Clinical trial NCT05637905: Monocyte Chemoattractant Protein-1 in Psoriatic Arthritis Patients
Official title: The Predictive Value of Monocyte Chemoattractant Protein -1 in the Development of Cardiovacular Events in Psoriatic Arthritis Patients
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Psoriatic Arthritis
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2022-12-06
Enrollment: 44
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: OTHER
Sampling method: PROBABILITY_SAMPLE
Study population: psoriatic arthritis patients with or without clinically cardiovascular affaction

Brief summary: 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 .

Detailed description: 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 \[14\].

Eligibility criteria: Inclusion Criteria:

* PsA patients (age ≥ 18years) who fulfilled the CASPAR classification criteria\[15\]for psoriatic arthritis

Exclusion Criteria:

* PsA patients with

  1. infection.
  2. bone marrow disorders.
  3. other autoimmune diseases.
  4. diabetes.
  5. hypertention .
  6. hyperlipidemia.
  7. liver diseases.
  8. renal diseases.

Primary outcomes:
measure: MCP-1
timeFrame: two month
Secondary outcomes:
measure: Echocardiography
timeFrame: two month
Other outcomes:
Locations:
Study officials:
affiliation: Assiut University
name: Eman Abass, doctor
role: STUDY_DIRECTOR
affiliation: Assiut University
name: Mohamed Raouf, doctor
role: STUDY_DIRECTOR
affiliation: Assiut University
name: Esraa Ahmed, doctor
role: STUDY_DIRECTOR
References: