Evaluation of blood plasma changes by differential scanning calorimetry in psoriatic patients treated with drugs

Abstract

Psoriasis is a chronic inflammatory skin disease, most commonly resulting in the occurrence of red and silver scaly plaques. Application of differential scanning calorimetry (DSC) should be used as a new method to detect the different stages of the disease and to monitor medications with different anti-psoriatic drugs using patient’s blood plasma. The study included 72 white adults (35 men and 37 women; median age 56 years) with diagnosed psoriasis. According to the psoriasis area severity index (PASI) patients were selected into three groups: symptomless (PASI: 0), mild (PASI: 1–15), and serious symptoms (PASI: >15). According to medication patients were divided into untreated (n = 39) and treated (n = 33) groups. For systemic drug treatment cytostatic therapy (methotrexate, n = 12), retinoid treatment (acitretin, n = 10), and biologic response modifiers (adalimumab, n = 5; infliximab, n = 5; ustekinumab, n = 1) were applied. Denaturation of human plasma components were detected in Setaram Micro DSC II calorimeter. The patients had no third denaturation peak in the untreated mild and serious symptoms groups. In mild symptoms all the thermal parameters altered significantly, while in serious symptoms only the first melting and the calorimetric enthalpy altered significantly compared with symptoms-free states. In case of systematic cytostatic and retinoid drug treatment (methotrexate, n = 12; acitretin, n = 10) cases the DSC scans of patients with symptoms exhibited significant differences (p < 0.05) in melting temperatures and in calorimetric enthalpy compared with the untreated symptoms-free patients. Using biologic response modifier agents (adalimumab, infliximab, and ustekinumab) we had no enough samples for a statistical evaluation for each one, but after the intervention a stronger effect can be seen as in case of systematic drug treatment. In this study blood plasma measurement in psoriatic patients by DSC showed differences between untreated, conventional systemic drug treatment, and application of biologic response modifier agents, but further studies are needed to elucidate these relationships (supported by grant OTKA CO-272).