Patients with psoriatic arthritis have an increased number of lymphocytes in the duodenal mucosa in comparison with patients with psoriasis vulgaris.
OBJECTIVE
To determine if there is evidence of inflammation in the duodenal mucosa in patients with psoriatic arthritis (PsA) and to compare the results with those in patients with psoriasis vulgaris (PsV).


METHODS
Nineteen consecutive patients with PsA underwent gastroduodenoscopy, and biopsy specimens were taken from the duodenal and gastric mucosa. In addition to routine processing, the duodenal mucosal specimens were stained for CD3+, CD8+ and CD4+ T lymphocytes, tryptase-positive mast cells, and EG2-positive eosinophil granulocytes. The results were compared with those in duodenal mucosal specimens from patients with PsV and patients with irritable bowel syndrome.


RESULTS
Compared with PsV patients (without antibodies against gliadin), patients with PsA had a highly significant increase in intraepithelial CD3+ and CD8+ lymphocytes and also in CD4+ lymphocytes in the lamina propria in the villi. The lymphocyte increase was not related to presence of IgA antibodies against gliadin, endomysium, or transglutaminase, or to concomitant gastritis. Patients with PsA and PsV showed a pronounced increase in mast cells and eosinophil granulocytes.


CONCLUSIONS
The increased lymphocyte infiltration in the duodenal mucosa in PsA, but not in PsV, might indicate different pathogenetic mechanisms in these psoriasis variants.
Department of Medical Sciences, University Hospital, Uppsala, Sweden. ulla.lindqvist@medsci.uu.se
Ulla
U
Lindqvist
Gudjon
G
Kristjánsson
Inger
I
Pihl-Lundin
Eva
E
Hagforsen
Gerd
G
Michaëlsson
D000328:Adult; D015535:Arthritis, Psoriatic / Q000097:blood / Q000209:etiology / Q000473:pathology*; D017252:CD3 Complex / Q000032:analysis; D015704:CD4 Antigens / Q000032:analysis; D016827:CD8 Antigens / Q000032:analysis; D004384:Duodenoscopy; D004386:Duodenum / Q000473:pathology*; D047091:Eosinophil Granule Proteins / Q000032:analysis; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D006098:Granulocytes / Q000737:chemistry / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology*; D043183:Irritable Bowel Syndrome / Q000097:blood; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000737:chemistry / Q000473:pathology*; D008297:Male; D008407:Mast Cells / Q000737:chemistry / Q000473:pathology; D008875:Middle Aged; D011565:Psoriasis / Q000097:blood / Q000209:etiology / Q000473:pathology*; D012697:Serine Endopeptidases / Q000032:analysis; D053802:Tryptases
D017252:CD3 Complex; D015704:CD4 Antigens; D016827:CD8 Antigens; D047091:Eosinophil Granule Proteins; D012697:Serine Endopeptidases; D053802:Tryptases