Psoriatic arthritis

Background

Psoriatic arthritis (PsA) is the second most common form of inflammatory arthritis after rheumatoid arthritis and occurs in 7% people with psoriasis. Family studies suggest that there is a strong genetic contribution to susceptibility with siblings of a patient with PsA being up to 40 times more likely to develop the disease themselves. Despite this strong genetic contribution, the genetic basis of the disease has been difficult to investigate because of the overlap with both psoriasis and inflammatory arthritis, making it difficult to separate out the factors that are unique to PsA.

Research Programme

The aim of the programme of work is to identify genes and other factors that predispose to the development of PsA and the long-term outcome of patients, including response to treatment. By understanding the genes that are specifically associated with PsA and not psoriasis, it may become possible to screen patients with psoriasis and to determine whether they are at risk of developing PsA, allowing preventative strategies to be introduced. The genes identified would make ideal targets against which to develop new drugs.

Cohorts available

Susceptibility: Patients with PsA who were under active follow up by hospital rheumatologists were recruited from throughout the UK. So far, DNA samples from 2000 PsA subjects have been collected but the collection is on-going.
Portfolio No: 7881

Outcome: The Outcome of Treatment in Psoriatic Arthritis Study Syndicate (OUTPASS) collects blood for DNA, serum and RNA from patients about to start an anti-TNF therapy for PsA. Patients are followed prospectively for 12 months, with further collection of blood at 3, 6 and 12 months, as well as clinical data collection at all time points. Response to the anti-TNF drug is assessed using standard criteria. This study has only begun recently and collection needs to continue before enough samples are available for analysis.
Portfolio No: 13910

Access to data/samples: contact Anne Barton (anne.barton@manchester.ac.uk)

Collaborations

UK centres:

  • Aintree Hospital
  • Bolton PCT - Lever Chambers Health Centre
  • Bradford Hospital
  • Central Manchester Foundation Trust
  • Chesterfield Royal Hospital
  • Cumberland Infirmary
  • Derbyshire Royal Infirmary
  • Dewsbury & District Hospital
  • Guys Hospital
  • Haywood Hospital
  • Huddersfield Royal Infirmary
  • Ipswich Hospital
  • Lancaster Royal Infirmary
  • Leicester Royal Infirmary
  • Leighton Hospital
  • Macclesfield District General Hospital
  • Norfolk & Norwich University Hospital
  • North Devon Hospital
  • North Manchester General Hospital
  • Queen Alexandra Hospital
  • Queen Elizabeth Hospital, B'ham
  • Queens Medical Centre
  • Rotherham General Hospital
  • Royal Hallamshire Hospital
  • Royal Liverpool University Hospital         
  • Royal National Hospital For Rheumatic Diseases
  • Salford Royal Hospital
  • St Helens Hospital
  • Torbay Hospital
  • Withington Hospital
  • Wrightington, Wigan And Leigh
  • Wythenshawe Hospital

Europe
The Psoriatic Arthritis Genetics European (PAGE) consortium was formed to facilitate the identification of genes underlying psoriatic arthritis from across Europe. Collaborating centres include:

  • Manchester UK
  • Bath,UK
  • Leeds, UK
  • Dublin, Ireland
  • Frankfurt, Germany
  • Erlangen, Germany
  • Umea, Sweden
  • Rome, Italy

Research Summary

Perhaps unsurprisingly, many of the genes associated with psoriasis are also associated with PsA. However, there are some genes that show a stronger association with PsA than psoriasis including HLA B27, TRAF3IP2, RUNX3 and a region on chromosome 5q. Recent work suggests that the CD8 T cell may be the driving cell in causing disease and work is on-going to identify how the genetic changes cause disease in that cell type.

Contact/Principal investigator