Unraveling the biomolecular effects of Mongolian mind-body interactive psychotherapy on psoriasis: An exosome proteomic analysis

Abstract

Psoriasis is a chronic inflammatory skin disease etiologically related to stress. Mongolian mind-body interactive psychotherapy (MMIP) is a group psychotherapy that integrates traditional Mongolian medicine theory with modern psychology. Exosomes are nanovesicles that carry biomolecules such as proteins, and the lipid bilayer protects cargo from degeneration. The present study was conducted to discern the effects of MMIP on psoriasis from a biomolecular perspective, particularly by performing an exosome proteomic analysis. Plasma exosomes were extracted from 15 samples, derived from psoriasis patients (n = 5, before and after MMIP) and healthy controls (HCs; n = 5). All patients had spent 60 days engaging with MMIP. Proteomic analysis was conducted using high-throughput mass spectrometry, and the differentially expressed proteins (DEPs) were analyzed. Further, validation test was done in serum samples of psoriasis (n = 56) and HC (n = 29). After the MMIP, the psoriasis area and severity index improved by 75%. Compared to HCs, psoriasis patients demonstrated alterations in 41 DEPs, with significant involvement of ribosome and apelin/APJ pathway. The recovery of psoriasis following the therapy was found to be associated with significant alterations in 16 DEPs, involving pathways of Fc gamma-mediated receptor phagocytosis, tight junction, and vascular smooth muscle contraction. Notably, one of the immunoglobulins that were reduced in psoriasis was significantly elevated after the MMIP. Validation results showed that the levels of serum elafin were higher in psoriasis than in HC but significantly decreased after MMIP. In conclusion, this study demonstrated that MMIP has a significant influence on the profiles of immunoglobulins and inflammatory molecules, as well as several pathways participating in the psoriasis recovery, providing insights into the pathophysiology of psoriasis and possible potential therapeutic targets of the disease.