Areas of Future Research

Scientists are researching several areas in psoriatic arthritis (PsA) to improve the understanding of the disease, aid in diagnosis, and uncover effective treatment options.1

Biomarkers

Biomarkers are medical signs that can be accurately measured with specialized tools. They provide insight into the underlying disease process and are often used to diagnose disease or measure treatment outcomes. Currently, there are no specific biomarkers that can accurately predict the progression of PsA or what therapies would be most effective for an individual, but the field is rapidly progressing. Some of the promising biomarkers that have been identified include:2

  • Interleukins (IL) and T-helper (Th) cells – There are several interleukins, or chemical messengers, and T-helper cells are correlated with PsA disease activity. Scientists are investigating IL-17, IL-22, and IL-23, as well as Th17, as master regulators of inflammation and bone remodeling in PsA.3
  • Human Leukocyte Antigens (HLA-A, HLA-B and HLA-C) – The human leukocyte antigen system is what identifies the cells of the body, allowing the immune system to recognize self versus foreign invader cells. Most individuals with PsA initially develop psoriasis, and researchers are looking for biomarkers that can identify which individuals with psoriasis are more likely to develop PsA. The HLAs are being studied, as different combinations are associated with severe or milder types of PsA.3
  • Imaging – Over the last 30 years, imaging studies using magnetic resonance imaging (MRI) and/or Doppler ultrasound have helped researchers identify changes in individuals with psoriasis that are predictors of the development of PsA.2,3
  • Osteoclast precursors – These cells are the early form of cells that break down bone, a normal process that gets overly triggered in PsA causing joint damage and deformity. Scientists have identified these osteoclast precursors that are in higher numbers in individuals with PsA, and higher numbers in patients with psoriasis seem to be a predictor of developing PsA.2,3
  • Markers of treatment response Biologic treatment options target specific pathways in the inflammation response that are out of balance in PsA. Research is underway to identify biomarkers that will predict which biologic treatment may be most effective for each individual with PsA.3

New targets for biologic treatments

There is no cure for PsA, although some of the new biologic therapies can provide periods of remission. The search for more effective treatment continues, as researchers continue to look for novel ways to treat the disease and prevent its potentially devastating progression. Some of the new targets include:

  • T-cell activation – T-cells are a type of white blood cell that is normally activated in the body’s immune response. These cells are overly active in PsA, and scientists are searching for what triggers these T-cells as a potential target for treatment.4
  • Interleukin 17A (IL-17A) – IL-17A is a cytokine produced by the T helper 17 cells that exerts a host defense role in infectious disease and promotes inflammatory pathology in autoimmune diseases. IL-17A inhibitors have been shown to produce results in individuals with moderate to severe psoriasis, and with lesser response seen in PsA.5,6
  • Interleukin 6 (IL-6) – IL-6 is another cytokine that plays an important role in the disease progression of PsA. It is known to influence T-cell development, transforming naïve T-cells into T-helper 17 cells, important mediators in PsA. The role of IL-6 in PsA supports the idea that targeted treatments against IL-6 might be effective.7
Written by: Emily Downward | Last reviewed: October 2016.
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