may be characterised by dysregulation of the sphingosine 1 phosphate (S1P) signalling pathway, according to new research linking elevated biomarker levels with disease progression, enthesitis, and structural damage.
Psoriatic Arthritis and the S1P Axis
Psoriatic arthritis is a chronic inflammatory condition with diverse clinical manifestations. Researchers investigated the relationship between serum S1P and its receptor, sphingosine 1 phosphate receptor (S1PR), and clinical, radiological, and structural features of the disease.
The cross-sectional observational study included 64 participants, consisting of 21 healthy controls and 43 patients with psoriatic arthritis. Among the latter group, 16 had recent onset disease and 27 had established disease. Assessments included disease activity in psoriatic arthritis scores, bone mineral density measurements, Trabecular Bone Score, 3D Shaper analysis, and imaging evaluation using Doppler ultrasound and MRI. Serum levels of S1P and S1PR were measured using ELISA.
Biomarker Levels Increase with Disease Progression
The investigators found that S1P levels were significantly higher in patients with psoriatic arthritis than in healthy controls (p=0.013). The highest levels were observed in patients with established disease (p=0.009), suggesting a relationship between S1P signalling and disease progression.
No significant association was identified between S1PR levels and disease activity in psoriatic arthritis scores. However, higher S1PR levels were observed in patients with Achilles enthesitis detected by ultrasound (p=0.046). Elevated S1PR levels were also associated with bone proliferation and structural damage (p=0.03).
Established Disease Linked to Higher Bone Density
Additional findings demonstrated that patients with established psoriatic arthritis had significantly higher cortical volumetric bone mineral density than healthy controls (p=0.027).
The data suggest that dysregulation of the S1P and S1PR axis is associated with disease progression and structural changes in psoriatic arthritis. The observed associations with ultrasound detected enthesitis and new bone formation support a potential role for this pathway in the osteoimmunology of the enthesis. The findings also position S1P as a potential biomarker of structural damage and a possible therapeutic target in psoriatic arthritis.
Reference
Ruiz-Montesinos D et al. Role of the S1P/S1PR axis in inflammation and structural damage in psoriatic arthritis: a cross-sectional study with clinical, biochemical and imaging correlation. RMD Open. 2026;12(2):e006874.
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