Monocyte Chemoattractant Protein-1 in Psoriatic Arthritis Patients

Psoriatic Arthritis

1. Evaluate serum levels of (MCP-1) in PsA with or without cardiovascular affaction . 2. Detect subclinical cardiovascular affaction in patients with PsA for early diagnosis and management .

Psoriatic arthritis (PSA) is an autoimmune disease arising from the interply between proinflamatory cytokines \[1\]and external stimuli in genetically predisposed individuals.\[2\] * The disease is chronic and affects the peripheral joints and may include axial skeleton with or without extrarticular manifestations.\[3\] * Abnormal activation of the innate and adaptive immune systems contributes to chronic disease processes in both psoriasis and PSA .\[4\] The skin and the joints exhibit a prominent lymphocytic infiltrate consisting of activated CD4+ and CD8+ T cells as well as an increase in neutrophil infiltration\[5\]. Patients with PsA have a higher risk of developing a cardiovascular(CV) events than the general population. This could be attributed to the higher prevalence of traditional cardiovascular risk factors and to the disease characteristics such as systemic inflammation. \[6\] These patients may show asymptomatic cardiomyopathy even in the absence of traditional risk factors \[7\].Cardiac dysfunction is associated with a poor prognosis, increased mortality, and affact socioecenomic function of patients therefore, the diagnosis of the cardiac dysfunction in the asymptomatic phase of the disease \[8\] is important for the timely introduction of therapy \[9\].Monocyte chemotactic protien1(MCP-1) is a member of chemotactic chemokines(CC) which are secreted by immune effector cells and dysfunctional endothelium \[10\]. * The pivotal function of MCP-1 is to attract monocyte in the arterial wall through increased expression of adhesion molecules on their surface that interacts with endothelium\[11\]. * MCP-1 induce maturation of monocyte in the arterial wall ,which then become specialized macrophage in early atheroma and produce tissue factors supporting coagulation and proinflammatory cytokines such as IL-1 and IL-6. It affects the functions of the surrounding immune effector cells in locally thickened intima.\[12\] * During active disease in psoriatic skin lesions and synovial tissue, activated monocytes represent the major source of proinflammatory mediators, including the chemokine MCP-1 \[13\]. MCP-1 is thought to be involved in the pathogenesis of oedema and bone erosion in patients with PsA \[14\].

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