Elucidating Shared Mechanisms Contributing to NAFLD and PsA Disease Severity With Guselkumab Therapy

Nonalcoholic fatty liver disease (NAFLD), ranging from benign steatosis to severe nonalcoholic steatohepatitis (NASH), is increasingly common and linked to cirrhosis. Patients with psoriatic arthritis (PsA) are at higher risk for NAFLD and NASH, partly due to methotrexate (MTX) use, which is associated with hepatotoxicity. Key cytokines involved in PsA, such as TNF, IL-17, and IL-23, may also contribute to NAFLD progression. The proposed study aims to explore shared pathogenic pathways in NAFLD and PsA by evaluating the role of IL-17/23 through imaging, metabolomics, and synovial biopsies. Ultrasound-guided synovial biopsy, a safe and effective method, will be used to obtain tissue samples, enabling the identification of new molecular signatures and therapeutic targets to improve treatment of joint diseases.