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Have you ever wondered what other parts of your body could be affected by psoriatic arthritis (PsA)? PsA is mainly thought of as an autoimmune condition that causes symptoms such as joint pain, swelling, and stiffness. But research shows it can also affect other parts of the body, including the lungs.
Read on to learn what scientists know about the link between psoriatic arthritis and respiratory symptoms — including how common lung problems are for people with PsA and what can be done to protect lung health.
Researchers have found that people with psoriatic arthritis have a higher risk for developing certain lung diseases compared to the general population.
These conditions might include:
People with psoriatic arthritis may be more likely to develop ILD than people who have psoriasis alone. This suggests that the inflammatory part of psoriatic arthritis may make people more vulnerable to lung conditions.
Below is an overview of lung conditions that may affect people with PsA.
Chronic obstructive pulmonary disease (COPD) is a term for lung and airway diseases that make it difficult to breathe. Signs of COPD may include wheezing, coughing, and thicker mucus.
In both PsA and COPD, scarring and inflammation in the lungs can narrow airways and make it harder to breathe. Lifestyle choices that may raise the risk for both diseases include:
Some research suggests that PsA and COPD have similar inflammatory processes. This may help explain why the two conditions often show up together.
Interstitial lung disease (ILD) is a group of conditions that cause inflammation and scarring of lung tissue. As lung tissue thickens and hardens, it becomes harder for oxygen to move in and out of the lungs. The most common symptoms of ILD are a dry cough and shortness of breath.
Some people develop ILD when they have another autoimmune disease. One study of more than 27,000 people with PsA found that people with psoriatic arthritis were more likely to develop ILD than people who only had psoriasis.
Asthma is a condition that causes airways to narrow and swell. It can also cause mucus to thicken, which can make breathing harder.
One large study of nearly 111,000 people with psoriasis found that 9.2 percent of those with psoriasis also had asthma.
Research shows that people with inflammatory conditions are more likely to develop breathing issues than those without these problems. One study of 387 people with PsA found that 1 percent of this group had ILD.
In another study of 247 people with PsA, at least one lung lesion was found in 25 people, which was about 10 percent of the group. ILD was diagnosed in nine people, or about 3.6 percent of the participants.
The study also found lung spots in around 8.5 percent of people (21 out of 247) and airway abnormalities in about 6 percent (15 out of 247). A few people with ILD also had different types of pneumonia.
Another study discovered that people with psoriasis are more likely to develop COPD than people without psoriasis. A similar study found that people with arthritis have a greater chance of developing:
Psoriatic arthritis is a chronic inflammatory disease. The same inflammatory process that causes PsA joint pain may also affect the lungs.
In both PsA and lung disease, the immune system releases increased levels of certain proteins (called cytokines) that cause inflammation. High levels of certain cytokines can damage lung tissue over time.
Both psoriasis and COPD cause systemic inflammation. This means they cause inflammation throughout the entire body, not just in one organ.
Researchers have found that people with psoriasis have higher levels of certain inflammation markers. This suggests that people with psoriasis experience inflammation beyond the skin.
This ongoing, body-wide inflammation in both diseases can make other health problems worse and helps explain why they sometimes occur together.
Some drugs used to treat PsA may negatively affect the lungs. Disease-modifying antirheumatic drugs (DMARDs) can suppress the immune system, raising the risk of infection.
Biologics are a type of DMARD that help lower inflammation. These drugs can work well for PsA, but some research shows there may be a link between biologics and ILD.
Some biologics can cause mild respiratory symptoms, including:
The traditional DMARD methotrexate may also affect the lungs. If methotrexate is causing your lung changes, they will disappear after you stop taking it.
Some research shows that changes in certain genes can help explain the link between psoriasis and lung function. In one study, researchers found that changes in two genes were linked to a lower risk of psoriasis and better lung function.
These genes help control the immune system and inflammation. Changes in these genes may help explain why some people with psoriasis also have lung problems.
Smoking makes it much more likely to develop psoriasis and COPD.
People who smoke and have a gene called HLA-Cw6 are at a much higher risk of getting psoriasis than people who don’t smoke. Stress can make the risk even higher. The more you smoke, the higher your chance of developing psoriasis.
Smoking is also the main risk factor for COPD. Smoking causes inflammation in the lungs and other parts of the body.
Along with experiencing joint pain, people with psoriatic arthritis often have one or more inflammatory conditions. These may include:
Many of these conditions are also more likely to happen in people with lung conditions like COPD.
People with PsA can take steps to protect their lungs and lower their risk of lung conditions like COPD and ILD. These tips can also help with your PsA symptoms.
Smoking greatly raises the risk of psoriasis and COPD. Smoking narrows the airways, making it harder to breathe. Secondhand smoke can also cause breathing problems and lung disease.
The longer you smoke, the more swelling and chronic inflammation will happen in your lungs.
There is hope, though. After 24 hours of quitting, the body begins to repair itself. Your risk of disease keeps going down the longer you stay smoke-free.
Physical activity makes your lungs and heart stronger. Regular exercise also helps your body use oxygen more efficiently.
Keeping a healthy weight and staying hydrated will help give you more energy. Drinking water also helps thin mucus, making it easier to breathe. Thick mucus may increase your chances of getting sick.
Seeing your healthcare provider regularly can help prevent illness. This is especially important for lung conditions, which can often get overlooked in the early stages.
Staying up to date on vaccines is especially important for people with immune conditions. Vaccines help prevent serious illness.
On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.
Do you have a lung condition along with psoriatic arthritis? Let others know in the comments below.
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