University, Baldingerstrasse, D-35033 Marburg, Germany. E-mail: hofbauer{at}post.med.uni-marburg.de
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Abstract |
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Objectives. The degree of bone loss in patients with psoriatic arthritis (PsA) has not been well-defined. We tested the hypothesis, whether serum levels of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), a pro-apoptotic cytokine and osteoprotegerin (OPG), an anti-osteoclastic cytokine, are associated with changes in biochemical markers of bone turnover or bone mineral density (BMD) in patients with PsA.
Methods. In a cross-sectional study, we evaluated biochemical markers of bone turnover, BMD and serum levels of TRAIL and OPG in 116 patients with PsA (mean age: 52±13 yrs).
Results. In patients with PsA, osteopenia was present in one-third of women and men, while osteoporosis was more frequent in men (10.2%) than in women (1.75%). Serum levels of TRAIL were significantly higher in patients with PsA (66.1±45.3 pmol/l) compared with controls (50.0±20.1 pmol/l, P<0.01), whereas OPG serum levels were not different. There were no associations between TRAIL or OPG serum levels with BMD and biochemical markers of bone turnover. However, TRAIL serum levels were associated with C-reactive protein (CRP) levels (R = 0.201, P<0.05), whereas OPG serum levels were associated with the erythrocyte sedimentation rate (R=0.215, P<0.05).
Conclusion. In summary, BMD is decreased in one-third of patients with PsA, and predominantly men with PsA suffer from osteoporosis. While TRAIL serum levels are increased in PsA and correlated with CRP levels, neither TRAIL nor OPG serum levels are correlated with BMD or markers of bone metabolism.
KEY WORDS: Bone metabolism, Inflammatory arthritis, Osteoprotegerin, Psoriatic arthritis, Tumour necrosis factor-related apoptosis-inducing ligand
The present address of Dr Schoppet is Division of Cardiovascular Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
Dr Christ's current address is: Department of Internal Medicine, University of Basel, CH-4031 Basel, Switzerland.
Submitted 9 January 2006;
revised version accepted 24 February 2006.
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