Inflammatory Process In Psoriasis Research Articles

Anticytokine therapy with interleukin-17 in patients with moderate and severe psoriasis

Clinical observations of three patients aged 26, 43 and 37 years with severe psoriasis and psoriatic arthritis are presented. Clinical examples show the experience of effective treatment of patients with psoriasis and psoriatic arthritis using anti-cytokine therapy with an interleukin-17 inhibitor, initiated when the disease progresses. The clinical picture of the presented observations was characterized by an aggressive course of the skin and articular process, torpidity to basic therapy, despite the young age of the patients. It has been shown that the early termination of the progression of the inflammatory process in psoriasis with the use of genetically engineered biological therapy with secukinumab leads to a decrease in symptoms, both on the part of the skin and manifestations of the disease on the part of the musculoskeletal system. The high efficacy and safety of the drug allow complete control of the disease and improve the quality of life in patients suffering from severe forms of dermatosis.

Semaglutide therapy decreases epicardial fat inflammation and improves psoriasis severity in patients affected by abdominal obesity and type-2 diabetes.

Psoriasis is often associated with abdominal obesity and type-2 diabetes (T2D). The inflammatory process in psoriasis can target adipose tissue depots, especially those surrounding the heart and coronary arteries, exposing to an increased risk of cardiovascular diseases. A 50-year-old female patient referred to us for abdominal obesity and T2D, which were not controlled with lifestyle modifications. She had suffered from psoriasis for some years and was treated with guselkumab, without success. Epicardial adipose tissue (EAT) attenuation and pericoronary adipose tissue (PCAT) attenuation for each coronary, defined as mean attenuation expressed in Hounsfield unit (HU), were assessed by routine coronary computed tomography angiography. At baseline, EAT attenuation was -80 HU and PCAT attenuation of the right coronary artery (RCA) was -68 HU, values associated with an increased cardiac mortality risk. Psoriasis area and severity index (PASI) was 12.0, indicating severe psoriasis, while dermatology life quality index (DLQI) was 20, indicating a negative effect on the patient's life. Semaglutide (starting with 0.25 mg/week for 4 weeks, increased to 0.50 mg/week for 16 weeks, and then to 1 mg/week) was started. After 10 months, semaglutide treatment normalized glycated hemoglobin and induced weight loss, particularly at abdominal level, also followed by a reduction in computed tomography-measured EAT volume. EAT attenuation and PCAT attenuation of RCA decreased, showing an important reduction of 17.5 and 5.9% respectively, compared with baseline. PASI and DLQI decreased by 98.3 and 95% respectively, indicating an improvement in psoriasis skin lesions and an important amelioration of the patient's quality of life, compared with baseline. Psoriasis patients affected by obesity and type-2 diabetes (T2D) are often resistant to biologic therapies. Psoriasis is often associated with abdominal obesity, T2D, and cardiovascular diseases (CVD), given their shared inflammatory properties and pathogenic similarities. Epicardial adipose tissue (EAT) inflammation can cause the distinctive pattern of CVD seen in psoriasis. EAT and pericoronary adipose tissue (PCAT) attenuation, assessed by routine coronary computed tomography angiography (CCTA), can be used as biomarkers of inflammation and allow monitoring of medical anti-inflammatory therapies. The actions of semaglutide to reduce energy intake, improve glycemic control, and produce effective weight loss, particularly at the visceral fat depot level, can diminish adipose tissue dysfunction, reduce EAT attenuation and PCAT attenuation of the right coronary artery (RCA) and concomitantly ameliorate the clinical severity of psoriasis. Semaglutide therapy may be considered in psoriasis patients affected by T2D and abdominal obesity, despite low cardiovascular risk by traditional risk scores, who are resistant to biologic therapies.

The Effect of Vitamin D Supplementation in Psoriasis: A Systematic Literature Review

One of the key factors in the development of psoriasis is inflammation. In people with psoriasis, the immune system mistakenly attacks healthy skin cells, causing them to grow too quickly. This leads to the buildup of dead skin cells on the surface of the skin. Vitamin D can help to reduce inflammation by suppressing the production of pro-inflammatory cytokines. This study aimed to conduct a systematic review to explore the potential of vitamin D supplementation in psoriasis. The literature search process was carried out on various databases (PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar) regarding the potential of vitamin D supplementation in psoriasis. This study follows the preferred reporting items for systematic reviews and meta-analysis (PRISMA) recommendations. Vitamin D inhibits the inflammatory process in psoriasis by inhibiting the production of pro-inflammatory cytokines, activating anti-inflammatory, immune cells, and protecting cells from damage caused by inflammation.

Assessment of Cutaneous Parameters and Sympathetic Skin Response as a Non-Invasive Complementary Diagnostic Tool in Psoriasis: An Exploratory Study.

Various diagnostic tools are used to assess cutaneous psoriasis, but most of it were subjective. Sympathetic skin response (SSR), skin PH and temperature objectively measure the skin barrier functions that could aid clinicians to evaluate accurately and predict skin disease incidence even before the onset of clinical symptoms. The study's objective was to assess the utility of cutaneous parameters (skin temperature and pH) and SSRs influencing psoriatic patients' diagnosis management and treatment compared to controls. A total of 40 healthy participants and 40 psoriasis patients aged 18 to 65 years were recruited for this study. SSR, skin temperature and pH were assessed. The psoriasis disability index (PDI) was recorded from all the patients. Data analysis was carried out using SPSS version 20.0. The results shows significantly increased skin temperature, prolonged SSR latency (bilaterally) and decreased SSR amplitude (bilaterally) among patients affected with psoriasis compared to control subjects. There is a positive correlation between SSR latency with PDI and a negative correlation between SSR amplitude and PDI in psoriasis patients. SSR reveals sympathetic sudomotor dysfunction and increased skin temperature in psoriasis. Furthermore, there is a link between increased SSR latency and PDI, which shows that local nervous system impairment significantly contributes to the inflammatory process in psoriasis. Thus, SSR can be used as a complementary tool for the early identification and assessment of epidermal barrier integrity in psoriasis patients, along with the clinician's standard protocols.

Comparison of Serum Zinc and Copper Level in Psoriatic and Non-Psoriatic Individual

Psoriasis is a common chronic inflammatory disease of skin and multiple organs of body. The exact etiology of psoriasis is not yet certain. It is assumed that trace elements may have some role in pathogenesis of psoriasis. They can act as co-enzymes for metabolism and can act as antioxidants against free radicals. Therefore they can participate in epidermal proliferation and inflammatory process of psoriasis. This study aimed to evaluate the relation between psoriasis and trace elements namely zinc and copper. This study was conducted on 40 diagnosed cases of psoriasis and 40 non psoriatic individuals in the department of Dermatology and Venereology in Bangabandhu Sheikh Mujib Medical University, Dhaka. Biochemical analyses of serum copper and zinc were analyzed and compared statistically with cases and healthy controls. Serum zinc level was significantly lower and serum copper level was significantly higher in patient with psoriasis compared to control (p= < 0.001). Individuals with moderate to severe psoriasis had significantly lower zinc levels and significantly higher copper levels than patients with mild psoriasis, according to Psoriasis area and Severity Index Score (p= < 0.05). Correction of serum zinc and copper level could be beneficial for psoriasis patients. Bangladesh Med J. 2021 May; 50(2) : 28-31

Tingkat Perbedaan Serum <i>Nitric Oxide </i>terhadap Derajat Keparahan dan Durasi Psoriasis

Psoriasis belongs to erythrosquamous dermatosis with uncertain etiology. Nitric oxide (NO) that acts as growth and differentiation regulator of keratinocytes is thought to play an important role in the pathogenesis of this disease. This study was aimed to determine the difference of nitric oxide serum level with the severity and duration of psoriasis patients. A cross-sectional study was conducted in 22 subjects with psoriasis vulgaris in the outpatient clinic of Dr. Moewardi Hospital Surakarta from May-September 2018 with 22 healthy individuals as control group. The severity of psoriasis was assessed using psoriasis area severity index (PASI), and serum NO is measured using Greiss method. Data then analysed using T-test and Kruskal Wallis tests (p<0.05). There was a significant difference in serum NO between the psoriasis patients and control group (p=0.020); there was no significant difference between serum NO patients and PASI score and duration of disease. It can be concluded that NO is an important factor in the inflammatory process in psoriasis, especially in active lesion.

Preclinical efficacy investigation of human neutrophil elastase inhibitor sivelestat in animal model of psoriasis.

BackgroundPsoriasis is a chronic immune‐mediated inflammatory skin disease manifested by an increased rate of keratinocyte division. Currently, it has been established that the cytokines of the IL‐36 family play a significant role in the initiation and regulation of the inflammatory process in psoriasis. The IL‐36 cytokine found in skin is inactive and its activation requires proteolytic processing that may occur via the involvement of neutrophil serine proteases such as human neutrophil elastase (HNE). The localization of these enzymes in the upper layers of the epidermis suggests that topical application of HNE inhibitors could be efficacious in the treatment of psoriasis. Sivelestat is an HNE inhibitor developed for systemic use towards the treatment of acute respiratory failure.AimThe present study focussed on the investigation of the effects of sivelestat formulated for topical use, in the imiquimod‐induced model of psoriasis in mice.MethodsThe psoriasis‐like state was induced by application of imiquimod (Aldara®) 5% cream to mouse shaven skin. A group of 40 inbred mice of the BALB/c strain randomized into 4 groups of 10 was used in the experiment: Group 1 – no therapy (control), Group 2 – ointment (Vaseline) containing 1% sivelestat, Group 3 – cream (lanoline + olive oil + water in equal proportions) containing 1% sivelestat, Group 4 – 1% betamethasone dipropionate. Dermatological assessment of skin lesions was performed by means of the PASI method (mPASI), as well as histological and immunohistochemical evaluation.ResultsBased on the evaluation of efficacy manifestations, it was established that the total mPASI index value decreased by 50% during therapy with sivelestat cream and by 36% during therapy with sivelestat ointment. Histological study revealed that the epidermal thickness in groups that underwent therapy was 2.4–3.6 times lower compared to the control group. Immunohistochemical study of the skin indicated that following sivelestat treatment, the quantity of CD3+cells in the skin was 1.8–2.2 times lower, and the level of proliferative activity (Ki‐67+cells) was 2.3–2.9 lower compared to the non‐therapy group. In contrast to topical corticosteroids where the more pronounced anti‐inflammatory effect is typically seen with ointment formulations, with sivelestat we observed an opposite effect. The reasons for that reversal remain unclear.ConclusionBased on the results obtained using the animal model of imiquimod‐induced psoriasis, it was established that the HNE inhibitor sivelestat demonstrated efficacy comparable to that of a strong topical glucocorticoid steroidal drug (betamethasone dipropionate 1%). Significant resolution of skin lesions, reduction of epidermal thickness, diminishing of the skin infiltration with T‐lymphocytes and normalization of the cell division rate in epidermis and dermis were evident. Thus, suppression of IL‐36 mediated inflammation activity in the skin by topical application of a HNE inhibitor represents a promising new direction in the treatment of psoriasis. Certainly, HNE has other targets; thus, molecular studies could be subject of future experiments beyond the scope of the present study.

Calcitonin gene-related peptide upregulates IL-17A and IL-22 in γδ-T cells through the paracrine effect of langerhans cells on LC/γδ-T co-culture model

Intense mental stimulation and stress often directly induce or exacerbate psoriasis. On the contrary, patients with nerve injury and nervous system dysfunction have psoriasis remission. The nervous system plays an important role in the inflammatory process of psoriasis, and neuropeptides are considered as local mediators of disease maintenance. To examine the molecular mechanism involved in this, first we analyzed calcitonin gene-related peptide (CGRP)-treated langerhans Cells and γδ-T cells separately. CGRP induced IL-23 mRNA and protein expression via PDK1-Rsk signaling pathway. However, CGRP had no effect on secretion of IL-17A and IL-22 in γδ-T cells. Then we treated LCs/γδ-T cells Co-culture Model with CGRP. CGRP upregulated IL-17A and IL-22 expression in co-culture model through the paracrine effect of LCs. IL-17A and IL-22 are key cytokines of psoriasis. These findings provide a potential mechanism by which nerve factors affect the development of psoriasis.

Antimicrobial Late Cornified Envelope Proteins: The Psoriasis Risk Factor Deletion of LCE3B/C Genes Affects Microbiota Composition

Late cornified envelope proteins are predominantly expressed in the skin and other cornified epithelia. On the basis of sequence similarity, this 18-member homologous gene family has been subdivided into six groups. The LCE3 proteins have been the focus of dermatological research because the combined deletion of LCE3B and LCE3C genes (LCE3B/C-del) is a risk factor for psoriasis. We previously reported that LCE3B/C-del increases the expression of the LCE3A gene and that LCE3 proteins exert antibacterial activity. In this study, we analyzed the antimicrobial properties of other family members and the role of LCE3B/C-del in the modulation of microbiota composition of the skin and oral cavity. Differences in killing efficiency and specificity between the late cornified envelope proteins and their target microbes were found, and the amino acid content rather than the order of the well-conserved central domain of the LCE3A protein was found responsible for its antibacterial activity. Invivo, LCE3B/C-del correlated with a higher beta-diversity in the skin and oral microbiota. From these results, we conclude that all late cornified envelope proteins possess antimicrobial activity. Tissue-specific and genotype-dependent antimicrobial protein profiles impact skin and oral microbiota composition, which could direct toward LCE3B/C-del‒associated dysbiosis and a possible role for microbiota in the pathophysiology of psoriasis.

Influence of coronavirus infection on the course of psoriasis

A new SARS-CoV-2-associated coronavirus infection pandemic began in late 2019. The present article is devoted to the analysis of the mechanisms of COVID-19 impact on the course of psoriasis and its consequences. According to the scientific literature, patients with psoriasis are somewhat more likely to be infected with coronavirus infection than the healthy population, but tolerate it in a milder form. At the same time, cases of psoriatic process exacerbation during the active phase of the disease and after COVID-19 have been described. The negative effect of infection on skin disease can be explained by the common genome of the two nosologies, the «cytokine storm» and the prescription of COVID-19 drugs. In addition, both COVID-19 and psoriasis can cause liver dysfunction related to the specific pathogenesis of the diseases as well as the prescribed therapy. The article describes our own experience of monitoring patients with exacerbation of psoriasis against the background of coronavirus infection with pathological changes in liver tests. Inclusion of a fixed combination of glycyrrhizic acid and essential phospholipids in the complex treatment allowed to stop the exacerbation of the psoriatic process more effectively, to reduce the activity of liver enzymes without worsening the clinical conditions associated with COVID-19. Thus, in particular, a clinically significant improvement of the skin condition was recorded. In patient B., alanine aminotransferase activity decreased to 44.4 U/L and aspartate aminotransferase activity to 18.2 U/L. In turn, in patient M. the activity of liver enzymes decreased to 37.8 U/L and 34.7 U/L, respectively. The prescription of this drug can be considered pathogenetically justified, given the effect of glycyrrhizic acid on the production of key cytokines involved in the inflammatory process in psoriasis, coronavirus infection and liver pathology. In addition, the hypothesis of the ability of glycyrrhizic acid to prevent the entry of SARS-CoV-2 into the cell by reducing the expression of angiotensin-converting enzyme 2 is of interest.

The new external drug for the treatment of psoriasis based on inhibition of serine proteases

Background: Psoriasis is a chronic inflammatory immune-mediated disease characterized by an increased rate of keratinocyte division. The results of recent studies have made it possible to establish that the cytokines of the IL-36 family occupy a significant place in the initiation and regulation of the inflammatory process in psoriasis.
 IL-36 is in an inactive form and proteolytic processing is required for its activation in the skin, which is possible with the participation of neutrophilic serine proteases. Localization of these enzymes in the upper layers of the epidermis suggests the clinical efficacy of a topical targeted drug that inhibits serine proteases, sivelestat. On the basis of this active substance, we have created a drug in an external dosage form and conducted an experimental study of its effectiveness on a laboratory model of psoriasis.
 Aims: to evaluate the therapeutic efficacy of sivelestat in a laboratory model of imiquimod-induced psoriasis.
 Materials and methods: In the experiment, 40 inbred BALB/c mice were used, which were randomized into 4 groups of 10 each. An imiquimod-induced model of psoriasis was used. Mice of group No. I - without therapy (control), No. II - ointment (vaseline) containing 1% sivelestat, No. III - cream (lanolin + olive oil + water in equal proportions) containing 1% sivelestat, No. IV - betamethasone cream dipropionate 0.05%. Clinical assessment of skin rashes was performed using the PASI-modified method (mPASI), as well as histological and immunohistochemical examination of the skin.
 Results: When evaluating clinical manifestations, it was found that the total mPASI index when using sivelestat cream decreased by 50%, and sivelestat ointment - by 36%. The histological examination showed that the thickness of the epidermis in the groups where the therapy was applied was 2.4-3.6 times less than in the control group. An immunohistochemical study of the skin found that after treatment with sivelestat, the number of CD3 + cells in the skin was 1.8-2.2 times less, and the level of proliferative activity (Ki-67 + cells) was 2.3-2.9 times less. lower than in the group without therapy
 Conclusions: On a laboratory model of imiquimod-induced psoriasis, it was found that a serine protease inhibitor (sivelestat) has a therapeutic efficacy comparable to a strong topical glucocorticosteroid drug (betamethasone dipropionate 0.05%). A pronounced resolution of the elements of the skin rash, a reduction in the thickness of the epidermis, a decrease in skin infiltration with T-lymphocytes and a normalization of the rate of cell division of the epidermis and dermis are shown.
 Suppression of the activity of IL-36-mediated inflammation in the skin by means of topical inhibitors of serine proteases is a promising new direction in the treatment of patients with psoriasis.

Perspective trends of topical therapy of patients with psoriasis

Topical medications are used to treat not only limited, but also common forms of the disease. Currently prescribed external anti-inflammatory drugs have a low selectivity of action, which does not allow achieving a long-term and pronounced clinical effect without the development of undesirable phenomena.
 This review presents new options for the use of methotrexate in modern topical forms (AuNPs-3MPS), which make it possible to reduce the incidence of adverse events with a high efficiency of therapy. Shown is an innovative drug that blocks resident memory cells (PAP-1), which will influence the course and relapses of the disease, and possibly even lead to the cure of the patient from psoriasis. A new direction has been described inhibition of serine proteases (ER143, AAN-16) and thus inhibition of IL-36-mediated inflammation, which will allow controlling the inflammatory process in psoriasis in the early stages of its development. In addition, a number of drugs are shown whose action is based on blocking intracellular signaling pathways, which leads to inhibition of the development of the inflammatory response and resolution of psoriatic eruptions: inhibitors of Janus kinases (tofacitinib), transcription factor Stat3 (rS3-PA), secondary messenger of signals (SIS3), phosphodiesterase 7 (ASB16165) and 4 (AN-2728/crisaborol), ROR transcription factor (PF-06763809), phospholipase A2 (AVX001), hydrolases (DZ2002).
 The results of preclinical and initial stages of clinical trials with an assessment of the safety and tolerability of the studied substances are presented. Based on the review, the advantages and disadvantages of the proposed drugs are characterized. Topical therapy with a selective effect on the key links in the development of psoriasis will increase the effectiveness of treatment and reduce the frequency of unwanted effects.

Serum level of cytokine IL-30 in psoriatic patients and correlation with disease severity.

Psoriasis is a common chronic immune-mediated inflammatory skin disorder characterized by erythematous silvery scaling of the skin and associated severe itching. Reports indicate that psoriasis is affecting about 2% of the world population and life quality in a way that limits the patient activity and thereby productivity in a community. Therefore, determining appropriate therapeutics for psoriasis would make a difference in the lives of the patients and their communities. To address this, scientists have been working on different biological agents, such as interleukins and their antagonists, to regulate the common inflammatory process in psoriasis. For the current research project, serum was collected from 26 psoriatic patients and another 26 health controls, and the serums were examined for the level of IL-30 to determine differences among the tested groups and to investigate a possible correlation between IL-30 and psoriasis area severity index (PASI). The study delineated differences of the IL-30 among the groups and a positive correlation between IL-30 and PASI among the psoriatic cases, which insights a need for further studies that include a large scale of participants to fully elucidate the involvement of IL-30 in psoriasis.

THIOZOLIDINEDIONES IN THE TREATMENT OF PATIENTS WITH EXTENSIVE PSORIASIS AND CONCOMITANT ALIMENTARY OBESITY

Psoriasis is one of the most common chronic recurrent systemic autoimmune multifactorial diseases, affected the skin, joints, internal organs and systems of the body. Despite the significant prevalence of psoriasis and a large number of studies devoted this problem there is still no single view on the pathogenesis of this dermatosis. To clear up the pathogenesis of psoriasis, it seems to be reasonable to focus on the common comorbidities or multimorbidities, which may occur in the course of psoriasis, as this issue is still insufficiently studied. Recent reports have proven the evidences of indisputable link between psoriasis and obesity. The scientific literature extensively covers the issues of identical pathogenetic mechanisms of inflammatory processes in psoriasis and obesity. Given the current data on the role of systemic inflammation underlying the development of both psoriasis and obesity, the study of molecular mechanisms of its development and in particularly the role of proinflammatory nuclear transcription factors, thiazolidinediones have been found out as pathogenetically justified medicine of choice for the therapy of these diseases. In this study, we determined the effectiveness of using 30 mg of pioglitazone daily for 6 months in the course of treatment for patients with extensive psoriasis vulgaris of moderate severity, who were also diagnosed as having concomitant grade І-ІІ alimentary obesity that was supported by clinical and immunological findings evidenced of systemic inflammation. Analyzing the results obtained, we have found out the prolonged therapy with pioglitazone leads to a decrease in systemic inflammation and contributes to a milder recurrent course of psoriasis.

APPLICATION OF PIOGLITAZONE IN THE COMPREHENSIVE TREATMENT OF PSORIATIC PATIENTS WITH CONCOMITANT ALIMENTARY OBESITY

Psoriasis is one of the most common chronic recurrent systemic autoimmune multifactorial diseases, in which the skin, joints, internal organs and systems of the body are involved in the pathological process. Despite the significant prevalence of psoriasis and a large number of studies on this problem, there is still no single view on the pathogenesis of this dermatosis. To objectively understand the pathogenesis of psoriasis, it is necessary to take into account the insufficiently studied comorbidity of this pathology. Recently, an indisputable link between psoriasis and obesity has been proven. The scientific literature widely covers the issue of identical pathogenetic mechanisms of inflammatory processes in psoriasis and obesity. Given the current data on the role of systemic inflammation underlying the development of both psoriasis and obesity, the study of molecular mechanisms of its development and taking into account the role of proinflammatory nuclear transcription factors, thiazolidinediones are the pathogenetically justified drugs of choice for treatment of these diseases. In this study, we determined the effectiveness of using 15 mg of pioglitazone once a day for 6 months in the treatment of patients with extensive psoriasis vulgaris of moderate severity and concomitant grade І-ІІ alimentary obesity by clinical and immunological examination of systemic inflammation. Analyzing the results of the study, it was found that long-term use of pioglitazone, even in small doses, led to a decrease in systemic inflammation and contributed to a milder course of psoriasis in recurrence of the disease.

FEATURES OF THE CLINICAL COURSE OF PSORIASIS IN PATIENTS WITH OBESITY

Psoriasis is the most common chronic, genetically determined autoimmune polyetiological inflammatory disease with impaired epidermal proliferation, provoked by exogenous and endogenous factors, and manifested by erythematous and scaly elements, papules and plaques. According to the results of clinical and epidemiological studies, psoriasis affects about 3-4% of the population of our planet, regardless of gender, age, and ethnic group, and the specific gravity of this pathology in the general structure of skin diseases reaches, from the data of different authors, from 1% to 40 %. However, despite the significant incidence of psoriasis and a large amount of research on this problem, there is still no single view of the pathogenesis of this dermatosis. For an objective understanding of the pathogenesis of psoriasis, it is necessary to take into account the insufficiently studied comorbidity of this pathology. Therefore, in the studies of the pathogenesis of psoriasis in recent years, more attention is paid to the impairment of metabolic processes. Recently, an indisputable link between psoriasis and obesity has been proven. Obesity has been found to increase the risk of many diseases, including psoriasis. The literature has broadly highlighted the question of the pathogenetic mechanisms of inflammatory processes in psoriasis and obesity that form a vicious circle at the level of the immune system, which must be broken for the successful treatment of these diseases. In this research, we studied the clinical presentation of the disease, measured anthropometric parameters, determined the grade of obesity by BMI, analyzed the history of life and disease, and conducted clinical and biochemical blood tests. The results of the study revealed that alimentary obesity in patients with psoriasis leads to metabolic disorders, complicating the course of dermatosis, which leads to a worsening of the DLQI of patients, the inefficiency of standard methods of therapy and frequent exacerbations of psoriatic disease. Therefore, the prospect for further research is a more in-depth study of the comorbidity of psoriatic disease, which will identify new targets for the treatment of this dermatosis to prevent complications and more effective treatment of this pathology.

Ефективність застосування піоглітазону в комплексному лікуванні хворих на псоріаз із супутнім аліментарним ожирінням

Relevance. Psoriasis is the common chronic genetically determined autoimmune polyetiological inflammatory disease with impaired epidermal proliferation, provoked by exogenous and endogenous factors, and manifested by erythematous and scaly elements, papules and plaques. Despite the significant prevalence of psoriasis and a large number of studies on this problem, there is still no single view on the pathogenesis of this dermatosis. To objectively understand the pathogenesis of psoriasis, it is necessary to take into account the insufficiently studied comorbidity of this pathology. Recently, an indisputable link between psoriasis and obesity has been proven. The scientific literature widely covers the issue of identical pathogenetic mechanisms of inflammatory processes in psoriasis and obesity. Given the current data on the role of systemic inflammation underlying the development of both psoriasis and obesity, the study of molecular mechanisms of its development and taking into account the role of proinflammatory nuclear transcription factors, thiazolidinediones are the pathogenetically justified drugs of choice for treatment of these diseases. The objective. To determine the effectiveness of the use of 45 mg of pioglitazone 1 time per day for 26 weeks in the complex treatment of patients with widespread psoriasis vulgaris of moderate severity with concomitant alimentary obesity of I–II degrees. Materials and research methods. Clinical and immunological studies of indicators of systemic inflammation. Results. the use of 45 mg pioglitazone for 26 weeks led to a decrease in systemic inflammation in terms of IL-33 by 83.7%, IL-6 by 72%, uch-CRP by 76.8% and the PASI index by 46.8% with repeated relapse diseases. Conclusions. Long-term use of 45 mg of pioglitazone in the complex treatment of patients with widespread psoriasis vulgaris of moderate severity with concomitant alimentary obesity of I–II degrees proved to be effective and contributed to a milder course of psoriasis with repeated relapse of the disease.

KADAR VITAMIN DALAM PLASMA DARAH PADA PASIEN PSORIASIS DI KOTA MEDAN

Psoriasis is a chronic inflammatory disease mediated by the immune system with a prevalence of 2-3% in the world population whose manifestations are found in the skin and other organs. Data on the prevalence of psoriasis is still diverse in several hospitals in Indonesia. Multifactors play a role in the incidence of psoriasis both genetic and environmental. Psoriasis lesions occur due to an imbalance between proliferation and differentiation of keratinocytes. Vitamin D has a role in regulating the balance of the process. Vitamin D is a fat soluble vitamin that can suppress the inflammatory process in psoriasis lesions.This study aimed to determine the frequency distribution of age, sex and levels of 25-Hydroxyvitamin D in blood plasma 44 psoriasis patients.Kadar vitamin D tersebut diukur menggunakan metode ELISA (DBC). The results obtained were the average age of 42-year-old psoriasis patients with the youngest age of 18 years and the oldest at 77 years. Female sex was 56.8% and men were 43.2%.The highest vitamin D level was 59.1 ng / ml and the lowest was 7.3 ng / ml so that it averaged 25.92 ng /ml. Analysis of vitamin D levels produced suficiency (31.8%), insufficiency (31.8%) and deficiency (36.4%).It can be concluded that vitamin D levels in psoriasis patients in Medan city 68.2% have less categories (<29 ng / ml) and most deficiencies at 48-57 years old.

MiR-21 binding site SNP within ITGAM associated with psoriasis susceptibility in women.

BackgroundGreat progress has been made in the understanding of inflammatory processes in psoriasis. However, clarifying the role of genetic variability in processes regulating inflammation, including post-transcriptional regulation by microRNA (miRNA), remains a challenge.ObjectivesWe therefore investigated single nucleotide polymorphisms (SNPs) with a predicted change in the miRNA/mRNA interaction of genes involved in the psoriasis inflammatory processes.MethodsStudied SNPs rs2910164 C/G–miR-146a, rs4597342 T/C–ITGAM, rs1368439 G/T–IL12B, rs1468488 C/T–IL17RA were selected using a bioinformatics analysis of psoriasis inflammation-associated genes. These SNPs were then genotyped using a large cohort of women with psoriasis (n = 241) and healthy controls (n = 516).ResultsNo significant association with psoriasis was observed for rs2910164, rs1368439, and rs1468488 genotypes. However, the major allele T of rs4597342 –ITGAM was associated with approximately 28% higher risk for psoriasis in comparison to the patients with the C allele (OR = 1.28, 95% CI 1.01–1.61, p = 0.037). In case of genotypes, the effect of the T allele indicates the dominant model of disease penetrance as the CT and TT genotypes increase the chance of psoriasis up to 42% in comparison to CC homozygotes of rs4597342 (OR = 1.42, 95% CI = 1.05–1.94, p = 0.025).ConclusionSNP rs4597342 in 3'UTR of ITGAM influencing miR-21 binding may be considered a risk factor for psoriasis development. Upregulated miR-21 in psoriasis is likely to inhibit CD11b production in the case of the rs4597342 T allele which may lead to Mac-1 dysfunction, resulting in an aberrant function of innate immune cells and leading to the production of cytokines involved in psoriasis pathogenesis.

Circulating levels of chemokines in patients with psoriasis vulgaris and their association with disease severity: A case-control study from North India.

Psoriasis is a chronic inflammatory skin disease characterized by hyperproliferation and incomplete differentiation of epidermis, and accumulation of neutrophils and proinflammatory T cells in epidermis and dermis. Chemokines are believed to be the main players mediating the chemotaxis of leucocytes to the lesional site. Previous studies have established the role of various chemokine ligands and receptors at the lesional site in psoriasis. In this study, we have compared the serum levels of various chemokines, namely, inducible protein-10 (IP-10) (CXCL10), MCP-1 (CCL-2), monokine induced by gamma interferon (MIG) (CXCL-9), RANTES (CCL5), interleukin (IL)-8, and eotaxin in patients with chronic plaque psoriasis with that of healthy controls. We also studied whether the chemokine levels varied within different patient groups based on various clinical and demographic parameters, and if any of these chemokines correlated with disease activity. We studied 40 patients with chronic plaque psoriasis from a single center. Their clinical and demographic details were recorded in predesigned prforma. Patients with unstable forms of psoriasis like guttate, erythrodermic, or pustular psoriasis were excluded. The serum chemokine levels were measured by flow cytometry-based bead array set system. The serum levels of the patients were compared with that of 25 healthy controls. A subgroup analysis was also done to study the correlation of chemokine levels with age, sex, duration, and severity of disease. We observed a significant decrease in serum level of all these chemokines in patients, when compared with that of healthy controls. We also found that MIG levels showed a positive correlation with disease severity based on Psoriasis Area and Severity Index. The major limitation of the study is lack of data on the lesional chemokine levels compared to serum chemokines. The inflammatory process in psoriasis is orchestrated through chemokines. MIG is a potential serum biomarker for assessing disease severity.