Goeckerman Regimen Reduces Alarmin Levels and PASI Score in Paediatric Patients with Psoriasis.

Drahomíra Holmannová,Ctirad Andrýs,Tereza Švadláková,Zdeněk Fiala,Vladimír Palička,Květoslava Hamáková,Jan Krejsek,Pavel Borský,Barbora Císařová,Lenka Borská,Lenka Kotingová

doi:10.14712/18059694.2022.3

Drahomíra Holmannová, Ctirad Andrýs + Show 9 more

Open Access

https://doi.org/10.14712/18059694.2022.3

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Abstract

Psoriasis is a chronic systemic inflammatory disease with (extra-)cutaneous manifestations. Inflammation is associated with cellular stress and tissue damage which lead to the release of alarmins (signals of danger). Goeckerman regimen (GR) is a highly efficacious treatment consisting of the application of pharmaceutical crude tar and UVB light exposure. The reduction of inflammatory processes in the skin is accompanied by changes in the levels of inflammatory markers - alarmins (HMBG-1, S100A7, S1000A8, S100A9, S100A12, IL-17, IL-22, and IL-33). The alarmin levels in sera of 19 paediatric patients with psoriasis were determined before and after GR using commercial ELISA kits. The Psoriasis area severity index (PASI) was used to determine the disease severity. GR reduced both PASI and the levels of all measured alarmins. The levels of S100A7, S100A9, IL-22, IL-33, and HMGB-1 were significantly decreased. Positive correlations between IL-22 and PASI, between S100A9 and IL-17, S100A9 and IL-22, and a negative correlation between S100A8 and IL-33 were found. Goeckerman regimen is a very effective, safe and low-cost therapy. We confirmed, it modulates the immune system reactivity, ameliorates the severity of the disease and reduces the levels of alarmins reflecting the presence and intensity of inflammation.

Highlights

Psoriasis vulgaris is a common chronic immune system-mediated inflammatory skin disorder that affects approximately 3% of population
A significant relationship was found in the group of children before Goeckerman regimen (GR) between S100 Calcium Binding Protein A8 (S100A8) and IL-33 (Spearman’s rho = −0.469, p < 0.043), S100 Calcium Binding Protein A12 (S100A12) and calendar age (Spearman’s rho = 0.603, p < 0.006), IL-22 and Psoriasis area severity index (PASI) (Spearman’s rho = 0.569, p < 0.01)
After the GR, there was a significant relationship between S100 Calcium Binding Protein A9 (S100A9) and IL-17 (Spearman’s rho = 0.842, p < 0.00001), S100A9 and IL-22 (Spearman’s rho = 0.528, p < 0.02), IL-22 and IL-17 (Spearman’s rho = 0.680, p < 0.001)

Summary

Introduction

Psoriasis vulgaris is a common chronic immune system-mediated inflammatory skin disorder that affects approximately 3% of population. Its pathogenesis consists of sustained inflammation that leads to uncontrolled keratinocyte proliferation, their dysfunctional differentiation, and reduced time of maturation It constitutes of psoriatic plaques, overlying inflammatory areas that are infiltrated by immune cells, mostly by dendritic cells, macrophages, T cells, and neutrophils [1]. Psoriasis is driven by immunopathological responses to stimuli causing “sterile” inflammatory processes triggered by endogenous danger signals and cytokines released from damaged or dying cells or during cell stress. These signals are called alarmins (DAMPs, PAMPs) [2]. Goeckerman regimen is a very effective, safe and low-cost therapy We confirmed, it modulates the immune system reactivity, ameliorates the severity of the disease and reduces the levels of alarmins reflecting the presence and intensity of inflammation

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