Comprehensive correction of cytokine status in patients with psoriatic arthritis and metabolic syndrome

Abstract

Objective. To develop and evaluate the effectiveness of a comprehensive approach to correcting blood cytokine levels in patients with psoriatic arthritis (PsA) associated with metabolic syndrome (Ms), including tofacitinib (Tofa) and physiotherapy.

Material and methods. The study included 230 patients with PsA and Ms, randomized into 5 groups. All patients received standard drug therapy (SDT) for Ps A. Group 1 received St alone, group 2 received an additional 30 sessions of intravenous laser irradiation (SVLI+St), group 3 received an additional 30 sessions of 311 nm phototherapy (Ft+St), Group 4 received tofacitinib 10 mg 2 times a day for 6 months (Tofa+St), and group 5 received a combination of SVLI+Ft+Tofa+St. Blood levels of interleukins (IL) – 1β, -2, -4, -6, -8, -10, -13, -17, -18, -23, TNF-α, and INF-γ were determined using enzyme-linked immunosorbent assay.

Results. St therapy had no effect on the imbalance in the pro- and anti-inflammatory cytokine system in the blood. The greatest corrective effect was noted in the SVLI+Ft+Tofa+St group, where there was a decrease in the blood IL-1β by 72,2%, IL-2 by 67%, IL-6 by 79,5%, IL-8 by 80,6%, IL-13 by 51,2%, IL-17 by 64,7%, IL-18 by 40,1% IL-23 by 55,9%, TNF-α by 77,4%, INF-γ by 61,2% and an increase in the levels of IL-4 by 73,2%, IL-10 by 123,5%.

Conclusion. A comprehensive treatment program with the additional use of SVLI, Ft, and Tofa effectively corrected the cytokine status of the blood of patients with PsA and MS, resulting in a 40,1 %–80,6% reduction in baseline proinflammatory cytokine levels and an increase in antiinflammatory IL-4 and IL-10 levels by 73,2% and 123,5%, respectively.