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Hernandez-Nicols BF, Robledo-Pulido JJ, Alvarado-Navarro A. Etiopathogenesis of Psoriasis: Integration of Proposed Theories. Immunol Invest 2024; 53:348-415. [PMID: 38240030 DOI: 10.1080/08820139.2024.2302823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Psoriasis is a chronic inflammatory disease characterized by squamous and erythematous plaques on the skin and the involvement of the immune system. Global prevalence for psoriasis has been reported around 1-3% with a higher incidence in adults and similar proportions between men and women. The risk factors associated with psoriasis are both extrinsic and intrinsic, out of which a polygenic predisposition is a highlight out of the latter. Psoriasis etiology is not yet fully described, but several hypothesis have been proposed: 1) the autoimmunity hypothesis is based on the over-expression of antimicrobial peptides such as LL-37, the proteins ADAMTSL5, K17, and hsp27, or lipids synthesized by the PLA2G4D enzyme, all of which may serve as autoantigens to promote the differentiation of autoreactive lymphocytes T and unleash a chronic inflammatory response; 2) dysbiosis of skin microbiota hypothesis in psoriasis has gained relevance due to the observations of a loss of diversity and the participation of pathogenic bacteria such as Streptococcus spp. or Staphylococcus spp. the fungi Malassezia spp. or Candida spp. and the virus HPV, HCV, or HIV in psoriatic plaques; 3) the oxidative stress hypothesis, the most recent one, describes that the cell injury and the release of proinflammatory mediators and antimicrobial peptides that leads to activate of the Th1/Th17 axis observed in psoriasis is caused by a higher release of reactive oxygen species and the imbalance between oxidant and antioxidant mechanisms. This review aims to describe the mechanisms involved in the three hypotheses on the etiopathogeneses of psoriasis.
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Affiliation(s)
- Brenda Fernanda Hernandez-Nicols
- Centro de Investigación en Inmunología y Dermatología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Juan José Robledo-Pulido
- Centro de Investigación en Inmunología y Dermatología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Anabell Alvarado-Navarro
- Centro de Investigación en Inmunología y Dermatología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Chandra A, Senapati S, Roy S, Chatterjee G, Chatterjee R. Epigenome-wide DNA methylation regulates cardinal pathological features of psoriasis. Clin Epigenetics 2018; 10:108. [PMID: 30092825 PMCID: PMC6085681 DOI: 10.1186/s13148-018-0541-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/29/2018] [Indexed: 02/05/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory autoimmune skin disorder. Several studies suggested psoriasis to be a complex multifactorial disease, but the exact triggering factor is yet to be determined. Evidences suggest that in addition to genetic factors, epigenetic reprogramming is also involved in psoriasis development. Major histopathological features, like increased proliferation and abnormal differentiation of keratinocytes, and immune cell infiltrations are characteristic marks of psoriatic skin lesions. Following therapy, histopathological features as well as aberrant DNA methylation reversed to normal levels. To understand the role of DNA methylation in regulating these crucial histopathologic features, we investigated the genome-wide DNA methylation profile of psoriasis patients with different histopathological features. Results Genome-wide DNA methylation profiling of psoriatic and adjacent normal skin tissues identified several novel differentially methylated regions associated with psoriasis. Differentially methylated CpGs were significantly enriched in several psoriasis susceptibility (PSORS) regions and epigenetically regulated the expression of key pathogenic genes, even with low-CpG promoters. Top differentially methylated genes overlapped with PSORS regions including S100A9, SELENBP1, CARD14, KAZN and PTPN22 showed inverse correlation between methylation and gene expression. We identified differentially methylated genes associated with characteristic histopathological features in psoriasis. Psoriatic skin with Munro’s microabscess, a distinctive feature in psoriasis including parakeratosis and neutrophil accumulation at the stratum corneum, was enriched with differentially methylated genes involved in neutrophil chemotaxis. Rete peg elongation and focal hypergranulosis were also associated with epigenetically regulated genes, supporting the reversible nature of these characteristic features during remission and relapse of the lesions. Conclusion Our study, for the first time, indicated the possible involvement of DNA methylation in regulating the cardinal pathophysiological features in psoriasis. Common genes involved in regulation of these pathologies may be used to develop drugs for better clinical management of psoriasis. Electronic supplementary material The online version of this article (10.1186/s13148-018-0541-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aditi Chandra
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India
| | | | - Sudipta Roy
- MDDC, Lansdowne Place, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, IPGMER/SSKM Hospital, Kolkata, West Bengal, India
| | - Raghunath Chatterjee
- Human Genetics Unit, Indian Statistical Institute, 203 B. T. Road, Kolkata, West Bengal, 700108, India.
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Association of IL12B risk haplotype and lack of interaction with HLA-Cw6 among the psoriasis patients in India. J Hum Genet 2016; 62:389-395. [PMID: 27829679 DOI: 10.1038/jhg.2016.139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/04/2016] [Accepted: 10/11/2016] [Indexed: 12/14/2022]
Abstract
Psoriasis is a complex multifactorial chronic inflammatory skin disorder involving both genetic and environmental susceptibility factors. It is strongly associated with HLA-Cw6, but several studies suggested that further genetic factors may confer additional risk. We investigated the association of two single-nucleotide polymorphisms (SNPs), rs3212227 at the 3'-untranslated region and rs7709212 located at ~6.7 kb upstream from the transcription start site of IL12B gene in a case-control study comprising 1702 individuals from India. We found both SNPs were significantly associated with psoriasis (rs7709212: odds ratio (OR)=1.37, P-value=1.09 × 10-5; rs3212227: OR=1.38, P-value=8.88 × 10-6). IL12B gene was significantly upregulated in involved skin of psoriasis patients with risk genotype carriers (rs7709212_TT and rs3212227_TT) compared with non-risk genotype carriers (rs7709212_CC and rs3212227_GG). Significantly higher serum protein concentration of IL12 was also observed among risk allele carriers compared with non-risk allele carriers irrespective of the presence of HLA-Cw6 allele. Haplotype analysis suggested significant increased risk (OR=1.50, P-value=5.01 × 10-8) to the disease when both risk alleles of IL12B were present. IL12 serum protein concentration of risk haplotype (TT-TT) carriers showed significant upregulation compared with the non-risk carriers independent of HLA-Cw6 alleles. Our data suggested the association of IL12B with the psoriasis, however no evidence was observed for the epistatic effect of IL12B with HLA-Cw6 among the psoriasis patients in India.
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Zhao Z, Xie F, Zhang X, Yang J, Wang R, Yang R, Li H. Update on the association between interleukin-12 p40 gene polymorphism and risk of psoriasis: A meta-analysis. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2016.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Brito-Luna MJ, Villanueva-Quintero DG, Sandoval-Talamantes AK, Fafutis-Morris M, Graciano-Machuca O, Sanchez-Hernandez PE, Alvarado-Navarro A. Correlation of IL-12, IL-22, and IL-23 in patients with psoriasis and metabolic syndrome. Preliminary report. Cytokine 2016; 85:130-6. [PMID: 27344023 DOI: 10.1016/j.cyto.2016.06.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/20/2016] [Accepted: 06/15/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Psoriasis is an autoimmune skin disease characterised by proliferation of keratinocytes, primarily due to cytokines Th1 and Th17. This profile is involved in pathogenesis of metabolic syndrome, a frequently found comorbidity in patients with psoriasis. OBJECTIVE In this study we determine the correlation of levels of pro-inflammatory cytokines TNF-α, IL-23, IL-12, and IL-22 in patients with psoriasis with and without metabolic syndrome and clinically healthy controls. METHODS We included 55 patients with plaque psoriasis: 30 with metabolic syndrome (PPMS), 25 without metabolic syndrome (PP), 15 healthy subjects (HS) and 15 with metabolic syndrome (MS). Quantification of serum levels of IL-12, TNF-α, IL-22, and IL-23 was done by ELISA. RESULTS We observed that serum levels of IL-12 were more elevated in PP group, while the lowest levels of TNF-α were seen in HS group. IL-22 was found to be higher in PP than in PPMS (p<0.05). PP patients with PASI scores rating as severe showed higher levels of IL-12. TNF-α level analysis showed significant differences in HS group compared with the others; levels of this cytokine were lower in patients with PP and moderate PASI scores than in MS group (p<0.05). We found no correlation between cytokine levels and psoriasis or between cytokines and PASI scores. In PP group, a positive correlation was observed between IL-23 and fasting glucose (r=0.432, p<0.05), as well as a negative correlation between IL-23, IL-22, and IL-12 versus waist circumference (r=-0.504, r=-0.556 and r=-0.511, respectively; p<0.05). CONCLUSIONS Psoriasis is not just a skin disorder, but rather a condition with systemic implications, with intervention of pro-inflammatory cytokines that contribute to metabolic syndrome and other comorbidities, which in turn increases the risk of developing cardiovascular disease.
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Affiliation(s)
- M J Brito-Luna
- Jalisco Dermatology Institute "Dr. José Barba Rubio", Secretary of Health, Jalisco, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - D G Villanueva-Quintero
- Jalisco Dermatology Institute "Dr. José Barba Rubio", Secretary of Health, Jalisco, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - A K Sandoval-Talamantes
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - M Fafutis-Morris
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - O Graciano-Machuca
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
| | - P E Sanchez-Hernandez
- Immunology Laboratory, Department of Physiology, Health Sciences University Centre, University of Guadalajara, México, Sierra Mojada 950, Col. Independencia, CP 44340 Guadalajara, Jalisco, Mexico.
| | - A Alvarado-Navarro
- Centre for Research in Immunology and Dermatology, Health Sciences University Centre, University of Guadalajara, Mexico, Av. Federalismo Norte 3102, Atemajac del Valle, CP 45190 Zapopan, Jalisco, Mexico.
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Xiao JP, Wang XR, Zhang S, Wang HY, Ye L, Pan HF, Wang DG. Association between rs6887695 and 3'-untranslated region polymorphisms within the interleukin-12B gene and susceptibility to autoimmune diseases in Asian and European population: A meta-analysis. Autoimmunity 2016; 49:277-84. [PMID: 27068848 DOI: 10.3109/08916934.2016.1166215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The associations between rs6887695 and 3'-untranslated region (3'-UTR) single-nucleotide polymorphisms (SNPs) within interleukin-12B (IL-12B) and autoimmune diseases (ADs) remain controversial and inconclusive. The aim of this study was to evaluate the association between IL-12B (3'-UTR A/C and rs6887695 C/G SNPs) and ADs by meta-analysis. METHODS PubMed and EMBASE were exhaustively searched for studies on the association between IL-12B SNPs and ADs. Publication bias was examined by a funnel plot and Egger's test. The robustness of the pooled results was assessed by sensitivity analysis. A fixed- or a random-effects model was applied to calculate the pooled odds ratios (ORs). RESULTS A total of 34 studies were included in this meta-analysis. The pooled results demonstrated that IL-12B rs6887695 SNPs were significantly associated with the risk of ADs. However, there was no significant association between IL-12B 3'-UTR SNPs and ADs. When the studies were stratified by ethnicity, significant association between IL-12B 3'-UTR SNPs and ADs was observed in both Asian and European population. In addition, allele A within 3'-UTR of IL-12B gene was found to be a protective factor for T1DM, but a risk factor for psoriasis. CONCLUSION The IL-12B 3'-UTR and rs6887695 SNPs are associated with susceptibility to ADs.
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Affiliation(s)
- Jian-Ping Xiao
- a Department of Nephrology , The Second Affiliated Hospital of Anhui Medical University , Anhui , China and
| | - Xue-Rong Wang
- a Department of Nephrology , The Second Affiliated Hospital of Anhui Medical University , Anhui , China and
| | - Sen Zhang
- a Department of Nephrology , The Second Affiliated Hospital of Anhui Medical University , Anhui , China and
| | - Hai-Yan Wang
- a Department of Nephrology , The Second Affiliated Hospital of Anhui Medical University , Anhui , China and
| | - Lei Ye
- a Department of Nephrology , The Second Affiliated Hospital of Anhui Medical University , Anhui , China and
| | - Hai-Feng Pan
- b Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Anhui , China
| | - De-Guang Wang
- a Department of Nephrology , The Second Affiliated Hospital of Anhui Medical University , Anhui , China and
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