Weight loss linked to decreased inflammatory markers among patients of psoriatic arthritis

A recent study published in Arthritis Research And Therapy sheds light on the potential anti-inflammatory effects of weight loss in patients with psoriatic arthritis (PsA). The research indicates that weight loss contributes to decreased levels of inflammatory cytokines, particularly interleukin-23 (IL-23) and leptin. PsA patients often struggle with obesity, which is intertwined with disease activity and cardiovascular risk.

The study, conducted by Dr. Anton Jonatan Landgren and colleagues from the Department of Rheumatology and Inflammation Research at the University of Gothenburg, Sweden, aimed to explore the effects of Very Low Energy Diet (VLED) on cytokines and adipokines in PsA patients. VLED involved a low-calorie diet for 12 or 16 weeks, tailored based on patients' baseline BMI. Subsequent dietary guidance was provided to participants, along with gradual reintroduction of food.

● The study enrolled 41 PsA patients and 39 matched controls.

● After the 6-month follow-up, PsA patients who underwent weight loss exhibited significant reductions in IL-23 (P <.001) and leptin (P <.001) levels, two key inflammatory markers.

● Serum total adiponectin and high molecular weight adiponectin increased significantly.

● These findings mirrored changes observed in the control group. The study unveiled correlations between changes in BMI and various disease markers.

● Positive correlations were observed between BMI changes and IL-23, Disease Activity Score based on 28 joints using C-reactive protein (DAS28-CRP), CRP, IL-13, IL-17, leptin, and tumour necrosis factor (TNF)-α.

● Negative correlations emerged between BMI and total adiponectin levels.

While the study's strengths included its successful weight loss intervention and follow-up design, the absence of a PsA control group without dietary intervention and the impact of temporary starvation on cytokine levels were noted limitations. The study underscores the crucial link between obesity, inflammation, and PsA, with IL-23 playing a pivotal role.

This research brings us closer to understanding the intricate relationship between weight loss, inflammation, and PsA. The findings offer valuable insights into the potential benefits of weight management strategies for mitigating inflammatory markers and enhancing disease management in PsA patients.

Reference:

Landgren AJ, Jonsson CA, Bilberg A, et al. Serum IL-23 significantly decreased in obese patients with psoriatic arthritis six months after a structured weight loss intervention. Arthritis Res Ther. 2023;25(1):131. Published 2023 Jul 27. doi:10.1186/s13075-023-03105-8