Phenotypic heterogeneity in psoriatic arthritis: towards tissue pathology-based therapy

Najm, A. , Goodyear, C. S. , McInnes, I. B. and Siebert, S. (2023) Phenotypic heterogeneity in psoriatic arthritis: towards tissue pathology-based therapy. Nature Reviews Rheumatology, 19, pp. 153-165. (doi: 10.1038/s41584-022-00874-5) (PMID:36596924)

Abstract

Psoriatic arthritis (PsA) is a heterogeneous disease involving multiple potential tissue domains. Most outcome measures used so far in randomized clinical trials do not sufficiently reflect this domain heterogeneity. The concept that pathogenetic mechanisms might vary across tissues within a single disease, underpinning such phenotype diversity, could explain tissue-distinct levels of response to different therapies. In this Review, we discuss the tissue, cellular and molecular mechanisms that drive clinical heterogeneity in PsA phenotypes, and detail existing tissue-based research, including data generated using sophisticated interrogative technologies with single-cell precision. Finally, we discuss how these elements support the need for tissue-based therapy in PsA in the context of existing and new therapeutic modes of action, and the implications for future PsA trial outcomes and design.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McInnes, Professor Iain and Siebert, Professor Stefan and Najm, Dr Aurelie and Goodyear, Professor Carl
• Authors: Najm, A., Goodyear, C. S., McInnes, I. B., and Siebert, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Research Centre: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
• Journal Name: Nature Reviews Rheumatology
• Publisher: Nature Research
• ISSN: 1759-4790
• ISSN (Online): 1759-4804
• Published Online: 03 January 2023