Association of interleukin-17 with peripheral spondyloarthropathic changes detected by musculoskeletal ultrasound in psoriatic patients

Abstract

Aim of the workTo evaluate potential role of musculoskeletal ultrasound (MSUS) in detection of early peripheral spondyloarthropathic changes in psoriatic patients correlating these changes with serum interleukin-17 (IL-17) level. Patients and methodsStudy included 52 psoriatic patients and 30 matched healthy controls. Patients were assessed by modified Ritchie articular index (mRAI) and modified health assessment questionnaire (MHAQ). Serum IL-17 was measured and joints assessed by MSUS. Enthesopathy was scored using Madrid Sonographic Enthesitis Index (MASEI). ResultsPatients were 22 females and 30 males with a mean age of 41.5 ± 7.1 years and the mean duration of psoriatic skin lesion of 11.4 ± 6.9 years. Ten patients (19.2%) had rheumatic complaint while 42 (80.8%) had not. Serum IL-17 was found to be significantly increased in psoriatic patients (122.3 ± 238.9 pg/ml) compared to the controls (16.5 ± 4.6 pg/ml) (p < 0.001), and also in patients with rheumatic complaint (465.8 ± 441.1 pg/ml) than those without (50.4 ± 41.1 pg/ml). IL-17 significantly correlated with clinical parameters of disease activity, but not with the acute phase reactants. Abnormal US findings documented enthesopathy in 86.5% of patients (which was clinically detected only in 17.3%) while arthritis was found in 38.5% of the patients. There was a significant correlation between serum IL-17 levels and MASEI (total, erosion and calcification scores). ConclusionMSUS proved valuable, simple and non-invasive tool in early detection of enthesopathy and subclinical arthritis in psoriatic patients. Association of elevated serum level of IL-17 with MSUS findings clarifies its potential role in developing musculoskeletal complaints in psoriatic patients.