About 20% to 30% of people with psoriasis develop painful joint inflammation over time, a condition known as psoriatic arthritis.
The disease combines the swollen, sore joints of arthritis with the itchy, scaly red skin of psoriasis. If left untreated, psoriatic arthritis can lead to permanent damage to bones and joints.
Why do some people with psoriasis develop psoriatic arthritis and not others? That was the question an international team of researchers sought to answer in a recent study — and to do so, they zeroed in on a particular type of cellular activity….
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What happens inside the joint is key
The researchers used mouse models of psoriatic arthritis to examine the disease mechanisms on the cellular level.
They found that psoriasis triggers the production of special immune precursor cells in the inflamed skin. “These cells can migrate from the skin to the bloodstream and from there to the joints,” says Dr. Simon Rauber of Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU). However, he adds, the simple migration of immune cells into the joint isn’t sufficient to cause inflammation there.
So, the researchers took a close look at the processes that take place in the joint. There, migratory immune cells encounter connective tissue cells called fibroblasts. And these fibroblasts aren’t happy to meet the new immune cell arrivals.
Usually, fibroblasts can fight off unwanted immune cells. Not in people who develop psoriatic arthritis, though.
“The protective function of these connective tissue cells is usually considerably reduced in people who develop psoriatic arthritis,” says team leader and FAU professor Dr. Andreas Ramming. “As a result, the inflammatory cells that enter the joint cannot be brought into check, and go on to trigger an inflammatory reaction in the joint.”
The results help explain why some psoriasis patients go on to develop joint disease. The key difference lies in the joint’s ability to keep those migratory immune cells in check. If it can’t, that’s when psoriatic arthritis happens.
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Fighting back at psoriatic arthritis
These findings could pave the way for new approaches for preventing psoriatic arthritis before it starts. Since the migratory immune cells can already be detected in the blood before they trigger joint inflammation, they could act as an early warning signal, allowing patients at risk to be identified well before psoriatic arthritis takes hold.
Future treatment strategies could be aimed at intercepting these inflammatory cells and preventing them from initiating joint inflammation. That could help prevent psoriatic arthritis rather than treating the damage after it has already happened.
In the meantime, previous research has revealed how diet and nutrition impact autoimmune conditions like psoriasis and may help keep some of the damaging effects in check…
Diet. Research has connected the Standard American Diet with psoriasis and psoriatic arthritis. Diets beneficial for psoriasis include the Mediterranean diet, a modified intermittent fasting diet known as the 5:2 method, and fiber-rich diets.
Vitamins. People with autoimmune diseases, such as psoriasis, often have low vitamin D levels. Both vitamin D and omega-3 fatty acids have demonstrated positive impacts on autoimmune conditions.
Supporting immune response. Autoimmune conditions are tied to an overactive immune system that mistakenly attacks healthy cells. Immunomodulators are drugs designed to weaken or suppress an overactive immune system. Thymoquinone, one of the active compounds in black cumin seed oil, is a powerful anti-inflammatory and is considered a natural immune system modulator, meaning it may help balance an overactive immune response.
If you’re on medication for your condition, be sure to discuss the addition of supplements or dietary changes with your doctor.
Sources:
How psoriasis affects joints — Friedrich-Alexander-Universität Erlangen-Nürnberg
Skin-derived myeloid precursors and joint-resident fibroblasts spread psoriatic disease from skin to joints — Nature Immunology
Scientists uncover why psoriasis can turn into joint disease — ScienceDaily
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