Role of the IL-23 pathway in the pathogenesis and treatment of enthesitis in psoriatic arthritis. (2nd July 2020)

• Record Type: Journal Article
• Authors: Rossini, Maurizio; Epis, Oscar Massimiliano; Tinazzi, Ilaria; Grembiale, Rosa Daniela; Iagnocco, Annamaria
• Is Part Of: Expert opinion on biological therapy. Volume 20:Number 7(2020)
• Page Start: 787
• Page End: 798
• Publication Date: 2020-07-02
• Subjects: Enthesitis -- interleukin-23 -- pathogenesis -- psoriatic arthritis -- spondyloarthritis -- treatment; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2020.1737855
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Introduction: Enthesitis is a key feature of spondyloarthritis (SpA). Several studies have underlined the role of interleukin (IL)-23 in SpA development as a crucial cytokine in the pathogenesis of enthesitis. Area covered: This review summarizes recent evidence of the role of IL-23 in the pathogenesis of and as a target of the treatment of enthesitis. We review the definition, diagnosis and clinical impact of enthesitis and its connection with microbial infections, gut dysbiosis, and mechanical stress. We also review clinical trials and real-life studies of drugs targeting the p19 or p40 subunits of IL-23. Expert opinion: Novel therapies targeting the p19 or p40 subunit of IL-23 appear to be promising treatment options for patients with enthesitis. Although we are currently unable to identify the best therapeutic window to target IL-23 in SpA disease evolution, the promising ability of this therapy to control the gut-entheseal axis is increasing our knowledge of SpA pathogenesis.