Authors
Michaela Köhm, Anke König, Isabel Rzehak, Nadia Ninosu, Magdalena Figat, Frank Behrens
Published in
Zeitschrift fur Rheumatologie. Sep 25, 2026. Epub Sep 25, 2026.
Abstract
Psoriatic arthritis is a heterogeneous, immune-mediated systemic disease with manifestations affecting joints, entheses and skin. A characteristic feature is the absence of autoantibodies, while mechanisms of innate and tissue-resident immunity predominate. The concept of MHC-I-associated diseases provides an integrative framework for pathogenetic classification. Central elements of the concept include the association with HLA class I alleles, alterations in antigen processing, for example mediated by ERAP1/2, and activation of the interleukin IL-23/IL-17 axis. The enthesis functions as a key organ in which mechanical stress, microbial stimuli and genetic predisposition trigger local immune activation. This leads to the development of a systemic inflammatory response involving different clinical domains. Genetic and immunological heterogeneity explain the diversity of phenotypes and treatment responses and underpins the perspective of endotype-based stratification for precision medicine approaches.
PMID:
42791362
Bibliographic data and abstract were imported from PubMed on 26 Sep 2026.
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