Psoriasis and Cardiovascular Risk in Children: The Usefulness of Carotid Intima-Media Thickness

Association between retinol binding protein-4 and psoriasis vulgaris: a systematic review and meta-analysis

Background

Psoriasis vulgaris is a chronic skin disease which is related to cardiovascular and metabolic diseases. In the pathogenesis of these diseases, adipokines, including retinol binding protein-4 (RBP-4), play crucial roles. Studies have also shown that RBP-4 might be a meaningful factor in psoriasis however, relying on the analysis of a single study have some drawbacks.

Objective

To evaluate the association between RBP-4 and psoriasis vulgaris more comprehensively.

Methods

Six databases were searched to obtain relevant publications. The selection of the included studies was based on a criteria. The standardized mean difference (SMD) was used for analysis. A value of p < 0.05 was defined as significance.

Results

Seven studies were included, with 271 cases and 235 controls. In the comparison between patients and controls, the merged data suggested that levels of RBP-4 were significantly higher in patients (SMD = 0.61, 95%CI: 0.14, 1.07, p < 0.05). In five studies containing the data of RBP-4 levels before and after treatment, no significance was found, either for RBP-4 levels in the after-treatment group and control group in these five studies (p > 0.05). Subgroup analysis was conducted based on the therapy method. Patients with systematic treatment showed a significant decrease of BRP-4 level after the treatment (SMD = -0.64, 95%CI: -1.26, -0.03, p < 0.05).

Conclusion

For patients with psoriasis vulgaris, RBP-4 levels are elevated, and systematic treatment can lower these levels. RBP-4 might act as a key indicator for the diagnosis, efficacy assessment, and comorbidity monitoring of the patients. Further studies with well-designed protocols and enlarged populations are still needed.

Oxidative Stress Induced by High Salt Diet—Possible Implications for Development and Clinical Manifestation of Cutaneous Inflammation and Endothelial Dysfunction in Psoriasis vulgaris

Although oxidative stress is recognized as an important effector mechanism of the immune system, uncontrolled formation of reactive oxygen and nitrogen species promotes excessive tissue damage and leads to disease development. In view of this, increased dietary salt intake has been found to damage redox systems in the vessel wall, resulting in endothelial dysfunction associated with NO uncoupling, inflammation, vascular wall remodeling and, eventually, atherosclerosis. Several studies have reported increased systemic oxidative stress accompanied by reduced antioxidant capacity following a high salt diet. In addition, vigorous ionic effects on the immune mechanisms, such as (trans)differentiation of T lymphocytes are emerging, which together with the evidence of NaCl accumulation in certain tissues warrants a re-examination of the data derived from in vitro research, in which the ionic influence was excluded. Psoriasis vulgaris (PV), as a primarily Th17-driven inflammatory skin disease with proven inflammation-induced accumulation of sodium chloride in the skin, merits our interest in the role of oxidative stress in the pathogenesis of PV, as well as in the possible beneficial effects that could be achieved through modulation of dietary salt intake and antioxidant supplementation.