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Introduction: Psoriatic arthritis (PSA) is a progressive inflammatory arthritis of the joints and entheses. The symptoms manifest with a large variety e.g., dactylitis, monarthritis, polyarthritis, spondylitis, with or without Psoriasis (PSO) (10%), resulting in joint destruction and disability in severe cases. Knowledge of the differences in clinical manifestation and underlying altered gene expression between genders and disease entities is important for early diagnosis and treatment success (Tannarum et al. [1]) but is often lacking.

Methods: Gender specific investigations were carried out in a dual approach. 18 PSO,14 PSA and 20 PSA/PSO patients, divided into similarly sized gender-specific groups, whose disease progression and clinical parameters were analyzed. In addition, whole blood samples of our PSO/PSA cohort (n=52) compared to age-matched healthy controls were isolated and sequenced to identify differences within transcriptome analysis via bulk RNA-Seq [2].

Results: Clinical characterization revealed that female PSA/PSO patients have higher CRP values and lower PASI-Scores. Male PSA patients were significantly more likely to show axial involvement, described by inflammatory backpain or radiological evidence of sacroiliitis. PSO patients had higher PASI than PSA patients, across both sexes.

Principal component analysis of gene expression profiles showed two distinct clusters driven by sex chromosomes. Pairwise comparison with age- and sex-matched controls revealed more female-specific than male-specific differentially expressed genes across all diseases.

Conclusion: In conclusion, the main sex differences are the higher CRP levels, lower PASI-Scores and more axial involvement between PSA/PSO and PSA women and men. PSO patients had higher PASI-Scores. However, observations need to be further investigated and validated in a larger cohort. Nevertheless, our findings demonstrate the importance of individual and sex-depending diagnosis and therapy of PSO/PSA patients. The future goal is to find links between the various characteristics of psoriasis/psoriatic arthritis and the expression of different genes for different immune related pathways in order to develop new targeted therapeutic approaches and identifying biomarkers.

Disclosures: The authors declare no conflicts of interest.

Figure 1 [Fig. 1]

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