In a recent study published in the Arthritis and Rheumatology, Omar Cruz-Correa and team have made a significant stride towards predicting the development of Psoriatic Arthritis (PsA) in psoriasis patients. PsA is an immune-mediated inflammatory arthritis associated with psoriasis, posing considerable risks to patients' health and well-being. However, predicting which psoriasis patients will eventually develop PsA has remained elusive, leaving many undiagnosed until the onset of musculoskeletal symptoms.
The study, carried out by a team of experts in the field, explored the potential of DNA methylation markers in forecasting PsA among psoriasis patients even before any arthritis symptoms emerged. DNA methylation is an essential epigenetic modification that plays a critical role in regulating gene expression, affecting various physiological processes.
Researchers collected blood samples from two groups of psoriasis patients - those who eventually developed arthritis (converters) and those who did not (biologic naive). The two groups were carefully matched for age, sex, psoriasis duration, and follow-up duration. Utilizing a multi-variate linear regression model with clinical covariates, the team identified differences in DNA methylation patterns between the converter and non-converter groups.
Remarkably, the study discovered a set of 36 highly relevant DNA methylation markers across 15 genes and multiple intergenic regions. These markers exhibited a significant correlation with the development of PsA. The markers were selected based on their FDR-adjusted p-values lower than 0.05 and a minimum change in methylation of 0.05, indicating their robust potential as predictive indicators.
To further validate their findings, the researchers developed support vector machine classification models, incorporating the identified methylation markers alongside clinical variables. The classification model proved to be highly accurate, successfully distinguishing between patients who would eventually develop PsA and those who would not, achieving an impressive area under the ROC curve of 0.9644.
This study's implications are profound. By identifying specific DNA methylation markers at an early stage of psoriatic disease, medical professionals may be able to predict the onset of PsA and intervene with appropriate treatments to manage the condition effectively. Early diagnosis and intervention have the potential to alleviate patients' suffering and improve their quality of life significantly.
Cruz‐Correa, O. F., Pollock, R. A., Machhar, R., & Gladman, D. D. (2023). PREDICTION OF PSORIATIC ARTHRITIS IN PATIENTS WITH PSORIASIS USING DNA METHYLATION PROFILES. In Arthritis & Rheumatology. Wiley. https://doi.org/10.1002/art.42654