Psoriasis Levels Research Articles

Investigation of adropin and IMA levels in psoriasis and their relation to duration and severity of disease

Investigation of adropin and IMA levels in psoriasis and their relation to duration and severity of disease

Investigation of oxidant and antioxidant levels in patients with psoriasis

Background/aimPsoriasis is an immune-mediated chronic inflammatory skin disease that is seen in 1%–3% of the population. It is characterized by symmetrical papulosquamous lesions on the scalp, knees, elbows, sacral region, and extensor surfaces of the extremities. Psoriasis affects both sexes equally. It is thought that reactive oxygen species have an important role in inflammatory skin diseases, especially in psoriasis. There are few studies investigating serum oxidant-antioxidant levels in psoriasis. In this study, we aimed to investigate serum oxidant and antioxidant levels in psoriasis and their effects on its pathogenesis. Materials and methodsIncluded in this study were 50 patients with psoriasis who had not been treated with any systemic medication and 45 healthy volunteers (control group). The total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA), and 8-hydroxy 2’-deoxyguanosine (8H2D) were studied via venous blood sampling. The parameters were measured spectrophotometrically. The study was approved by the Local Ethics Committee of the Atatürk University Faculty of Medicine.ResultsThe mean ages of the patients and control group were 32.48 (±14.45) and 35.64 (±17.40) years, respectively. Of the patients, 23 were male and 27 were female. Of the healthy volunteers, 20 were male and 25 were female. The mean disease duration was 8.77 (±6.90) years. The mean Psoriasis Area and Severity Index (PASI) score was 11.41 (±9.62). The mean TOS levels of the patient and control groups were 63.12 (±33.23) and 4.50 (±9.74), respectively. This difference was statistically significant (P = 0.00). The mean TAS levels of the patient and control groups were 3.15 (±0.70) and 3.16 (±0.44), respectively, without any statistically significant difference. The mean MDA levels in the patient and control groups were 14.84 (±6.66) and 12.77 (±4.87), respectively, without any statistically significant difference. The mean 8H2D levels of the patient and control groups were 16,781.2 (±5918.95) and 15,276.13 (±6084.95), respectively. This difference was also not statistically significant. There was no correlation between PASI scores and the above-mentioned parameters.ConclusionIn the present study, the TOS levels showed a significant statistical difference between the psoriasis and control groups. This finding supports the effect of the oxidant system in the pathogenesis of psoriasis. This was the first study to investigate MDA, TOS, TAS, and 8H2D levels together in patients with psoriasis. More studies are needed to clearly understand the relationship between psoriasis and the oxidant-antioxidant system.

Down-regulation of tissue levels of serine protease inhibitor (vaspin) in psoriasis vulgaris patients: a possible mechanism of narrowband ultraviolet B radiation.

Vaspin is a serine protease inhibitor of the serpin family which has an anti-inflammatory effect. It has an important role in the pathogenesis of some inflammatory diseases such as psoriasis. There are no previous studies comparing the effect of narrowband ultraviolet B (NB-UVB) radiation on tissue vaspin levels in psoriasis. So we aimed in this case-control study to estimate the possible role of vaspin in the pathogenesis of psoriasis, and to evaluate the effect of NB-UVB radiation on tissue vaspin in psoriasis. This study included 21 non-obese patients with moderate psoriasis and 20 non-obese clinically healthy age and sex matched controls. Patients underwent 24 sessions of NB-UVB radiation. A 4mm punch skin biopsy was taken from all patients before and after treatment and from the controls for estimation of tissue vaspin level by enzyme-linked immunosorbent assay. Vaspin levels was significantly lower in patients before NB-UVB (99.72 pg/mg ± 12.11 pg/mg) compared to controls (257.34 pg/mg ± 28.11 pg/mg) with (P < 0.001). In addition, high significant difference was detected between vaspin levels in patients before (99.72 pg/mg ± 12.39 pg/mg) and after NB-UVB (190.92 pg/mg ± 27.61 pg/mg) with (P < 0.001). In conclusion, improvement of psoriatic plaques by NB-UVB is associated with an upregulation of tissue vaspin levels. Therefore, we suggest that vaspin has an important role in psoriasis pathogenesis.

High sensitivity C-reactive protein, a predictor of cardiovascular mortality and morbidity, and psoriasis: a case control study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Psoriasis, a chronic inflammatory disease, is associated with systemic comorbidities. The blood levels of various inflammatory markers are increased in psoriasis. One of them is high sensitivity C-reactive protein (hs-CRP). The serum level of hs-CRP is increased in many inflammatory diseases like psoriasis, cardio vascular diseases, infections, arthritis and others. The objectives of the study were to determine serum level of hs-CRP in psoriasis in relation to its PASI score, which is a subjective method to determine severity of the disease, whereas hs-CRP is an objective and more reliable method. And to have a better idea of systemic inflammatory process caused by psoriasis, serum level of hs-CRP was evaluated in psoriasis patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A case control study was conducted including 38 patients of chronic plaque psoriasis from dermatology outpatient department of Maharaja Agrasen Medical College (MAMC), Agroha, India, and 38 healthy controls.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The serum level of hs-CRP was significantly raised in psoriasis patients (p&amp;lt;0.001). The mean hs-CRP level in psoriasis patients was 6.824±8.562 mg/l whereas it was 1.072±0.929 mg/l in controls. Two observations were noticed, one, the increase in hs-CRP level correlated with PASI score and second, it was much higher in psoriatic patients as compared to controls.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The much higher hs-CRP levels in psoriasis as compared to controls and its correlation with severity of psoriasis has led us to propose that this much high hs-CRP is a biomarker of systemic inflammatory process of psoriasis as well as inflamed cutaneous lesions.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Assessment and Clinical Relevance of Serum IL-19 Levels in Psoriasis and Atopic Dermatitis Using a Sensitive and Specific Novel Immunoassay

Because development of reliable biomarkers in psoriasis and atopic dermatitis has lagged behind therapeutic progress, we created a blood-based test to fill the void in objective methods available for dermatological assessments. Our novel interleukin-19 (IL-19) immunoassay was initially tested to determine concentrations of IL-19 serum levels, then correlated with the psoriasis activity and severity index (PASI) in psoriasis, and the eczema area and severity index (EASI) in atopic dermatitis. Not only was IL-19 increased in psoriasis and correlated to PASI, but ixekizumab administration led to rapid, sustained IL-19 decreases to normal levels, with decreases at 2-weeks correlating with PASI improvement at 16-weeks. IL-19 increased upon ixekizumab withdraw, prior to relapse, and decreased following re-treatment. In baricitinib- and etanercept-treated psoriasis patients, IL-19 decreases also correlated with improvement. Many patients with limited skin disease, including genital psoriasis and psoriatic arthritis patients, also had increased IL-19, which was reduced to normal levels upon ixekizumab treatment, correlating with PASI improvement. We also measured IL-19 in baricitinib-treated atopic dermatitis patients. In atopic dermatitis, IL-19 was significantly elevated, correlated with EASI scores, and decreased with skin improvement. Therefore, measurement of serum IL-19 provides clinicians with an objective disease-activity assessment tool for psoriasis and atopic dermatitis patients.

Psöriyazis Hastalarında İşitme Kaybı Olur mu?

Objective: Sensorineural hearing loss has been associated with various diseases including vitiligo, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease and Behcet's disease in the etiopathogenesis of which autoimmunity and chronic inflammation play a role. However, limited studies are available evaluating hearing levels in psoriasis which is another chronic inflammatory and autoimmune disease. The present study evaluates hearing levels in patients with psoriasis, a chronic inflammatory disease which are often accompanied by other comorbid conditions, and makes a comparison with healthy controls. Material and Methods: Fifty psoriasis patients and 50 healthy volunteers were included in the study. All participating patients underwent a complete otorhinolaryngologic examination prior to undergoing audiometry. The patients underwent pure-tone audiometry in an audiometry laboratory with voice isolation. Results: In the present study, statistically significant differences were noted between the groups in terms of hearing threshold in both left and right ear at 2000 Hz, and in the right ear at 4000 Hz and 8000 Hz. In all instances of significant difference, the patients in the psoriasis group had higher values. The mean air- and bone-conduction hearing thresholds in the left and right ear were significantly higher in the psoriasis group (p<0.05). The correlation analysis which was made to identify any possible relationship between Psoriasis Area Severity Index (PASI) and duration of disease revealed no significant relationship or correlation. Conclusion: It should be kept in mind that hearing loss can occur in psoriasis patients, and they should be followed up regularly with audiometry.

Evaluation of Social Anxiety Levels and Related Factors in Psoriasis Patients: A Controlled, Cross- Sectional Study

Psoriasis patients usually feel shame over their appearance and suffer from poor self-esteem, social anxiety, and avoidance. However, little is known about factors affecting social anxiety levels in these patients. We sought to examine the psychological, as well as disease-related factors which may affect social anxiety levels in psoriasis patients. Our study consisted of 50 psoriasis outpatients and a corresponding 50 age and sex-matched healthy control volunteers who filled out the Liebowitz Social Anxiety Scale (LSAS), the Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS), Ways of coping questionnaire (WCQ) and Eysenck Personality Questionnaire Revised: abbreviated form (EPQR-A). The patients also completed the Dermatology Life Quality Index (DLQI). The extensiveness and severity of the disease were examined by employing the Psoriasis Area and Severity Index (PASI). Compared with our controls, psoriasis patients displayed significantly higher degrees of social anxiety. Both social fear⁄avoidance subscale scores of LSAS showed a significant correlation to impairment in quality of life (r: 0.373, p: 0.008, r: 0.336, p: 0.018). No appreciable correlation was observable among the PASI and LSAS scores. Regression analysis showed that EPQR-A-extraversion and neuroticism subscale scores had significant influence on LSAS-Social Anxiety scores, accounting for 41.5% of the variance. EPQR-A-extraversion was found to have significant influence on LSAS-Social avoidance scores, accounting for 26.8% of the variance. Our results indicate that psoriasis causes increased levels of social anxiety which is closely related to impaired quality of life. Personality characteristics might contribute considerably in expressing psychosocial morbidity among individuals living with psoriasis.

Defining the Therapeutic Range for Adalimumab and Predicting Response in Psoriasis: A Multicenter Prospective Observational Cohort Study

Biologics have transformed management of inflammatory diseases. To optimize outcomes and reduce costs, dose adjustment informed by circulating drug levels has been proposed. We aimed to determine the real-world clinical utility of therapeutic drug monitoring in psoriasis. Within a multicenter (n = 60) prospective observational cohort, 544 psoriasis patients were included who were receiving adalimumab monotherapy and had at least one serum sample and Psoriasis Area and Severity Index (PASI) score available within the first year. We present models giving individualized probabilities of response for any given drug level: a minimally effective drug level of 3.2 μg/ml discriminates responders (PASI75 indicates 75% improvement in baseline PASI) from nonresponders, and gives an estimated PASI75 probability of 65% (95% confidence interval = 60–71). At 7 μg/ml, PASI75 probability is 81% (95% CI = 76–86); beyond 7 μg/ml, the drug level/response curve plateaus. Crucially, drug levels are predictive of response 6 months later, whether sampled early or at steady state. We confirm serum drug level to be the most important factor determining treatment response, highlighting the need to take drug levels into account when searching for biomarkers of response. This real-world study with pragmatic drug level sampling provides evidence to support the proactive measurement of adalimumab levels in psoriasis to direct treatment strategy, and is relevant to other inflammatory diseases.

Inter relationship of plasma lipid profile parameters with plasma uric acid levels in psoriasis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Psoriasis is a chronic immune mediated skin disease accompanied with disturbances in systemic lipid turnover. Hyperuricemia has been frequently observed as an additional complication in psoriasis. The relationship between the raised plasma lipid parameters and the uric acid levels in psoriasis need to be ascertained. A study was undertaken to assess the possible relationship of plasma lipid parameters with plasma uric acid levels in psoriasis and to relate any such relationship to psoriasis disease severity.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Non arthritic psoriasis patients were randomly selected and were grouped into mild (Group 1), moderate (Group 2) as well as severe (Group 3) based on their PASI scores.&lt;strong&gt; &lt;/strong&gt;Plasma lipid parameters and uric acid levels were assessed in these patients.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The results show a significant (p&amp;lt;0.001) parallel raise in plasma uric acid levels along with plasma lipid parameters&lt;strong&gt; &lt;/strong&gt;with the severity of disease in these patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A plasma uric acid level along with plasma total cholesterol and triacylglycerol levels&lt;strong&gt; &lt;/strong&gt;fetch much information on the severity of psoriasis disease.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

SOCIAL-HYGIENIC MONITORING OF MORBIDITY BY PSORIASIS UNDER CONDITIONS OF THE ZAPOROZHSKY INDUSTRIAL REGION

Relevance. The high prevalence of psoriasis among the population of the earth (0.1-7.0%), as well as the difficulty of its treatment, necessitate the development of new methods for its prevention and increasing the effectiveness of treatment.&#x0D; Objective. To study the peculiarities of the incidence of psoriasis in the population of the Zaporozhye region under the influence of unfavorable environmental factors.&#x0D; Methods. Under supervision in 2012, there were 5475 patients with psoriasis, of whom 2439 (44.5%) were women, 2731 (49.9%) were men and 305 (5.6%) were children. In 2013, there were 5635 patients with psoriasis, of whom 2504 (44.4%) were women, 2818 (50.0%) were men and 313 (5.6%) were children.&#x0D; Results. The highest levels of psoriasis in the Zaporozhye region are registered in Zaporozhye, Gulyaypol, Veselovsky, Kuibyshev, Primorsk and Vasilievsky districts. In these administrative units, the prevalence of psoriasis was within 269.6 - 513.8 cl. / 100 thousand, significantly higher than the average regional level (p &lt;0.05), the prevalence of psoriasis in Zaporozhye (by 146.1 - 180.6 sl. / 100 thousand), in Gulyaypol district (by 96.1 - 141.9 cases / 100 thousand), and Veselovsky district (by 84.9 - 105.9 cases / 100 thousand).&#x0D; Conclusions: For the first time, a systematic approach to the analysis of the incidence of psoriasis with regard to environmental factors was used, in order to achieve stable remission in patients with active psoriasis, it is necessary to correct exogenous and endogenous trigger factors in order to minimize their effects.

SOCIAL-HYGIENIC MONITORING OF MORBIDITY BY PSORIASIS UNDER CONDITIONS OF THE ZAPOROZHSKY INDUSTRIAL REGION

Relevance. The high prevalence of psoriasis among the population of the earth (0.1-7.0%), as well as the difficulty of its treatment, necessitate the development of new methods for its prevention and increasing the effectiveness of treatment.&#x0D; Objective. To study the peculiarities of the incidence of psoriasis in the population of the Zaporozhye region under the influence of unfavorable environmental factors.&#x0D; Methods. Under supervision in 2012, there were 5475 patients with psoriasis, of whom 2439 (44.5%) were women, 2731 (49.9%) were men and 305 (5.6%) were children. In 2013, there were 5635 patients with psoriasis, of whom 2504 (44.4%) were women, 2818 (50.0%) were men and 313 (5.6%) were children.&#x0D; Results. The highest levels of psoriasis in the Zaporozhye region are registered in Zaporozhye, Gulyaypol, Veselovsky, Kuibyshev, Primorsk and Vasilievsky districts. In these administrative units, the prevalence of psoriasis was within 269.6 - 513.8 cl. / 100 thousand, significantly higher than the average regional level (p &lt;0.05), the prevalence of psoriasis in Zaporozhye (by 146.1 - 180.6 sl. / 100 thousand), in Gulyaypol district (by 96.1 - 141.9 cases / 100 thousand), and Veselovsky district (by 84.9 - 105.9 cases / 100 thousand).&#x0D; Conclusions: For the first time, a systematic approach to the analysis of the incidence of psoriasis with regard to environmental factors was used, in order to achieve stable remission in patients with active psoriasis, it is necessary to correct exogenous and endogenous trigger factors in order to minimize their effects.

TNFα and IL-17A are differentially expressed in psoriasis-like vs eczema-like drug reactions to TNFα antagonists.

Tumor necrosis factor α (TNFα) blocking drugs are in use for a wide range of autoimmune disorders. In up to 5% of patients, this class of drugs produces puzzling cutaneous side effects that are the subject of this investigation, namely psoriasiform and eczema-like skin inflammation. These side effects can occur after any time of treatment and regardless of the underlying disorders. The exact pathophysiology is as yet unknown. A total of 33 patients (19 female, average age 52 years) who had a cutaneous reaction to infliximab, adalimumab or etanercept were included. The type of inflammatory reaction was determined, and the corresponding cytokine expression was evaluated by immunohistochemistry for TNFα, IL-1β, IL-22, IL-6, IL-17A, IL33, IL-8 and IL-36α (semi-quantitative grading system from - to ++++). In addition, RNA expression levels of IL-17A and TNFα were confirmed by quantitative real-time PCR. IL-17A (P < .039) and TNFα (P < .008) were expressed at significantly higher levels in psoriasis or pustular-like reactions (PPR) compared to eczematous-like reactions (ELR). There was no significant difference in the expression of IL-1β, IL-22, IL-6, IL-33, IL-8 and IL-36α between PPR and ELR. TNFα and IL-17A are both cytokines known to be involved in psoriasis but less so in non-psoriasiform dermatitis or eczema. Therefore, their overexpression in PPR is plausible and suggests that the pathogenesis of PPR mirrors at least in part those of psoriasis. Further investigations will define the exact role of these cytokines in rare cutaneous side effects of anti-TNFα therapy. Our results suggest that IL-17A inhibition could be a therapeutic option in patients with anti-TNF induced psoriasis.

The relevance of serum vitamin D in psoriasis: a review

Observational research has identified low serum levels of 25-hydroxyvitamin D (25[OH]D) in many non-skeletal diseases. Whether this is causal or due to underlying illness is unknown. Low serum 25[OH]D levels are also reported in the general population. Observational and experimental studies identify that vitamin D supplementation may be beneficial in reducing all-cause mortality in elderly women, as well as cancer mortality. Our aim was to review the literature to identify the relevance of serum 25[OH]D levels in psoriasis. Forty-five studies were included in our analysis. Most of these studies identified low serum 25[OH]D levels in psoriasis patients. Evidence of causality is lacking. Treatment with phototherapy leads to an increase in serum 25[OH]D. There is little evidence that the increase in 25[OH]D after phototherapy correlates with improved disease severity. Multiple studies report an improvement in psoriasis with vitamin D supplementation. These data are predominantly from small observational or non-randomised interventional studies. Randomised controlled trials to date have had small numbers and short follow-up periods. The optimal dose of supplementation is unknown and dosing is not standardised across different studies. The definition of vitamin D insufficiency varies across studies. Low serum 25[OH]D levels may be associated with comorbidities in psoriasis patients, including metabolic syndrome and cardiovascular risk. Evidence of causation is absent. Until further high-quality evidence is available, the relevance of low serum 25[OH]D levels in psoriasis patients is unknown, as is the benefit of supplementation on disease control. Supplementation in patients with low 25[OH]D is of benefit to those at risk of impaired bone health.

Association of Serum Uric Acid Levels in Psoriasis: A Systematic Review and Meta-Analysis.

High levels of serum uric acid (SUAC) are frequently detected in patients with psoriasis. However, the relationship between psoriasis and hyperuricemia remains unknown. Here we conducted a meta-analysis to identify the SUAC levels in subjects with psoriasis and to determine whether there is an associated risk between psoriasis and hyperuricemia.A comprehensive search of the literature from January 1980 to November 2014 across 7 databases (MEDLINE, Embase, Cochrane Central Register, and 4 Chinese databases) was conducted to determine whether there is an associated risk between psoriasis and hyperuricemia.Among the 170 identified reports, 14 observational studies were included in this meta-analysis. We found a significant higher SUAC level (MD 0.68, 95% CI 0.26–1.09; P = 0.002) in patients with psoriasis in Western Europe, but no significant differences were found between the East Asia and India subgroup (MD 1.22, 95% CI –0.13–2.56; P = 0.08) or the Middle East subgroup (MD 0.48, 95% CI –0.49–1.44; P = 0.33). Similar results were obtained from the meta-analysis of SUAC levels in subjects with severe psoriasis.Our meta-analysis showed that the correlation between psoriasis and hyperuricemia was either ethnicity- or region-dependent and that patients with psoriasis in Western Europe were more likely to have hyperuricemia.

Pentraxin 3 levels in psoriasis, their relationship with disease severity and the efficacy of narrow-band ultraviolet B therapy

Pentraxin 3 levels in psoriasis, their relationship with disease severity and the efficacy of narrow-band ultraviolet B therapy

Interleukin-29 induces epithelial production of CXCR3A ligands and T-cell infiltration

Psoriasis is considered as a model for chronic immune-mediated disorders. Th17-cells are pivotal players in those diseases. Recently, we demonstrated that Th17-cells produce interleukin (IL)-29 and that IL-29 is highly present in psoriatic lesions. Whether IL-29, with its action on epithelial cells and melanocytes, contributes to psoriasis pathogenesis, was unknown so far. Analysis of IL-29-treated human keratinocytes revealed induction of the chemokines CXCL10, CXCL11, and, to a much lesser extent, CXCL9. Unlike these CXCR3A ligands, known to attract Th1-, CD8(+), NK-, and Th1/Th17 transient cells, no influence was found on chemokines attracting other immune cell populations or on molecules modulating the CXCR3A/CXCR3A ligand interaction. CXCR3A ligand expression was also induced by IL-29 in melanocytes and in epidermis models and explanted skin. Regarding other psoriasis-relevant cytokines, interferon-γ and, less potently, tumor necrosis factor-α and IL-1β shared and strengthened IL-29's capacity. Murine IL-29 counterpart injected into mouse skin provoked local CXCL10 and CXCL11 expression, T-cell infiltration, and, in consequence, skin swelling. The elevated IL-29 expression in psoriatic lesions was associated with upregulation of CXCR3A ligands compared to non-lesional skin of these patients and to the skin of healthy donors and atopic dermatitis patients, which lack IL-29 production. Importantly, neutralization of IL-29 reduced CXCR3A ligand levels in explant cultures of psoriatic lesions. Finally, elevated blood CXCL11 levels were found in psoriasis that might be useful for monitoring lesional activity of the IL-29 axis. In summary, the Th17-cytokine IL-29 induces specific chemokines and, in consequence, provokes skin infiltration of potentially pathogenic T-cells. IL-29 selectively induces CXCR3A-binding chemokines (CXCL9, CXCL10, CXCL11) in skin cells. Murine IL-29 counterpart induces skin T-cell infiltration and inflammation in mice. CXCR3A ligands are IL-29-dependently increased in lesional skin of psoriasis patients. CXCR3A ligand levels in psoriatic skin correlate with epidermal T-cell numbers. Increased blood CXCL11 levels in psoriasis may be a biomarker for local IL-29 action.

Changes of serum lipocalin-2 and retinol binding protein-4 levels in patients with psoriasis and Behçet's disease.

The correlation between psoriasis, Behcet's Disease (BD) and metabolic syndrome (MetS) is related to chronic inflammation [1, 2]. It is suggested that the inflammation that is caused by increased cytokines leads to an increase in insulin resistance and MetS. It has been shown that Lipocalin-2 (LCN-2), and Retinol-binding protein-4 (RBP-4) are related to obesity and insulin-resistance in humans [3, 4]. The current study aimed to investigate LCN-2 and RBP-4 levels in psoriasis and BD, which are [...]

25-hydroxy vitamin D and ischaemia-modified albumin levels in psoriasis and their association with disease severity

ABSTRACTPsoriasis is a T-helper-1 (TM)/TM7-mediated chronic inflammatory skin disease, characterised by hyperproliferation of keratinocytes. Psoriasis and cardiovascular disease share similar pathogenic mechanisms such as vascular endothelial cell dysfunction, oxidative stress and metabolic syndrome. 25-hydroxy vitamin D is an immune-regulatory hormone, with the ability to reduce cellular proliferation in psoriasis. Ischaemia-modified albumin (IMA) is a marker of oxidative stress. This study examined 25-hydroxy vitamin D, IMA and high-sensitivity C-reactive protein (hs-CRP) levels in patients with psoriasis, in comparison with healthy controls and their possible association with disease severity. A total of 43 cases of psoriasis and 43 controls were included in this cross-sectional study, and severity grading was performed according to psoriasis area severity index (PASI) scoring. Serum 25-hydroxy vitamin D, IMA and hs-CRP were evaluated in all study subjects. In psoriasis, 25-hydroxy vitamin D showed a significant decline, while hs-CRP and IMA levels were significantly elevated, as compared with controls. Serum 25-hydroxy vitamin D showed a significant negative correlation with PASI score. hs-CRP and IMA showed a significant positive correlation with PASI score. Significant negative correlation was observed between 25-hydroxy vitamin D and hs-CRP; 25-hydroxy vitamin D and IMA levels in psoriasis. The results indicate that psoriasis is associated with significantly lowered 25-hydroxy vitamin D levels, along with increased systemic inflammation and oxidative stress, especially in severe disease. Thus, vitamin D supplementation might reduce systemic inflammation and oxidative stress and help in delaying the pathogenesis of co-morbidities associated with psoriasis.

Assessment of pruritus in patients with psoriasis and atopic dermatitis: subjective and objective tools.

Pruritus is a major symptom of skin disease. The quest to identify a valid and reliable method to assess this important symptom has led to the development of a myriad of measurement tools. Some clinical trials using subjective measurements of itch intensity have reported itch intensity levels in psoriasis that are close to severity levels found in atopic dermatitis. Although it is possible that we have previously underestimated the severity of pruritus in psoriasis, these unexpected findings prompted us to review and evaluate these subjective methodologies. We provide an overview of the current tools available to measure itch severity, including subjective rating scales and questionnaires and objective measures of scratch activity through videotape observation and wrist actigraphy. We discuss the advantages and limitations of these methods and encourage consideration of a novel objective method of evaluation.

Increased serum C-reactive protein level in Japanese patients of psoriasis with cardio- and cerebrovascular disease.

Psoriasis is a chronic inflammatory skin disease, which may be associated with metabolic syndrome accompanied by cardio- and cerebrovascular diseases. We investigated the relation between serum C-reactive protein (CRP) and cardio- and cerebrovascular diseases in Japanese psoriasis vulgaris patients. Ninety-seven psoriasis vulgaris patients and 79 healthy controls were assessed for serum CRP levels by immunoturbidimetry. The data were analyzed in terms of Psoriasis Area and Severity Index (PASI) scores, and comorbidity of cardio- and cerebrovascular disease and metabolic syndrome. Serum CRP levels in psoriasis vulgaris patients were significantly higher than those of healthy controls. There was no significant difference between male and female CRP levels in either psoriasis or healthy controls. No correlation was detected between PASI scores and serum CRP levels, either. Psoriasis with cardio- and cerebrovascular disease showed significantly higher CRP levels compared with those without the diseases. Furthermore, psoriasis with metabolic syndrome showed significantly higher serum CRP levels than those without the metabolic syndrome. In conclusion, serum CRP level is increased in psoriasis, and may be a useful marker for the prediction of the future risk of cardio- and cerebrovascular disease.