Disease Severity In Psoriasis Patients Research Articles

Evaluation of the inflammatory parameters as potential biomarkers of systemic inflammation extent and the disease severity in psoriasis patients.

The disease severity of psoriasis is mainly assessed subjectively via psoriasis area and severity index (PASI) and body surface area (BSA), while an optimal measure of cutaneous response, may overlook systemic inflammation in psoriasis patients. The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), monocyte to high density lipoprotein ratio (MHR), and systemic immune-inflammation index (SII) exhibit notable associations with the inflammation severity in multiple diseases. The aim of this retrospective study was to explore the associations between inflammatory parameters and the skin lesions' severity of psoriasis. After analysis, we found that patients with psoriasis had higher NLR, MLR, PLR, MHR, and SII levels compared to the control group. At baseline, the parameters of NLR (r = 0.124, P = 0.003), MLR (r = 0.153, P < 0.001), MHR (r = 0.217, P < 0.001) and SII (r = 0.141, P = 0.001) had a positive correlation with PASI in psoriasis patients. At the same time, we analyzed thepatients who received different systemic therapy. We observed a significant decrease in NLR, PLR, MLR, and SII in psoriasis patients after treatment. Notably, TNF-α inhibitors and IL-17A inhibitors subgroups showed amore significant reduction than IL-23/IL-12/23 inhibitors and MTX medication. Additionally, we found the change of NLR (r = 0.194, P < 0.001), PLR (r = 0.104, P = 0.014), MLR (r = 0.191, P < 0.001), MHR (r = 0.106, P = 0.012), and SII (r = 0.228, P < 0.001) had a positive correlation with the change of PASI in psoriasis patients. In conclusion, this study suggests that NLR, MLR, and SII may serve as useful biomarkers for assessing systemic inflammation extent and disease severity in psoriasis patients.

The Relationship of Serum Trimethylamine N-Oxide Levels with Carotid Intima-Media Thickness and Disease Activity in Psoriasis Patients.

Psoriasis is an inflammatory disease that can cause cardiovascular comorbidities. Some recent studies have indicated that impaired gut microbiota and metabolites may be associated with inflammatory diseases. In this study, the relationship between serum trimethylamine n-oxide (TMAO, a gut bacterial metabolite) level and carotid intima-media thickness (CIMT) and disease severity in psoriasis patients was investigated. Age- and gender-matched 73 patients and 72 healthy controls were included in the study. In both groups serum trimethylamine n-oxide(TMAO), oxidized low-density lipoprotein (ox-LDL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, total cholesterol, high-sensitivity C-reactive protein (hs-CRP), creatinine, aspartate aminotransferase (AST) and alanine aminotransferase(ALT) levels were recorded and the carotid intima-media thickness (CIMT) was measured by B-mode ultrasonography by a cardiologist. TMAO, hs-CRP, oxidized-LDL, triglyceride and CIMT levels were statistically higher in the patient group. HDL levels were statistically higher in the control group. There was no significant difference between the two groups in terms of total cholesterol and LDL-C levels. In partial correlation analyzes in the patient group, positive correlations were observed between TMAO and CIMT, LDL-C and total cholesterol levels. Linear regression analysis showed that TMAO levels positively predicted CIMT levels. This study confirmed that psoriasis is a risk factor for the development of cardiovascular disease and that elevated serum TMAO levels in these patients indicate the presence of intestinal dysbiosis. Furthermore, TMAO levels were found to be a predictor of the risk of developing cardiovascular disease in psoriasis patients.

Correlation of Vitamin D3 Levels with Disease Severity in Psoriasis Patients - A Case-Control Study.

Correlation of Vitamin D3 Levels with Disease Severity in Psoriasis Patients - A Case-Control Study.

Abnormal functional connectivity in psoriasis patients with depression is associated with their clinical symptoms.

Psoriasis is a chronic, autoimmune disorder that is related to mental health disorders such as depression. However, few studies have focused on the features of brain activity in psoriasis patients with depression (PPD) and the association between brain activity and disease severity. A total of 29 PPD and 24 healthy controls were involved in this study, and all participants underwent resting-state functional magnetic resonance imaging (fMRI) scanning. The psoriasis area and severity index (PASI) and the self-rating depression scale (SDS) were used to measure clinical symptoms. Compared with HCs, PPD patients showed increased fractional amplitude of low-frequency fluctuation (fALFF) in the Frontal_Mid_L and increased functional connectivity (FC) between the hypothalamus-R and the Cingulum_Mid_R. Correlation analysis suggested a positive correlation between PASI and SDS scores in PPD, while the fALFF and FC values were negatively correlated with their SDS and PASI scores. These brain regions may be associated with the development of depressive symptoms and disease severity in psoriasis patients.

Long non-coding RNA RP11-342L8.2, derived from RNA sequencing and validated via RT-qPCR, is upregulated and correlates with disease severity in psoriasis patients.

This study aimed to explore the dysregulated long non-coding RNA (lncRNA) expression profile in psoriatic tissue vs. normal skin tissue via RNA sequencing (RNA-seq), then further sort candidate lncRNAs to be validated by reverse transcription quantitative polymerase chain reaction (RT-qPCR), in order to investigate the comprehensive linkage of lncRNA with psoriasis. Twenty-five psoriasis patients were consecutively enrolled, with their psoriatic and surrounding normal skin tissues obtained. Ten pairs of psoriatic and normal tissues were proposed to RNA-seq. Then, top 6 differentially expressed lncRNAs (DElncRNA) were sorted as candidate lncRNAs for validation by RT-qPCR in 25 pairs of samples. Principal component analysis (PCA) exhibited that lncRNA profile clearly distinguished psoriatic tissue from normal tissue, so did heatmap. Volcano plot disclosed 412 upregulated and 625 downregulated DElncRNAs in psoriatic tissue vs. normal tissue. Gene Ontology (GO) and Kyoko Encyclopedia of Genes and Genomes (KEGG) enrichment analyses exhibited that these DElncRNAs were mainly enriched in immune, inflammation, or proliferation-related biological processes and pathways such as neutrophil degranulation, regulation of immune response, positive regulation of cell proliferation, and MAPK signaling pathway. By RT-qPCR validation, lncRNAs RP11-22A3.2, RP11-342L8.2, and CTD-2006H14.2 were increased (all P < 0.001), while lncRNAs AP000442.4, CCDC144NL-AS1, and MIR663AHG were decreased (all P < 0.01) in psoriatic tissue vs. normal tissue. Interestingly, psoriatic lncRNA RP11-342L8.2 was also observed to positively correlated with psoriasis area and severity index (PASI) (r = 0.405, P = 0.045). Our present study exhibits some evidence for the landscape of lncRNAs implicated in psoriasis.

Correlation of Vitamin D3 Levels with Disease Severity in Psoriasis Patients - A Case-Control Study.

Vitamin D is involved in the activation of innate and adaptive immunity. In the epidermis, vitamin D is involved in the differentiation and maturation of keratinocytes. A fall in the vitamin D levels can activate auto-immunity. This study was aimed at correlating the serum vitamin D level of psoriasis patients with disease severity. This case-control study included 50 newly diagnosed cases of psoriasis (group A) and 50 controls (group B). Serum vitamin D levels were assessed in both groups. The levels were correlated with the duration of disease, psoriasis area and severity index (PASI) score, and erythrocyte sedimentation rate (ESR) level. Psoriasis patients had significantly lower vitamin D levels than controls. There was a significant negative correlation between serum vitamin D level and disease duration, PASI score, and ESR level (p-value <0.001). Rising age and female gender were also associated with significantly lower vitamin D. We found a high prevalence of vitamin D deficiency in psoriatic patients. The level is strongly associated with every aspect of disease severity. Its level can predict the course of disease and prognosis.

Evaluation of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Chronic Plaque Psoriasis.

Psoriasis is a common inflammatory dermatological condition and affects 2-3% population worldwide. Psoriasis area and severity index (PASI) and body surface area (BSA) are two commonly used scales used to measure disease severity in psoriasis patients. However, these scales are plagued by weaknesses as inter-observer variation and insufficient evaluation of micro-vascular inflammation. Thus, it is necessary to have an objective and simple measure of the severity of inflammation. The ratio of neutrophils-to-lymphocytes (NLR) and platelets-to-lymphocytes (PLR) are simple and inexpensive markers of systemic inflammatory response that can be measured as part of a complete blood count and are already used in the setting of inflammatory diseases. The utility of the NLR and PLR in psoriasis however, remains relatively unexplored. The present study was undertaken to assess if NLR, PLR and C-reactive protein were altered in chronic plaque psoriasis patients as compared to controls and also to determine correlation of NLR and PLR values with disease severity as measured by PASI. This case control study consisted of equal numbers (45 each) chronic plaque psoriasis patients and control subjects. The subjects were evaluated by way of history taking, clinical and blood examination. Thereafter, the results were tabulated and examined statistically. Our study results indicate that psoriasis patients tended to have a higher neutrophil count, lymphocyte count, NLR and C-reactive protein in comparison the control subjects (P < 0.05). We concluded that such easily available and low cost indices of systemic inflammation are raised in psoriasis patients and are positively correlated with the severity of involvement. They can thus not only be used to monitor the effect of systemic drugs in psoriasis.

Assessment of anxiety, depression, social anxiety, anxiety sensitivity, and perceived stress in psoriasis patients: a controlled cross-sectional study

Objective: Psoriasis is a chronic inflammatory skin disease, and psychiatric comorbidities are common in these patients. Skin lesions can cause shame, anxiety, social avoidance, irritability, and depressive symptoms in psoriasis patients. This study aimed to investigate anxiety, depression, social anxiety, anxiety sensitivity, and perceived stress in patients with psoriasis and their relationship with disease severity and duration. Methods: Forty patients and 40 healthy controls were included in our study. All study patients were administered the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), the Liebowitz Social Anxiety Scale (LSAS), the Perceived Stress Scale (PSS-14), and the Anxiety Sensitivity Index (ASI-3). Disease severity in psoriasis patients was assessed using the Psoriasis Area Severity Index (PASI). Results: Anxiety, depression, social anxiety, perceived stress, and anxiety sensitivity were significantly higher in psoriasis patients than in healthy controls. There was no correlation between PASI scores and BAI, BDI, LSAS, PASS-14 and ASI-3 scores. Also, no correlation was found between disease duration and BAI, BDI, LSAS, PSS-14 and ASI-3 scores. Conclusion: Our results show that anxiety, depression, social anxiety, anxiety sensitivity, and perceived stress are high in psoriasis patients regardless of disease duration and severity. This is the first study to examine anxiety sensitivity in psoriasis patients to the best of our knowledge. Clinicians should consider the possible psychiatric comorbidity at all stages of the disease in patients with psoriasis. Collaboration between the disciplines of dermatology and psychiatry is necessary to ensure full recovery and maintain patient well-being.

Serum calprotectin correlates with risk and disease severity in psoriasis patients and the decrease of calprotectin predicts better response to tumor necrosis factor inhibitors.

The article "Serum calprotectin correlates with risk and disease severity in psoriasis patients and the decrease of calprotectin predicts better response to tumor necrosis factor inhibitors, by M. Qian, N.-J. Song, published in Eur Rev Med Pharmacol Sci 2018; 22 (13): 4299-4309-DOI: 10.26355/eurrev_201807_15426-PMID: 30024620" has been withdrawn from the authors since the conclusions of the paper had some shortcomings and the authors decided to improve them further. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/15426.

Association between HLA-Cw6 allele expression and characteristics of Javanese ethnic psoriasis patients in Indonesia

BACKGROUND Psoriasis is an autoimmune disease with involvement of genetic and environmental factors. The HLA-Cw6 allele is the strongest genetic factor that correlates with earlier onset and more severe clinical manifestation of psoriasis. In Javanese ethnic, HLA-Cw6 allelic expression has not been identified, although increasing psoriasis patients were found in hospital dermatology departments. The study was aimed to determine the allelic expression of HLA-Cw6 based on the onset and severity of psoriasis in Javanese ethnic.&#x0D; METHODS A cross-sectional study was conducted from March to September 2018. Sixty psoriasis patients in the Margono Soekarjo Hospital and Banyumas Regional General Hospital were recruited consecutively. Psoriasis type, diagnosis, onset, and disease severity were assessed by dermatologists. HLA-Cw6 allelic expression was identified by DNA isolation, quantitative testing, and HLA-Cw6 genotyping. Fisher’s exact and chi-square tests were used to evaluate the association of HLA-Cw6 with age, clinical type, disease severity, onset, and gender.&#x0D; RESULTS The HLA-Cw6 allele positivity was identified at 297 base pairs (bp), while control showed at 618 bp bands. Among 60 subjects, 13 subjects (22%) showed HLACw6 positivity, and 47 subjects (78%) were HLA-Cw6 negative. HLA-Cw6 genotypes were similarly distributed concerning age, onset, gender, clinical type, and disease severity in psoriasis patients of Javanese ethnic (p &gt; 0.05).&#x0D; CONCLUSIONS HLA-Cw6 expression type may not have influence to the characteristics of patients with psoriasis.

Evaluation of ADA activity as a potential marker of disease severity in psoriasis patients.

BackgroundPsoriasis is a dermatological disorder with a multifactorial origin and is associated with many biochemical and immunological changes.PurposeThis study aimed to examine the association of serum ADA activity, uric acid (UA), and high-sensitivity CRP (hs-CRP) with psoriasis and the role of ADA in disease severity.Materials and methodsIn this comparative cross-sectional study, 50 clinically and histopathologically diagnosed psoriasis patients and 50 age- and sex-matched healthy controls were enrolled. Blood samples were taken and analysis of the biochemical parameters was performed according to Giuisti and Galanti method, uricase and ELISA technique for ADA activity, UA, and hs-CRP, respectively. The severity of the disease was scored according to Psoriasis Area and Severity Index (PASI). Statistical analysis of differences within and between the study groups was carried out using the Student’s t-test, one-way post hoc ANOVA, and Pearson’s correlation. Linear regression was used to establish the independent association of ADA with disease severity.ResultsThe serum ADA activity, UA, and hs-CRP levels of the psoriatic patients were found to be significantly higher (P<0.001). hs-CRP was positively correlated with ADA and UA in patients (P<0.001). There was no significant difference in total cholesterol, low-density lipoprotein, and triacylglycerol in psoriasis patients, whereas we noted a decreased high-density lipoprotein level in psoriasis patients as compared to controls. Linear regression showed that ADA was independently associated with the disease severity and was statistically significant (P<0.001).ConclusionADA activity was positively and significantly associated with the severity of psoriasis, therefore, it could be suggested as a marker for disease severity in psoriasis patients.

Serum calprotectin correlates with risk and disease severity in psoriasis patients and the decrease of calprotectin predicts better response to tumor necrosis factor inhibitors.

This study aimed to investigate the correlation of serum calprotectin expression with risk and severity of psoriasis, as well as its predictive value for clinical response to tumor necrosis factor inhibitors (TNFi) treatment in psoriasis patients. 72 psoriasis patients and 70 health controls (HCs) were enrolled. Blood samples were collected, and serum calprotectin was determined by commercial enzyme-linked immuno sorbent assay (ELISA). All patients were treated by TNFi treatment, and followed up at 6 months, and the last follow-up date was 2016/11. Calprotectin level was elevated in psoriasis patients compared to HCs (p < 0.001), and it disclosed a good diagnostic value of psoriasis with area under curve (AUC) 0.872, 95% CI: 0.810-0.935. Calprotectin expression was positively associated with Psoriasis Area and Severity Index (PASI) score (R = 0.452, p < 0.001), while it was not associated with BSA (R = 0.125, p = 0.297). 58.3% patients achieved PASI75 and 43.1% patients achieved PASI90 at M6. Calprotectin was decreased during the 6-month treatment (p < 0.001). Changes of calprotectin during the first month (∆calprotectin (M0-M1)) in PASI75 group were more than that of non-PASI75 group (p < 0.001). Also, multivariate logistic analysis revealed that ∆calprotectin (M0-M1) (p = 0.001) was an independent factor for PASI75 achievement at M6 after TNFi treatment, while pre-systemic biologic treatment (p = 0.001) was an independent factor for non-PASI75 achievement. Serum calprotectin expression is correlated with risk and severity of psoriasis, and the decrease of calprotectin during the first month could predict better clinical response to TNFi treatment in psoriasis patients.

MiR-126 correlates with increased disease severity and promotes keratinocytes proliferation and inflammation while suppresses cells' apoptosis in psoriasis.

This study aimed to investigate the miR-126 expression in lesional skin and its correlation with clinical features in psoriasis patients and to explore the effect of upregulated miR-126 on cells' proliferation, apoptosis, and inflammation in human keratinocytes. A total of 102 psoriasis patients were consecutively enrolled in this study. MiR-126 expressions in lesional skin and paired nonlesional skin were detected by quantitative polymerase chain reaction (qPCR). Human keratinocytes (HaCaT cells) were transfected with miR-126 mimic plasmids and blank mimic plasmid. Cell Counting Kit-8 and annexin V/propidium iodide assays were performed to assess the cells' proliferation and apoptosis, and protein levels of apoptotic markers (cleaved caspase-3 [C-caspase-3] and B-cell lymphoma-2 [Bcl-2]) were detected by Western blot assay. Inflammatory cytokines mRNA and protein levels were detected by qPCR and Western blot assays, respectively. MiR-126 expression was upregulated in lesional skin tissue compared with paired nonlesional skin tissue, and its expression positively associated with Psoriasis Area and Severity Index score in psoriasis patients. MiR-126 expression was increased in miR-126 mimic group compared with negative control (NC) mimic group after plasmids transfection into HaCaT cells, and cells' proliferation was enhanced while cells' apoptosis rate was reduced in miR-126 mimic group than NC mimic group. Protein expressions of C-caspase and Bcl-2 also indicated miR-126 mimic decreased the cells' apoptosis. In addition, miR-126 mimic increased TNF-α, IFN-γ, IL-17A, and IL-22 expressions while decreased IL-10 expression. In conclusion, miR-126 correlates with elevated risk and increased disease severity in psoriasis patients, and upregulation of miR-126 promotes cells' proliferation and inflammation while inhibits cells' apoptosis in keratinocytes.

MicroRNA-17-92 cluster promotes the proliferation and the chemokine production of keratinocytes: implication for the pathogenesis of psoriasis

Keratinocytes are the main epidermal cell type that constitutes the skin barrier against environmental damages, which emphasizes the balance between the growth and the death of keratinocytes in maintaining skin homeostasis. Aberrant proliferation of keratinocytes and the secretion of inflammatory factors from keratinocytes are related to the formation of chronic inflammatory skin diseases like psoriasis. MicroRNA-17-92 (miRNA-17-92 or miR-17-92) is a miRNA cluster that regulates cell growth and immunity, but the role of miR-17-92 cluster in keratinocytes and its relation to skin diseases have not been well investigated. In the present study, we initially found that miR-17-92 cluster promoted the proliferation and the cell-cycle progression of keratinocytes via suppressing cyclin-dependent kinase inhibitor 2B (CDKN2B). Furthermore, miR-17-92 cluster facilitated the secretion of C-X-C motif chemokine ligand 9 (CXCL9) and C-X-C motif chemokine ligand 10 (CXCL10) from keratinocytes by inhibiting suppressor of cytokine signaling 1 (SOCS1), which enhanced the chemotaxis for T lymphocytes formed by keratinocytes. In addition, we detected increased expression of miR-17-92 cluster in psoriatic lesions and the level of lesional miR-17-92 cluster was positively correlated with the disease severity in psoriasis patients. At last, miR-17-92 cluster was increased in keratinocytes by cytokines through the activation of signal transducers and activators of transcription 1 (STAT1) signaling pathway. Our findings demonstrate that cytokine-induced overexpression of miR-17-92 cluster can promote the proliferation and the immune function of keratinocytes, and thus may contribute to the development of inflammatory skin diseases like psoriasis, which implicates miR-17-92 cluster as a potential therapeutic target for psoriasis and other skin diseases with similar inflammatory pathogenesis.

THU0256 Pharmacodynamics of ASP015K, A Novel Janus Kinase Inhibitor, in Healthy Volunteers

BackgroundASP015K is an oral Janus kinase (JAK) inhibitor with moderate selectivity for JAK3, a key enzyme for interleukin-2 (IL-2) signaling. With IL-2 stimulation, JAK1/3 augments STAT5 phosphorylation (STAT5-P), which is...

Efficacy of Two Algae Formulations on Lipid Metabolism, Inflammation, Oxidative Stress Status and Disease Severity in Psoriasis Patients

Efficacy of Two Algae Formulations on Lipid Metabolism, Inflammation, Oxidative Stress Status and Disease Severity in Psoriasis Patients

Tumour necrosis factor α (TNF‐α)‐converting enzyme (TACE) and soluble TNF‐α receptor type 1 in psoriasis patients treated with narrowband ultraviolet B

The aim of the study was to examine the tumour necrosis factor alpha (TNF-alpha)-converting enzyme (TACE) concentration in peripheral blood mononuclear cells (PBMC) and its relationship with plasma concentration of soluble TNF-alpha receptor type 1 (sTNF-R1) and with the disease severity in psoriasis patients treated with narrowband ultraviolet B (NB-UVB). The study has been conducted among 40 patients with plaque-type psoriasis vulgaris: 23 had only skin lesions (PV) and 17 had co-existing, inactive, psoriatic arthritis (PsA). Control blood samples were obtained from 20 healthy subjects. The assessment of the severity of skin lesions (using Psoriasis Area and Severity Index - PASI), TACE and sTNF-R1 concentrations (using quantitative sandwich enzyme immunoassays) have been performed at baseline (T 0) and after 20 NB-UVB irradiations (T 20). The baseline sTNF-R1 and TACE concentrations in all patients was higher than that in controls (2.55 +/- 1.67 vs. 1.70 +/- 0.15 ng/ml, P<0.001, respectively, and 2.62 +/- 0.32 vs. 1.31 +/- 0.30 ng/ml, P<0.001, respectively). The sTNF-R1 and TACE concentrations were lower in PV than in PsA patients (2.47 +/- 0.16 vs. 2.65 +/- 0.13 ng/ml, and 2.52 +/- 0.22 vs. 2.76 +/- 0.39 ng/ml, P<0.05, respectively). The baseline PASI correlated with sTNF-R1 and to TACE concentrations (R=0.48 and 0.39, P<0.05, respectively). The sTNF-R1 correlated to TACE concentration (R=0.52, P<0.05). The significant decline in sTNF-R1 and TACE concentrations at T 20 was noticed, TACE reached control values (1.20 +/- 0.44 ng/ml in PV patients and 1.16 +/- 0.48 ng/ml in PsA patients, respectively). TACE from PBMC can contribute to up-regulation of sTNF-R1 in patients with active psoriasis vulgaris and with psoriatic arthritis. It also can serve as a sensitive marker of the disease severity.