{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:21:51Z","timestamp":1788351711659,"version":"build-2803163510"},"reference-count":32,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Andalusian Society of Rheumatology"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,5,10]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Psoriatic arthritis (PsA) is a chronic inflammatory disease with a complex clinical spectrum. Sphingosine-1-phosphate (S1P) and its receptor (S1PR) are key lipid mediators involved in immunity and bone remodelling. This study evaluates the inter-relationship between serum levels of S1P and S1PR and clinical activity, radiological findings and different stages of PsA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional observational study was conducted including 64 subjects: 21 healthy controls and 43 patients with PsA: 16 with recent-onset PsA and 27 with established PsA (EPsA). Clinical variables such as disease activity in PsA (DAPSA), bone mineral density (BMD), Trabecular Bone Score, 3D-Shaper and inflammatory activity by Doppler ultrasound and MRI were assessed. S1P and S1PR levels were measured by ELISA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>S1P levels were significantly higher in the PsA group compared with controls (p=0.013), with the highest values observed in the EPsA subgroup (p=0.009). Although no significant correlation was observed with the DAPSA Score, S1PR levels were significantly higher in patients with Achilles enthesitis detected by ultrasound (p=0.046) and in those with bone proliferation\/structural damage (p=0.03). Patients with EPsA showed significantly higher cortical volumetric BMD compared with controls (p=0.027).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The S1P\/S1PR axis is dysregulated in PsA and is associated with disease progression. Its correlation with ultrasound findings of enthesitis and new bone formation suggests that S1P acts as a critical mediator in the osteoimmunology of the enthesis, positioning it as a potential biomarker of structural damage and a novel therapeutic target.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-006874","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:55:22Z","timestamp":1780919722000},"page":"e006874","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Role of the S1P\/S1PR axis in inflammation and structural damage in psoriatic arthritis: a cross-sectional study with clinical, biochemical and imaging correlation"],"prefix":"10.1136","volume":"12","author":[{"given":"Dolores","family":"Ruiz-Montesinos","sequence":"first","affiliation":[{"name":"FISEVI, Hospital Universitario Virgen Macarena, Seville, Spain"},{"name":"Departamento de Anatom\u00eda, Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Mendoza-Mendoza","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital Universitario Virgen Macarena, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2707-5550","authenticated-orcid":false,"given":"Jes\u00fas","family":"Bocio N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"FISEVI, Hospital Universitario Virgen Macarena, Seville, Spain"},{"name":"Departamento de Citolog\u00eda e Histolog\u00eda Normal y Patol\u00f3gica, Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Dominguez-Quesada","sequence":"additional","affiliation":[{"name":"FISEVI, Hospital Universitario Virgen Macarena, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Serrano-Guijo","sequence":"additional","affiliation":[{"name":"UGC Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda \u00c1ngeles","family":"V\u00e1zquez-G\u00e1mez","sequence":"additional","affiliation":[{"name":"UGC Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain"},{"name":"Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Rico","sequence":"additional","affiliation":[{"name":"UGC Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain"},{"name":"Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Colmenero","sequence":"additional","affiliation":[{"name":"UGC Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Javier","family":"Perez-Venegas","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital Universitario Virgen Macarena, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Montoya-Garc\u00eda","sequence":"additional","affiliation":[{"name":"UGC Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain"},{"name":"Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e8","family":"Giner","sequence":"additional","affiliation":[{"name":"Departamento de Citolog\u00eda e Histolog\u00eda Normal y Patol\u00f3gica, Universidad de Sevilla, Seville, Spain"},{"name":"UGC Medicina Interna, Hospital Universitario Virgen Macarena, Seville, 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The role of sphingosine 1-phosphate metabolism in bone and joint pathologies and ectopic calcification. 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