The Involvement of Oxidative Stress in Psoriasis: A Systematic Review.

Elena-Codruța Dobrică,Mihnea-Alexandru Găman,Vlad-Mihai Voiculescu,Matei-Alexandru Cozma,Amelia Maria Găman

doi:10.3390/antiox11020282

Abstract

Psoriasis is a chronic, immune-mediated inflammatory dermatosis characterized by the appearance of erythematous plaques, covered by white scales, occasionally pruritogenic, and distributed mainly on the extensor areas. Oxidative stress is defined as an imbalance or a transient or chronic increase in the levels of free oxygen/nitrogen radicals, either as a result of the exaggerated elevation in their production or the decrease in their ability to be eliminated by antioxidant systems. Although the pathogenesis of psoriasis remains far from elucidated, there are studies that delineate an involvement of oxidative stress in this skin disorder. Thus, a systematic search was computed in PubMed/Medline, Web of Science and SCOPUS and, in total, 1293 potentially eligible articles exploring this research question were detected. Following the removal of duplicates and the exclusion of irrelevant manuscripts based on the screening of their titles and abstracts (n = 995), 298 original articles were selected for full-text review. Finally, after we applied the exclusion and inclusion criteria, 79 original articles were included in this systematic review. Overall, the data analyzed in this systematic review point out that oxidative stress markers are elevated in psoriasis and share an association with the duration and severity of the disease. The concentrations of these biomarkers are impacted on by anti-psoriasis therapy. In addition, the crosstalk between psoriasis and oxidative stress is influenced by several polymorphisms that arise in genes encoding markers or enzymes related to the redox balance. Although the involvement of oxidative stress in psoriasis remains undisputable, future research is needed to explore the utility of assessing circulating serum, plasma, urinary and/or skin biomarkers of oxidative stress and of studying polymorphisms in genes regulating the redox balance, as well as how can these findings be translated into the management of psoriasis, as well in understanding its pathogenesis and evolution.

Highlights

This article is an open access articlePsoriasis is a chronic, immune-mediated inflammatory dermatosis characterized by the appearance of erythematous plaques, covered by white scales, occasionally pruritogenic, and distributed mainly on the extensor areas [1]
In order to investigate the scientific progress achieved so far in understanding the role of oxidative stress in this dermatological illness, we investigated the associations between different parameters of the antioxidant status, the total oxidative capacity and the severity of psoriasis, the role in psoriasis of different genetic polymorphisms in enzymes involved in the redox balance, as well as the influence of certain topical or systemic treatments routinely applied in psoriasis on the redox balance
The inclusion criteria considered were: 1. Original studies evaluating the relationship between different parameters of oxidative status and psoriasis severity OR original studies evaluating different polymorphisms in genes encoding enzymes involved in the oxidative status in psoriasis OR original studies which assessed the oxidative status of patients with psoriasis before and after the use of approved topical or systemic antipsoretic therapies

Summary

Introduction

This article is an open access articlePsoriasis is a chronic, immune-mediated inflammatory dermatosis characterized by the appearance of erythematous plaques, covered by white scales, occasionally pruritogenic, and distributed mainly on the extensor areas (elbows, knees, scalp, chest) [1]. Due to its role as a barrier and its direct exposure to environmental factors, the skin is an important source of free radicals that play, when in low concentrations, an essential role in the defense against microorganisms and in cell differentiation [8] When their concentration increases, leading to oxidative stress, free radicals appear to be involved in DNA alteration, cell protein degradation, lipid oxidation, apoptosis, tissue injury, altered response of T-helper cells and secretion of interleukin-17 (IL-17) [9]. As all these are essential stages in the initiation and perpetuation of psoriasis, the hypothesis that oxidative stress plays a key role in the pathophysiology of this chronic dermatosis has emerged [10]

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