Psoriatic arthritis (PsA) and multiple sclerosis (MS) are immune-mediated disorders that have both hereditary and environmental origins.
An estimated 3-5% of people are thought to be afflicted by one of the almost 100 distinct autoimmune disorders.
Dysregulation of the immune system is the cause of both MS and PsA. In addition, they have certain common risk factors and are progressive and chronic.
PsA and MS can coexist, despite the lack of a clear link between them as there is with other autoimmune diseases. You might be more likely to develop the other if you coexist with one.
Overview of MS
Your immune system unintentionally targets healthy tissue called myelin in multiple sclerosis (MS), an autoimmune disease. This is the material that creates the coating that shields your nerve fibres.
Your brain, spinal cord, and the rest of your body cannot send nerve signals to each other if the myelin sheath around your nerves is damaged. This results in symptoms of MS like:
- muscle weakness
- numbness and tingling
- bowel and bladder problems
- cognitive changes
- difficulty walking
- emotional changes
- spasticity
- vision problems
- dizziness
- fatigue
Irreversible damage might also occur to the nerves themselves.
It is estimated by statistics that approximately one million Americans suffer from multiple sclerosis. That figure is expected to be over 2.8 million persons worldwide.
Overview of PsA
Psoriasis (PsO) and PsA are two conditions that can coexist. PsA is a chronic, inflammatory form of arthritis.
Psoriatic disorders are classified as autoimmune diseases that arise from your immune system attacking healthy tissues inadvertently. Your joints are that tissue when it comes to PsA. PsO believes it's the skin.
Typically, PsA symptoms show up in your joints after PsO skin symptoms. On the other hand, arthritic symptoms could also appear before a skin rash. Rarely, do PsA patients never experience skin symptoms.
Many people with psoriasis never have joint problems since around 1 in 4 persons with PsO go on to develop PsA.
You are more likely to acquire PsA if you have severe PsO.
Similarities and differences
PsA and MS are similar in certain ways.
They both:
- are autoimmune conditions
- are not contagious
- have no cure
- possess risk factors from the environment and genetics
- are inflammatory and chronic (lasting a long time).
- possess a spectrum of symptom severity that differs from one to individual.
- can develop gradually and get worse over time
- experience intermittent symptoms, including flare-ups and remissions.
Additionally, there are several variations:
| Characteristic | PsA | MS |
|---|---|---|
| The typical age of onset | ages 30–50 | ages 20–40 |
| Life expectancy | ||
| Sex | more common in females | |
| Affected areas | joints and entheses (ligament-bone connections) | The peripheral nervous system (nerves outside the spinal cord and brain) and the central nervous system (spinal cord and brain) |
| Effects of nonsteroidal anti-inflammatory drugs (NSAIDs) | NSAID use may raise a person's risk of PsA development. | Certain MS diseases, such as demyelination, cell death, and motor impairment, may be lessened by NSAID therapy. |
Potential links between PsA and MS
A 2019 assessment of the literature revealed a substantial correlation between psoriasis and an increased risk of acquiring MS, while further study is required to fully understand the relationship between PsA and MS.
A few important connections could help to clarify this relationship:
Overactive immune system
When you have an autoimmune disease, your body's healthy tissue gets attacked by your immune system, which is not something it should do.
MS and PsA both have this kind of immune-mediated genesis.
For example, the inflammatory response in both MS and PsA is influenced by the cytokines IL-23 and TNF-alphaTrusted Source. Proteins called cytokines regulate the development and function of blood and immune cells.
Genetic risk factors
PsA and MS are not inherited directly. However, some genes may be inherited that increase your risk of developing either ailment.
According to estimates, 33–50% of persons with PsA also have PsO or PsA in a first-degree relative.
MS has a close family connection as well. According to studies on identical twins, there is a 1 in 4 risk that if one twin gets MS, the other will likewise get MS. The likelihood of having MS in the general population is roughly 1 in 334.
Approximately 200 genes have been linked by researchers to an individual's risk of getting multiple sclerosis.
Environmental risk factors
PsA and MS share several environmental or modifiable risk factors, such as:
- Overweight: Cytokines produced by excess body weight exacerbate inflammation.
- Tobacco use: A 2020 study that discovered higher levels of TNF-alpha in the blood of cigarette smokers than in control volunteers suggests that tobacco induces inflammation.
- Vitamin D deficiency: By increasing the activity of one type of immune cell (T helper 2) and inhibiting the activity of another (T helper 1), vitamin D reduces inflammation.
- Stress: According to research, stress triggers the inflammatory response.
- Infection: Through processes like molecular mimicry, certain viruses can trigger the immune system to target your healthy c.
PsO has a substantial correlation with viral, fungus, and bacterial infections, including:
- HIV
- staphylococcus aureus
- streptococcus
- helicobacter pylori
MS may arise following infections like:
- measles
- chlamydia pneumonia
- Epstein-Barr virus (EBV)
- canine distemper
- human herpes virus-6 (HHV-6)
Treating MS and PsA
Neither PsA nor MS have a known cure as of yet. However, there are treatments available for any ailment that can assist you in controlling symptoms, delaying the course of the illness, and avoiding consequences.
MS
The purpose of treating MS is to:
- manage your symptoms
- slow disease progression
- raise your standard of living generally
- lessen the frequency and intensity of relapses
Disease-modifying treatments are among the MS treatment choices that can help lower the frequency of relapses, postpone the onset of disability, and restrict new disease activity. Oral drugs, injectables, and infusions are offered as disease-modifying therapy.
Additionally, you can be offered drugs to address particular MS symptoms, including antidepressants to control mood swings or muscle relaxants to cure spasms.
PsA
The purpose of PsA therapy is to:
- reduce discomfort and stiffness in the joints
- raise your standard of living generally
- slow disease progression
- prevent joint damage
Options for PsA treatment include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Aspirin, ibuprofen, and naproxen are examples of NSAIDs that can help lessen joint discomfort and swelling.
- Traditional disease-modifying antirheumatic drugs (DMARDs): Conventional DMARDs, such as methotrexate, help prevent joint injury and limit the progression of illness by reducing inflammation.
- Biologics: These are more recent, more focused DMARDs that work by targeting particular immune system proteins to stop PsA-related inflammation.
- JAK inhibitors: JAK inhibitors, the newest and most focused PsA treatment, work by blocking the proteins in the JAK-STAT signalling pathway, which helps to reduce inflammation and slow the course of the illness.
- Surgery: Surgery is not always necessary, however, it can be necessary if you have a severely injured joint or if taking medicine is not helping to ease your symptoms.
Lifestyle changes
Lifestyle changes can be beneficial for people with PsA as well as MS.
You can control your symptoms and enhance your general quality of life by forming the following habits:
- eating a well-balanced diet
- getting regular physical activity
- using stress-reduction techniques or other techniques
- limiting alcohol
- not smoking
- getting plenty of rest
Takeaway
While PsA and MS may have differing physical effects on a person, they are both characterised by genetic and environmental risk factors.
A person can have PsA in addition to MS. If you have PsA or PsO, your physician may suggest an MS screening.
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