THE VALUE OF IMMUNOGENETIC MARKERS IN THE EARLY DIAGNOSIS OF PSORIATIC ARTHRITIS

Objectives. The study of pro-inflammatory genetic markers of psoriatic arthritis and its importance in early diagnosis.

Materials and methods. The current study included 104 patients with psoriatic arthritis. The diagnosis of psoriatic arthritis was established on the basis of the specialized opinion of two qualified rheumatologists, the total evaluation of the individual manifestations of the disease, as well as the generally accepted criteria for CASPAR psoriatic arthritis.

Results. The first group consisted of patients with early psoriatic arthritis with a duration of the disease less than 2 years (n=51), the second – tardive psoriatic arthritis, in which the duration of the disease was more than 2 years (n=53). In the main group, compared to the control group, there was an increase in the frequency of HLA - B13, B16 (38) and B27 (23.2%, 23.2% and 20.2%, respectively, and in the control group 10%, 4.7% and 7.3%, respectively). There was a tendency to reduce the frequency of B7 antigen in patients with psoriatic arthritis compared to control group (12.1% and 21.3%, respectively, p=0.09).

Discussions. The onset of psoriasis at an early age was associated with HLA-B13 (OR=3.29; p<0,001). The detection frequency of B38 antigen (subtype HLA-B16) was increased at all radiological stages of psoriatic arthritis and was – 16.4% in stage I-IIA, 25% – in IIB, 40.9% – in III-IV compared to 8.7% in the control group, while the strength of the associative connection increased with an increase in the severity of joint destruction.

Conclusions. The allele B16(38) is conjugated with polyartritic and interphalangeal distal variants of the joint syndrome, as well as erosive arthritis, B13 - with the distal interphalangeal variant and B27 - with polyarticular variant and spondyloarthritis. The risk of psoriasis at a young age is associated with HLA-B13 and at an older age with HLA-B27.