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Cagan M, Donmez HG, Fadiloglu E, Beksac MS. Skin disorders in women with poor obstetric history: MTHFR polymorphisms and importance of preconceptional counseling. Curr Med Res Opin 2024; 40:905-909. [PMID: 38557333 DOI: 10.1080/03007995.2024.2337668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES This study focused on the link between skin disorders and Methylenetetrahydrofolate reductase (MTHFR) polymorphisms. METHODS Study cases were taken from a pre-conceptional care program where patients with poor obstetric history were evaluated in terms of systemic disorders including skin diseases. This retrospective cohort (n = 472) consisted of 110 (23.3%) and 362 (76.7%) women with or without skin disorders, respectively. For ease of analysis, the history of skin diseases was classified into seven categories: (1) acne/rosacea/other acneiform disorders; (2) fungal disease; (3) pruritis/xerosis; (4) psoriasis vulgaris; (5) acrochordons and other benign skin growths; (6) urticaria/dermatitis; and (7) viral diseases. RESULTS In this retrospective cohort of 472 women, we explored the impact of MTHFR A1298C and C677T polymorphisms on skin disorders. Despite similar allelic frequencies, our findings revealed a statistically significant association between the presence of MTHFR polymorphisms and skin disorders (p = .027). Subgroup analysis indicated significantly higher rates of MTHFR polymorphisms in patients with psoriasis vulgaris (p = .033) and acrochordons (p = .030), highlighting their potential relevance in specific skin disorder subtypes. CONCLUSIONS The increased prevalence of psoriasis and acrochordons among women with MTHFR deficiency underscores the complex relationship between genetic factors and dermatological health. Our findings emphasized the critical role of MTHFR polymorphisms not only in poor obstetric history but also as significant contributors to skin disorders. This dual association highlights the importance of comprehensive preconception counseling, especially customized for women affected by skin disorders.
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Affiliation(s)
- Murat Cagan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Hanife Guler Donmez
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Türkiye
| | - Erdem Fadiloglu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Mehmet Sinan Beksac
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
- Department of Obstetrics and Gynecology, Istinye University, Liv Ankara Hospital, Ankara, Türkiye
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Chen C, Liu S, Liu J, Zheng Z, Zheng Y, Lin Z, Liu Y. No causal effect of genetically determined circulating homocysteine levels on psoriasis in the European population: evidence from a Mendelian randomization study. Front Immunol 2023; 14:1288632. [PMID: 38022504 PMCID: PMC10663369 DOI: 10.3389/fimmu.2023.1288632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Although numerous studies demonstrated a link between plasma homocysteine (Hcy) levels and psoriasis, there still exists a certain level of controversy. Therefore, we conducted a Mendelian randomization study to investigate whether homocysteine plays a causative role in the development or exacerbation of psoriasis. Methods A two-sample Mendelian randomization (MR) analysis was conducted. Summary-level data for psoriasis were acquired from the latest R9 release results from the FinnGen consortium (9,267 cases and 364,071 controls). Single nucleotide polymorphisms (SNPs) robustly linked with plasma Hcy levels at the genome-wide significance threshold (p < 5 × 10-8) (18 SNPs) were recognized from the genome-wide meta-analysis on total Hcy concentrations (n = 44,147 participants) in individuals of European ancestry. MR analyses were performed utilizing the random-effect inverse variance-weighted (IVW), weighted median, and MR-Egger regression methods to estimate the associations between the ultimately filtrated SNPs and psoriasis. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. Results MR analyses revealed no causal effects of plasma Hcy levels on psoriasis [IVW: odds ratio (OR) = 0.995 (0.863-1.146), p = 0.941; weighed median method: OR = 0.985 (0.834-1.164), p = 0.862; MR-Egger regression method: OR = 0.959 (0.704-1.305), p = 0.795]. The sensitivity analyses displayed no evidence of heterogeneity and directional pleiotropy, and the causal estimates of Hcy levels were not influenced by any individual SNP. Conclusion Our study findings did not demonstrate a causal effect of genetically determined circulating Hcy levels on psoriasis.
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Affiliation(s)
- Chaojian Chen
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Shuo Liu
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Junhao Liu
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Ziqi Zheng
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Yixi Zheng
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Zhongliang Lin
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Yuchun Liu
- The Intensive Care Unit, Jieyang People’s Hospital, Jieyang, China
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Wang F, Wang Y, Kong X, Mu J, Wang Z, Yang X, Ye J. Association between psoriasis and serum apolipoprotein A1 and B: A systematic review and meta-analysis. Heliyon 2023; 9:e21168. [PMID: 37928384 PMCID: PMC10622706 DOI: 10.1016/j.heliyon.2023.e21168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Background Psoriasis has been linked to dyslipidemia. However, the magnitude of the association between psoriasis and serum apolipoproteins A1 and B remains unclear. Methods We systematically searched PubMed, Embase, and Cochrane Library databases for eligible studies published before August 10, 2023. Data were pooled using Stata software. We adopted a random-effects model for the meta-analysis. Additionally, we conducted subgroup analyses of the studies according to the psoriasis type and matched body mass index (BMI). Results Seventeen studies involving 2467 participants were included. Psoriasis was associated with decreased serum apolipoprotein A1 (weighted mean difference [WMD] = -9.05, P < 0.001) and increased serum apolipoprotein B (WMD = 11.68, P < 0.001). In subgroup analysis after matching BMI, the findings showing an association of psoriasis with serum apolipoprotein A1 (WMD = -14.07, P < 0.001) and serum apolipoprotein B (WMD = 13.07, P < 0.001) were consistent with the overall results. The subgroup analysis for the presence or absence of psoriatic arthritis showed that serum apolipoprotein A1 was significantly decreased in psoriasis with (WMD = -11.29, P < 0.001) and without arthritis (WMD = -8.69, P = 0.039); whereas serum apolipoprotein B was significantly increased in psoriasis with (WMD = 13.57, P < 0.001) and without arthritis (WMD = 9.21, P < 0.001). Conclusions Our study revealed that psoriasis is associated with decreased serum apolipoprotein A1 and increased serum apolipoprotein B levels compared with healthy controls.
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Affiliation(s)
- Fang Wang
- Dermatology Department, The First Clinical Medical College of Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yuan Wang
- Dermatology Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xiangyi Kong
- Dermatology Department, The First Clinical Medical College of Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Jing Mu
- Dermatology Department, The First Clinical Medical College of Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Zhimin Wang
- Dermatology Department, The First Clinical Medical College of Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Xuesong Yang
- Dermatology Department, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Jianzhou Ye
- Dermatology Department, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, Yunnan, China
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Wang L, Li X, Montazeri A, MacFarlane AJ, Momoli F, Duthie S, Senekal M, Eguiagaray IM, Munger R, Bennett D, Campbell H, Rubini M, McNulty H, Little J, Theodoratou E. Phenome-wide association study of genetically predicted B vitamins and homocysteine biomarkers with multiple health and disease outcomes: analysis of the UK Biobank. Am J Clin Nutr 2023; 117:564-575. [PMID: 36811473 PMCID: PMC7614280 DOI: 10.1016/j.ajcnut.2023.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Although a number of health outcomes such as CVDs, metabolic-related outcomes, neurological disorders, pregnancy outcomes, and cancers have been identified in relation to B vitamins, evidence is of uneven quality and volume, and there is uncertainty about putative causal relationships. OBJECTIVES To explore the effects of B vitamins and homocysteine on a wide range of health outcomes based on a large biorepository linking biological samples and electronic medical records. METHODS First, we performed a phenome-wide association study (PheWAS) to investigate the associations of genetically predicted plasma concentrations (genetic component of the circulating concentrations) of folate, vitamin B6, vitamin B12, and their metabolite homocysteine with a wide range of disease outcomes (including both prevalent and incident events) among 385,917 individuals in the UK Biobank. Second, 2-sample Mendelian randomization (MR) analysis was used to replicate any observed associations and detect causality. We considered MR P <0.05 as significant for replication. Third, dose-response, mediation, and bioinformatics analyses were carried out to examine any nonlinear trends and to disentangle the underlying mediating biological mechanisms for the identified associations. RESULTS In total, 1117 phenotypes were tested in each PheWAS analysis. After multiple corrections, 32 phenotypic associations of B vitamins and homocysteine were identified. Two-sample MR analysis supported that 3 of them were causal, including associations of higher plasma vitamin B6 with lower risk of calculus of kidney (OR: 0.64; 95% CI: 0.42, 0.97; P = 0.033), higher homocysteine concentration with higher risk of hypercholesterolemia (OR: 1.28, 95% CI: 1.04, 1.56; P = 0.018), and chronic kidney disease (OR: 1.32, 95% CI: 1.06, 1.63; P = 0.012). Significant nonlinear dose-response relationships were observed for the associations of folate with anemia, vitamin B12 with vitamin B-complex deficiencies, anemia and cholelithiasis, and homocysteine with cerebrovascular disease. CONCLUSIONS This study provides strong evidence for the associations of B vitamins and homocysteine with endocrine/metabolic and genitourinary disorders.
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Affiliation(s)
- Lijuan Wang
- School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Xue Li
- School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Azita Montazeri
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Susan Duthie
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Marjanne Senekal
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Ines Mesa Eguiagaray
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ron Munger
- Department of Nutrition and Food Sciences and the Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Derrick Bennett
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Michele Rubini
- Department of Neuroscience and rehabilitation, University of Ferrara, Ferrara, Italy
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom; Cancer Research UK Edinburgh Centre, The University of Edinburgh MRC Institute of Genetics and Cancer, Edinburgh, United Kingdom.
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Zhang Q, Lin J, Zhang Z, Han L, Huang Q, Zhu J, Wang B, Fang X, Zheng Z, Yawalkar N, Liang J, Yan K. MTHFR Polymorphism and Folic Acid Supplementation Influence Serum Homocysteine Levels in Psoriatic Patients Treated with Methotrexate. J Clin Med 2022; 11:jcm11154580. [PMID: 35956194 PMCID: PMC9369514 DOI: 10.3390/jcm11154580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Hyperhomocysteinemia has been reported in psoriasis. We investigated the effect of methylenetetrahydrofolate reductase (MTHFR), polymorphism and folic acid supplementation on serum homocysteine levels in psoriasis. Methods: Serum homocysteine levels were detected at baseline and at week 12 in 201 patients who were genotyped with MTHFR rs1801133 without and 93 psoriatic patients with folate supplement. Results: TT genotype carriers of MTHFR rs1801133 had significantly higher serum homocysteine levels at baseline and at week 12, a better PASI 75 response rate at week 8, and a higher PASI 90 response rate at week 12 than the CT and CC genotype carriers. Multiple regression analysis demonstrated that serum homocysteine concentration at baseline was significantly associated with sex, weight, PASI score at baseline, and the rs1801133 genotype. The significant upregulation of serum homocysteine levels after treatment with methotrexate (MTX) was only observed in male CT and CC genotype carriers and female CC genotype carriers. In contrast, folic acid supplementation significantly decreased serum homocysteine levels after MTX treatment but only in male psoriatic patients. Conclusions: The effect of MTX on serum homocysteine levels was associated with the polymorphism of MTHFR rs1801133 and sex. Folic acid supplementation only decreased serum homocysteine levels in male psoriatic patients.
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Affiliation(s)
- Qi Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jinran Lin
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhenghua Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ling Han
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qiong Huang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jie Zhu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Bing Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xu Fang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhizhong Zheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Nikhil Yawalkar
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Jun Liang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
- Correspondence: (J.L.); (K.Y.); Tel.: +86-13501748188 (K.Y.); Fax: +86-21-52887782 (K.Y.)
| | - Kexiang Yan
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
- Correspondence: (J.L.); (K.Y.); Tel.: +86-13501748188 (K.Y.); Fax: +86-21-52887782 (K.Y.)
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Relationships of Serum Homocysteine, Vitamin B12, and Folic Acid Levels with Papulopustular Rosacea Severity: A Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5479626. [PMID: 35832851 PMCID: PMC9273444 DOI: 10.1155/2022/5479626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/18/2022] [Indexed: 02/07/2023]
Abstract
Background Rosacea is a chronic inflammatory skin disease with a multifactorial etiology. Recently, associations between serum homocysteine (Hcy) levels and inflammatory skin diseases, such as psoriasis and hidradenitis suppurativa, have been reported. However, no study has explored the levels of serum Hcy, folic acid, and vitamin B12 in patients with rosacea. Objective To investigate serum Hcy, vitamin B12, and folic acid levels in patients with papulopustular rosacea (PPR), we characterized the association of these levels with PPR severity. Methods This case-control study included 138 PPR patients and 58 healthy controls. The serum levels of Hcy, vitamin B12, and folic acid were measured. A correlation was assessed between disease severity and serum levels of Hcy, vitamin B12, and folic acid. Results Serum vitamin B12 and folic acid levels were significantly lower in PPR patients than in the healthy controls (p = 0.011 and p = 0.0173, respectively). Although serum Hcy levels did not significantly differ between PPR patients and healthy controls, PPR severity was positively correlated with serum Hcy levels (p < 0.001). Conclusions Our results suggest a possible association between hyperhomocysteinemia and vitamin B12 deficiency in patients with PPR.
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Mir M, Dogra D, Koul K. Hemostatic and coagulation profile in psoriasis: A hospital-based word case control omitted Study. Indian J Dermatol 2022; 67:247-251. [DOI: 10.4103/ijd.ijd_630_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Prtina A, Rašeta Simović N, Milivojac T, Vujnić M, Grabež M, Djuric D, Stojiljković MP, Soldat Stanković V, Čolić MJ, Škrbić R. The Effect of Three-Month Vitamin D Supplementation on the Levels of Homocysteine Metabolism Markers and Inflammatory Cytokines in Sera of Psoriatic Patients. Biomolecules 2021; 11:biom11121865. [PMID: 34944509 PMCID: PMC8699679 DOI: 10.3390/biom11121865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
Psoriasis is an autoimmune and inflammatory skin disease. Psoriatic patients express higher levels of plasma homocysteine (Hcy) concentration and pro-inflammatory mediators than healthy people; this is frequently associated with vitamin D deficiency. The aim of this clinical study was to investigate the effects of high doses of vitamin D supplementation on the parameters of Hcy metabolism and cytokines in sera of psoriatic patients. This prospective study was conducted on 40 psoriatic patients who had the vitamin D deficiency. All patients received vitamin D 5000 IU/day for three months. Clinical and biochemical measurements were taken at baseline and at follow up (3 months). The results showed that the severity of clinical features, measured by the psoriasis area severity index (PASI) score, were considerably improved in patients after vitamin D supplementation. After vitamin D supplementation, most of the patients (n = 25 or 62.5%) had mild clinical form (p < 0.001). After twelve weeks of intervention period, there were significant increases in vitamin D and B12 serum levels in comparison to the levels that had been measured at the beginning of the study (56.77 ± 14.66 nmol/L and 301.08 ± 95.02 pg/mL vs. 103.85 ± 32.20 nmol/L and 362.81 ± 118.56 pg/mL, respectively; p < 0.001). Moreover, serum levels of Hcy and folate were significantly lower at the end of the study in comparison with the initial levels (12.45 ± 1.92 µmol/L and 8.01 ± 3.88 mg/mL vs. 10.38 ± 1.66 µmol/L and 6.27 ± 2.60 mg/mL, respectively). High doses of vitamin D supplementation led to a significant decrease in pro-inflammatory cytokines (IFN-ɤ, TNF-α, IL-1β, IL-6, IL-8, and IL-17) and high-sensitivity C-reactive protein (hsCRP), whereas the production of anti-inflammatory cytokines (IL-10, IL-5) was up-regulated. In conclusion, supplementation with high doses of vitamin D could be one of the possible preventive and therapeutic measures to reduce systemic inflammation in psoriatic patients.
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Affiliation(s)
- Alma Prtina
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Nela Rašeta Simović
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Tatjana Milivojac
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Milorad Vujnić
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Milkica Grabež
- Department of Preventive Medicine, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Dragan Djuric
- Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Miloš P. Stojiljković
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Valentina Soldat Stanković
- Internal Medicine Clinic, University Clinical Center of the Republic of Srpska, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Miodrag J. Čolić
- Medical Faculty Foča, University of East Sarajevo, 73300 Foča, Bosnia and Herzegovina;
| | - Ranko Škrbić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
- Correspondence: ; Tel.: +387-51-234-101
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Bazid H, Hammam M, Aboashour M, Ellaithy M, Mostafa M, Holah NS. Study of serum level and immunohistochemical expression of von Willebrand factor in psoriasis. J Immunoassay Immunochem 2021; 43:54-66. [PMID: 34225585 DOI: 10.1080/15321819.2021.1941097] [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: 01/11/2023]
Abstract
Von Willebrand factor (vWF) is angiogenic, hypercoagulable, and inflammatory marker that increases inflammation and vasculitis and reflects endothelial cells dysfunction. vWF could play a role in psoriasis pathogenesis and prognosis. To assess the serum and immunohistochemical expression of vWF in psoriasis to evaluate its possible role in disease pathogenesis and prognosis. This case-control study included 30 cases of psoriasis vulgaris with different degrees of severity and 30 age- and sex-matched healthy controls. Serum level of vWF was measured by ELISA. Immunohistochemical staining of skin biopsies for von Willebrand factor (vVF) antibody was done. Significantly higher vWF serum level in cases (24.3 ± 14.0) vs (15.7 ± 6.85) for controls (p = .002) and significantly higher epidermal expression intensity in patients than in controls (P value = .001). There was also significant difference between cases and control regarding the dermal expression of vWF in inflammatory cells, adenexa, and endothelial cell (P value = .001, 0.065, 0.004, respectively,). Von Willebrand factor could be used as an indicator of the hypercoaguable state which may develop in patients with psoriasis and may serve as a new therapeutic target in psoriasis treatment protocols. Patients with psoriasis especially those with high PASI score are more prone to develop vascular complication. Serum vWF could be used as a better marker for psoriasis severity than PASI which is considered the gold-standard noninvasive assessment but it only measures skin involvement, while psoriasis is considered a systemic disease.
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Affiliation(s)
- Heba Bazid
- Dermatology and Andrology Department, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
| | - Mostafa Hammam
- Department of Dermatology and Andrology, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
| | - Marwa Aboashour
- Department of Dermatology and Andrology, Menoufia Egypt, Sadat Hospital, Shebin El-Kom, Egypt
| | - Manal Ellaithy
- Medical Biochemistry department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Mohammed Mostafa
- Clinical Pathology department, National Research Center, Cairo, Egypt
| | - Nanis Shawky Holah
- Pathology Department, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
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Gene Expression of PSORI-CM01 and Yinxieling in the Treatment of Psoriasis Vulgaris. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021. [DOI: 10.1155/2021/6627286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. This study aimed to explore the mechanisms of action of the PSORI-CM01 and Yinxieling formulas in the treatment of patients with psoriasis vulgaris by analyzing gene expression in peripheral blood mononuclear cells (PBMCs). Methods. PBMC samples were collected from 21 patients before and after treatment. The study included nine patients in the PSORI-CM01 treatment group, 12 patients in the Yinxieling treatment group, and nine patients in the healthy control group. Gene expression levels in PBMCs were determined using the Affymetrix gene chip technology. Results. In the PSORI-CM01 group before and after treatment, a total of 668 differentially expressed genes were found, of which 445 were upregulated and 223 were downregulated. Before and after Yinxieling treatment, 657 differentially expressed genes were found, of which 168 were upregulated and 489 were downregulated. Venn analysis showed that 78 genes were not differentially expressed in the PSORI-CM01 group and 74 were not differentially expressed in the Yinxieling group compared with those in the controls. Among these genes, 72 genes were common to both groups, which were the genes on which the two drugs acted jointly. The results of KEGG analysis and Venn analysis on the signalling pathways of drug action in treatment groups showed that haemostasis and pathways involving Rho GTPases were common signalling pathways of drug action in the two groups. Conclusions. By a comparative analysis of the treatment groups, we found that both drugs have a positive effect on patients with psoriasis vulgaris, primarily by regulating the pathways related to platelet activation, aggregation, and blood coagulation. Trial registration: ChiCTR, ChiCTR-TRC-14005185, Registered 8 August 2014, http://www.chictr.org.cn/showproj.aspx?proj=4390
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11
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Insight into the Metabolite Pattern of Psoriasis: Correlation among Homocysteine, Methionine, and Polyamines. Symmetry (Basel) 2021. [DOI: 10.3390/sym13040606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is an incurable dermatological disorder, characterized by increased epidermal cell proliferation. Numerous studies have focused on the modulation of polyamine (PA) metabolism in psoriatic lesions, as well as the relationship between serum homocysteine (Hcy) levels and psoriasis severity. The correlation between Hcy and PA levels has not been investigated, although both of them depend on methionine (Met) loading. The aim of this study was to examine Met, Hcy, and polyamine levels in serum, saliva, lesions, and non-affected skin to investigate the eventual relationship between their levels in skin samples and to assess the correlation of each metabolite among the tested samples. This study was conducted on 24 patients with plaque-form psoriasis vulgaris. The original LC-MS/MS method was used for quantification of analytes. Hyperhomocysteinemia was observed and the serum levels of spermidine (Spd) and spermine (Spm) were also found to be elevated. A significant increase in Met (p < 0.05) and Spm (p < 0.001) concentrations in the psoriatic plaques were found, when compared to the non-affected skin. Significant correlations were established between all polyamines levels and between methionine and spermine in both types of cutaneous samples. This study illustrates the tight relationship between Met and Polyamine levels in epidermis of psoriatic patients. Our results could be helpful in psoriasis treatment, highlighting the importance of the balanced protein diet and intake of vitamins B12 and B9.
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Vilar R, Lukowski SW, Garieri M, Di Sanza C, Neerman-Arbez M, Fish RJ. Chemical Modulators of Fibrinogen Production and Their Impact on Venous Thrombosis. Thromb Haemost 2020; 121:433-448. [PMID: 33302304 DOI: 10.1055/s-0040-1718414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Thrombosis is a leading cause of morbidity and mortality. Fibrinogen, the soluble substrate for fibrin-based clotting, has a central role in haemostasis and thrombosis and its plasma concentration correlates with cardiovascular disease event risk and a prothrombotic state in experimental models. We aimed to identify chemical entities capable of changing fibrinogen production and test their impact on experimental thrombosis. A total of 1,280 bioactive compounds were screened for their ability to alter fibrinogen production by hepatocyte-derived cancer cells and a selected panel was tested in zebrafish larvae. Anthralin and all-trans retinoic acid (RA) were identified as fibrinogen-lowering and fibrinogen-increasing moieties, respectively. In zebrafish larvae, anthralin prolonged laser-induced venous- occlusion times and reduced thrombocyte accumulation at injury sites. RA had opposite effects. Treatment with RA, a nuclear receptor ligand, increased fibrinogen mRNA levels. Using an antisense morpholino oligonucleotide to deplete zebrafish fibrinogen, we correlated a shortening of laser-induced venous thrombosis times with RA treatment and fibrinogen protein levels. Anthralin had little effect on fibrinogen mRNA in zebrafish larvae, despite leading to lower detectable fibrinogen. Therefore, we made a proteomic scan of anthralin-treated cells and larvae. A reduced representation of proteins linked to the canonical secretory pathway was detected, suggesting that anthralin affects protein secretion. In summary, we found that chemical modulation of fibrinogen levels correlates with measured effects on experimental venous thrombosis and could be investigated as a therapeutic avenue for thrombosis prevention.
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Affiliation(s)
- Rui Vilar
- Department of Genetic Medicine and Development, University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - Samuel W Lukowski
- Department of Genetic Medicine and Development, University of Geneva Faculty of Medicine, Geneva, Switzerland.,Institute for Molecular Bioscience, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Marco Garieri
- Department of Genetic Medicine and Development, University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - Corinne Di Sanza
- Department of Genetic Medicine and Development, University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - Marguerite Neerman-Arbez
- Department of Genetic Medicine and Development, University of Geneva Faculty of Medicine, Geneva, Switzerland.,iGE3, Institute of Genetics and Genomics in Geneva, Geneva, Switzerland
| | - Richard J Fish
- Department of Genetic Medicine and Development, University of Geneva Faculty of Medicine, Geneva, Switzerland
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Abstract
Psoriasis is caused by a complex interplay among the immune system, genetic background, autoantigens, and environmental factors. Recent studies have demonstrated that patients with psoriasis have a significantly higher serum homocysteine (Hcy) level and a higher prevalence of hyperhomocysteinaemia (HHcy). Insufficiency of folic acid and vitamin B12 can be a cause of HHcy in psoriasis. Hcy may promote the immuno-inflammatory process in the pathogenesis of psoriasis by activating Th1 and Th17 cells and neutrophils, while suppressing regulatory T cells. Moreover, Hcy can drive the immuno-inflammatory process by enhancing the production of the pro-inflammatory cytokines in related to psoriasis. Hcy can induce nuclear factor kappa B activation, which is critical in the immunopathogenesis of psoriasis. There may be a link between the oxidative stress state in psoriasis and the effect of HHcy. Hydrogen sulfide (H2S) may play a protective role in the pathogenesis of psoriasis and the deficiency of H2S in psoriasis may be caused by HHcy. As the role of Hcy in the pathogenesis of psoriasis is most likely established, Hcy can be a potential therapeutic target for the treatment of psoriasis. Systemic folinate calcium, a folic acid derivative, and topical vitamin B12 have found to be effective in treating psoriasis.
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Tomita LY, da Costa AC, Andreoni S, Oyafuso LK, D’Almeida V, Fonseca FL, Rocha AC, Kobata C. Folate Nutritional Status among Psoriasis Patients not Exposed to Antifolate Drug. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401314666180702100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Folic acid fortification program has been established to prevent tube defects.
However, concern has been raised among patients using anti-folate drug, i.e. psoriatic patients, a
common, chronic, autoimmune inflammatory skin disease associated with obesity and smoking.
Objective:
To investigate dietary and circulating folate, vitamin B12 (B12) and homocysteine (hcy) in
psoriatic subjects exposed to the national mandatory folic acid fortification program.
Methods:
Cross-sectional study using the Food Frequency Questionnaire, plasma folate, B12, hcy and
psoriasis severity using the Psoriasis Area and Severity Index score. Median, interquartile ranges
(IQRs) and linear regression models were conducted to investigate factors associated with plasma folate,
B12 and hcy.
Results:
82 (73%) mild psoriasis, 18 (16%) moderate and 12 (11%) severe psoriasis. 58% female,
61% non-white, 31% former smokers, and 20% current smokers. Median (IQRs) were 51 (40, 60)
years. Only 32% reached the Estimated Average Requirement of folate intake. Folate and B12 deficiencies
were observed in 9% and 6% of the blood sample respectively, but hyperhomocysteinaemia
in 21%. Severity of psoriasis was negatively correlated with folate and B12 concentrations. In a multiple
linear regression model, folate intake contributed positively to 14% of serum folate, and negative
predictors were psoriasis severity, smoking habits and saturated fatty acid explaining 29% of circulating
folate.
Conclusion:
Only one third reached dietary intake of folate, but deficiencies of folate and B12 were
low. Psoriasis severity was negatively correlated with circulating folate and B12. Stopping smoking
and a folate rich diet may be important targets for managing psoriasis.
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Affiliation(s)
- Luciana Y. Tomita
- Departamento de Medicina Preventiva, Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | | | - Solange Andreoni
- Departamento de Medicina Preventiva, Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | | | - Vânia D’Almeida
- Departamento de Psicobiologia, EPM, UNIFESP, Sao Paulo, Brazil
| | | | - Ana C.L. Rocha
- Departamento de Medicina Preventiva, Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
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Oh J, An HJ, Kim JO, Jun HH, Kim WR, Kim EJ, Oh D, Kim JW, Kim NK. Association between Five Common Plasminogen Activator Inhibitor-1 ( PAI-1) Gene Polymorphisms and Colorectal Cancer Susceptibility. Int J Mol Sci 2020; 21:ijms21124334. [PMID: 32570732 PMCID: PMC7352892 DOI: 10.3390/ijms21124334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/31/2022] Open
Abstract
The plasminogen activator inhibitor-1 (PAI-1) is expressed in many cancer cell types and modulates cancer growth, invasion, and angiogenesis. The present study investigated the association between five PAI-1 gene polymorphisms and colorectal cancer (CRC) risk. Five PAI-1 polymorphisms (−844G > A [rs2227631], −675 4G > 5G [rs1799889], +43G > A [rs6092], +9785G > A [rs2227694], and +11053T > G [rs7242]) were genotyped using a polymerase chain reaction-restriction fragment length polymorphism assay in 459 CRC cases and 416 controls. Increased CRC risk was more frequently associated with PAI-1 −675 5G5G polymorphism than with 4G4G (adjusted odds ratio (AOR) = 1.556; 95% confidence interval (CI): 1.012–2.391; p = 0.04). In contrast, for the PAI-1 +11053 polymorphism, we found a lower risk of CRC with the GG genotype (AOR = 0.620; 95% CI: 0.413–0.932; p = 0.02) than with the TT genotype, as well as for recessive carriers (TT + TG vs. GG, AOR = 0.662; 95% CI: 0.469–0.933; p = 0.02). The +43AA genotype was associated with lower overall survival (OS) than the +43GG genotype. Our results suggest that the PAI-1 genotype plays a role in CRC risk. This is the first study to identify an association between five PAI-1 polymorphisms and CRC incidence worldwide.
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Affiliation(s)
- Jisu Oh
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (J.O.); (D.O.)
| | - Hui Jeong An
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.J.A.); (J.O.K.)
| | - Jung Oh Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.J.A.); (J.O.K.)
| | - Hak Hoon Jun
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (H.H.J.); (W.R.K.)
| | - Woo Ram Kim
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (H.H.J.); (W.R.K.)
| | - Eo Jin Kim
- Department on Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Doyeun Oh
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (J.O.); (D.O.)
| | - Jong Woo Kim
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea; (H.H.J.); (W.R.K.)
- Correspondence: (J.W.K.); (N.K.K.); Tel.: +82-31-881-7137 (N.K.K.); Fax: +82-31-881-7249 (N.K.K.)
| | - Nam Keun Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.J.A.); (J.O.K.)
- Correspondence: (J.W.K.); (N.K.K.); Tel.: +82-31-881-7137 (N.K.K.); Fax: +82-31-881-7249 (N.K.K.)
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Paraoxonase-1 and other factors related to oxidative stress in psoriasis. Postepy Dermatol Alergol 2020; 37:92-96. [PMID: 32467691 PMCID: PMC7247073 DOI: 10.5114/ada.2020.93386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/01/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction Psoriasis is considered as a risk factor for atherosclerosis and contributes to myocardial infarction, ischemic heart disease and brain stroke. Aim To estimate the atherogenic potential of psoriasis by analysing antioxidative and prooxidative factors (paraoxonase-1, α-tocopherol, uric acid, homocysteine), compare levels of these parameters between groups of psoriatic patients and healthy individuals as well as to analyse the impact of psoriasis severity and duration on the factors under the study and to define correlation between the marked factors and patients' lifestyles, body mass index (BMI) and abdominal circumference. Material and methods The investigated group consisted of 66 patients with psoriasis vulgaris, while the control group comprised 30 persons. Both groups were comparable as regards their age, sex and BMI as well as abdominal circumference. Results A significantly lower activity of paraoxonase-1 (p < 0.001), level of tocopherol (p < 0.05) and significantly higher concentration of homocysteine (p < 0.01), uric acid (p < 0.05) were found in patients with psoriasis as compared to the reference group. A higher homocysteine level occurs in patients with a negative family history of psoriasis (p < 0.05). In the group of patients with psoriasis and metabolic syndrome, the uric acid level was significantly higher (p < 0.05). Concentration of uric acid correlated negatively with the abdominal circumference value (p < 0.001). Conclusions Psoriasis promotes arteriosclerosis development by decreasing the levels of antiatherogenic and increasing the levels of proatherogenic agents. Adverse changes in psoriatic patients involve activity of paraoxonase-1, levels of α-tocopherol, uric acid, homocysteine as compared to healthy individuals selected by their age, BMI and abdominal circumference value.
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Teixeira GG, Mari NL, de Paula JCC, Cataldi de Alcantara C, Flauzino T, Lozovoy MAB, Martin LMM, Reiche EMV, Maes M, Dichi I, Simão ANC. Cell adhesion molecules, plasminogen activator inhibitor type 1, and metabolic syndrome in patients with psoriasis. Clin Exp Med 2020; 20:39-48. [PMID: 31758356 DOI: 10.1007/s10238-019-00595-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/09/2019] [Indexed: 12/21/2022]
Abstract
The objective of this study is to delineate the cellular adhesion molecule (CAM) profile and plasminogen activator inhibitor type 1 (PAI-1), and their association with metabolic syndrome (MetS) and carbohydrate metabolism biomarkers in psoriasis patients with mild and moderate severity. Sixty-seven patients with psoriasis as well as 102 healthy subjects were recruited. Insulin and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), but not glucose, were significantly higher in psoriasis than in controls. Psoriasis was characterized by increased plasma levels of platelet endothelial cell adhesion molecule 1 (PECAM-1), vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), E-selectin, and PAI-1 as compared with controls. Psoriasis diagnosis could explain 59.0% of CAM and PAI-1 variance, with a particularly strong impact on E-selectin (45.6%), VCAM-1 (32.7%), and PAI-1 (24.8%). Subjects with MetS showed significantly higher E-selectin and PAI-1 than those without MetS. Using VCAM-1, E-selectin, PAI-1 (all positively), and P-selectin (inversely) in a binary regression equation, it was found that 87.6% of all patients were correctly classified with a sensitivity of 92.5% and a specificity of 84.3%. CAM and PAI-1 were correlated with carbohydrate metabolism biomarkers (glucose, insulin, and HOMA-IR). In conclusion, CAM levels are associated with psoriasis diagnosis and MetS may influence E-selectin and PAI-1 concentrations. More studies are needed to verify the causality among these factors, as well as their relation to the different degrees of disease severity.
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Affiliation(s)
| | - Naiara Lourenço Mari
- Research Laboratory in Applied Immunology, University of Londrina, Londrina, Brazil
| | | | | | - Tamires Flauzino
- Research Laboratory in Applied Immunology, University of Londrina, Londrina, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Research Laboratory in Applied Immunology, University of Londrina, Londrina, Brazil
- Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Avenida Robert Koch, No. 60, Londrina, PR, CEP: 86038-440, Brazil
| | - Ligia Márcia Mário Martin
- Department of Dermatology, University of Londrina, Londrina, PR, Brazil
- Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil
| | - Edna Maria Vissoci Reiche
- Research Laboratory in Applied Immunology, University of Londrina, Londrina, Brazil
- Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Avenida Robert Koch, No. 60, Londrina, PR, CEP: 86038-440, Brazil
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Isaias Dichi
- Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil
| | - Andréa Name Colado Simão
- Research Laboratory in Applied Immunology, University of Londrina, Londrina, Brazil.
- Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Avenida Robert Koch, No. 60, Londrina, PR, CEP: 86038-440, Brazil.
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Evaluation of serum lipid, lipoprotein, and apolipoprotein levels in psoriatic patients: a systematic review and meta-analysis of case-control studies. Postepy Dermatol Alergol 2019; 36:692-702. [PMID: 31997997 PMCID: PMC6986295 DOI: 10.5114/ada.2019.91420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/11/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Psoriasis is a T cell-mediated inflammatory skin disease in which fatty acids may be a link between psoriasis and its comorbidity. Aim The present meta-analysis aimed to evaluate lipid, lipoprotein, and apolipoprotein levels in the psoriatic patients compared with the control subjects. Material and methods Four databases, including Web of Science, Scopus, PubMed, and Cochrane Library were searched until July 2017. All records analysed were case-control studies. The quality of the questionnaires was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was done by Rev Man 5.3 using mean difference (MD) and 95% confidence intervals (CIs). Results Out of 580 studies identified in four databases, 49 studies were included and analysed in this meta-analysis. The results showed that MD of total cholesterol, triglyceride, LDL, VLDL, HDL, Lp(a), Apo A1, and Apo B levels in the patients compared with the controls were (MD = 13.74 mg/dl; 95% CI: 7.72-19.75; p< 0.00001), (MD = 26.04 mg/dl; 95% CI: 20.77-31.31; p< 0.00001), (MD = 11.41 mg/dl; 95% CI: 6.26-16.57; p< 0.0001), (MD = 4.82 mg/dl; 95% CI: 3.63-6.00; p< 0.00001), (MD = -2.78 mg/dl; 95% CI: -4.53 - -1.03; p< 0.002), (MD = 8.51 mg/dl; 95% CI: 4.86-12.17; p< 0.0001), (MD = -6.60 mg/dl; 95% CI: -13.96 - 0.75; p< 0.08), and (MD = 9.70 mg/dl; 95% CI: 3.02-16.39; p< 0.004), respectively. Conclusions This meta-analysis identified abnormality of serum lipid, lipoprotein, and apolipoproteinprofiles in psoriatic patients compared with the controls as well as possibly a greater risk of atherosclerosis and cardiovascular (CV) accidents in the patients.
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Evaluation of plasma levels of tissue factor and tissue factor pathway inhibitor in patients with psoriasis. Postepy Dermatol Alergol 2019; 36:442-448. [PMID: 31616219 PMCID: PMC6791144 DOI: 10.5114/ada.2019.87447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/25/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction Psoriasis is a chronic, recurrent, inflammatory skin disorder with systemic involvement. It has recently been established that psoriasis is associated with an increased cardiovascular risk. Chronic skin-specific inflammation may promote atherosclerosis. Myocardial infarction or stroke can also be a result of underlying haemostasis disorders. Disorders in fibrinolysis and thrombosis in patients with psoriasis have been observed by many authors. Aim This study points to the key role played by the tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the extrinsic pathway of blood coagulation and the potential influence of microvascular disorders in inflamed psoriatic skin on TF and TFPI activity. Material and methods The study included 47 patients with active psoriasis vulgaris, hospitalized in the Dermatological Ward of the Regional Specialist Hospital, Research and Development Centre in Wroclaw, as well as 18 people from the control group. Results There were significant differences in the blood concentrations of TF and TFPI in patients with psoriasis when compared to the control group. A low TFPI concentration in psoriatic patients may indicate an increased risk of atherosclerosis. Interpretation of a decreased level of TF in patients with psoriasis is difficult because it seems to be at odds with observations among patients with other atherosclerosis risk factors such as hypertension, hyperlipidaemia, diabetes or smoking. Conclusions It appears that further studies are necessary to explain this problem, perhaps to include an evaluation of TF levels in psoriatic skin.
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Kim JE, Lee HJ, Lee JS, Whang KU, Park YL, Lee SY, Kim HJ. Association between Homocysteine Levels and Psoriasis: A Meta-Analysis. Ann Dermatol 2019; 31:378-386. [PMID: 33911615 PMCID: PMC7992747 DOI: 10.5021/ad.2019.31.4.378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 12/10/2018] [Accepted: 12/17/2018] [Indexed: 02/05/2023] Open
Abstract
Background Psoriasis is a multifactorial disease associated with an increased risk for metabolic syndrome and cardiovascular diseases. Elevated levels of homocysteine (Hcy) are a marker of cardiovascular risk. Several studies have evaluated the associations between psoriasis and Hcy levels; however, the results remain inconclusive. Objective We performed a systematic review of the literature and a meta-analysis to better understand the relationship between psoriasis and Hcy. Methods Five scientific databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) were searched to identify relevant studies. A review of 307 publications identified 16 studies that directly assessed plasma levels of Hcy in psoriasis patients. Results A total of 16 studies including 2,091 subjects were included in the meta-analysis. Hcy levels were significantly higher in psoriasis patients relative to healthy controls (weighted mean difference [WMD], 3.30; 95% confidence interval [CI], 1.58∼5.02; I2=82.1%). Subgroup analyses revealed that patients with higher mean psoriasis area severity index (PASI) scores (PASI>10) had significantly higher Hcy levels compared to healthy controls (WMD, 4.17; 95% CI, 1.18∼7.16; I2=88.3%), whereas patients with lower mean PASI scores (PASI ≤10) had not (WMD, 0.76; 95% CI, −1.84∼3.35; I2=72.2%). Conclusion This meta-analysis found that psoriasis patients, in particular those with PASI >10, had significantly higher Hcy levels compared to healthy controls. Further research is needed to determine the association between Hcy levels and psoriasis severity.
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Affiliation(s)
- Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ho Jung Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jong Suk Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Kyu Uang Whang
- Department of Dermatology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sung Yul Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Beranek M, Malkova A, Fiala Z, Kremlacek J, Hamakova K, Zaloudkova L, Borsky P, Adamus T, Palicka V, Borska L. Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms. Int J Mol Sci 2019; 20:ijms20081908. [PMID: 30999684 PMCID: PMC6514650 DOI: 10.3390/ijms20081908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022] Open
Abstract
Goeckerman therapy (GT) of psoriasis vulgaris is based on the application of crude coal tar and ultraviolet radiation. We investigated DNA damage by the number of micronucleated binucleated cells (MNBC) in lymphocytes, serum homocysteine, vitamin B12, folic acid, and two polymorphisms (C677T and A1298C) in the MTHFR gene in 35 patients with exacerbated psoriasis vulgaris classified according to the psoriasis area and severity index (PASI) score and treated by GT. The median of PASI score decreased from nineteen to five, and MNBC increased from 10 to 18‰ after GT (p < 0.001 in both cases). Correlations of MNBC with homocysteine (Spearman’s rho = 0.420, p = 0.012) and vitamin B12 (rho = −0.389, p = 0.021) before the therapy were observed. Hyperhomocysteinemia was an independent predictor of genotoxicity (OR 9.91; 95% CI, 2.09–55.67; p = 0.003). Homocysteine was higher in females than in males (13 vs. 12 µmol/L, p = 0.045). In contrast, vitamin B12 levels in the females were lower than in the males (160 vs. 192 pmol/L, p = 0.047). Vitamin B12 in the females were negatively influenced by smoking status (160 pmol/L in smokers vs. 192 pmol/L in non-smokers, p = 0.025). A significantly higher MNBC was found in CC homozygous patients (A1298C polymorphism) than in AC heterozygotes (32 vs. 16‰, p = 0.005) and AA homozygotes (32 vs. 18‰, p = 0.036). Our data showed that homocysteine participates in the pathogenesis of psoriasis. Its serum levels correlated with MNBC and allowed the prediction of DNA damage to appear within GT. Both micronutrients status and homocysteine metabolic pathway contribute to the genotoxicity of GT.
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Affiliation(s)
- Martin Beranek
- Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University, 50005 Hradec Kralove, Czech Republic.
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Kralove, Charles University, 50005 Hradec Kralove, Czech Republic.
| | - Andrea Malkova
- Institute of Hygiene and Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic.
| | - Zdenek Fiala
- Institute of Hygiene and Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic.
| | - Jan Kremlacek
- Institute of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic.
| | - Kvetoslava Hamakova
- Clinic of Dermatology and Venereology, University Hospital Hradec Kralove, 50005 Hradec Kralove, Czech Republic.
| | - Lenka Zaloudkova
- Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University, 50005 Hradec Kralove, Czech Republic.
| | - Pavel Borsky
- Institute of Hygiene and Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic.
| | - Tomas Adamus
- Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic.
| | - Vladimir Palicka
- Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University, 50005 Hradec Kralove, Czech Republic.
| | - Lenka Borska
- Institute of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University, 50003 Hradec Kralove, Czech Republic.
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Serum homocysteine level, vitamin B12 levels, and erythrocyte folate in psoriasis: A case-control study. Int J Womens Dermatol 2019; 5:171-174. [PMID: 31360751 PMCID: PMC6637066 DOI: 10.1016/j.ijwd.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 12/09/2018] [Accepted: 12/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background One of the most important organ involvements in psoriasis is atherosclerotic cardiovascular disease. Homocysteine is known to have atherogenic properties, but some inconsistency exists in the literature about its probable role as a risk factor of cardiovascular disorder in patients with psoriasis. Objective Because of some controversies, we compared homocysteine levels and related parameters of metabolic cycles in patients with psoriasis and healthy individuals. Methods This case-control study was conducted on 50 patients with psoriasis and 50 healthy individuals as the controls. Serum homocysteine, vitamin B12 levels, and erythrocyte folate concentrations were checked in all participants. Results Mean serum homocysteine, erythrocyte folate, and vitamin B12 levels did not show any significant difference between the two groups (p > .05), but interestingly, in patients with psoriasis, men had a significantly higher incidence of hyperhomocysteinemia and lower levels of erythrocyte folate (p = .14). Overall, there is no significant difference in serum levels of homocysteine and metabolic-related parameters between the case and control group. There was no significant relationship between the severity of psoriasis and the body mass index of patients (p > .05). Conclusion Patients with psoriasis had a higher body mass index and higher levels of homocysteine in men. Hyperhomocysteinemia could be a predisposing factor of cardiovascular events, but more evaluations as a part of metabolic syndrome in patients with psoriasis are needed.
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Huraib GB, Harthi FA, Arfin M, Khlaiwi AA, Rizvi S, Al-Asmari A. Methylenetetrahydrofolate Reductase C677T Gene Polymorphism as Risk Factor for Psoriasis in Saudis. Biomark Insights 2019; 14:1177271919830973. [PMID: 30828245 PMCID: PMC6390219 DOI: 10.1177/1177271919830973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/20/2019] [Indexed: 12/13/2022] Open
Abstract
Methylenetetrahydrofolate reductase (MTHFR) has been linked with
the etiopathogenesis of psoriasis with inconsistent results.
Methylenetetrahydrofolate reductase C677T polymorphism was
evaluated in 106 Saudi psoriasis vulgaris patients and 280 matched healthy
controls using PCR-RFLP (restriction fragment length plymorphism) technique. The
cardiovascular risk factors were also compared in cases and controls. Allele T
and genotypes CT and TT were found to be increased while allele C and genotype
CC significantly decreased in psoriasis patients as compared with controls
(P < .001). These results showed that the T-allele and
T-containing genotypes (TT, CT) of MTHFR C677T are
significantly linked with psoriasis susceptibility while C-allele and CC
genotype are protective for it. Body mass index, fasting glucose, total
cholesterol, low-density lipoprotein, triglycerides, and C-reactive protein,
known markers for cardiovascular diseases, were found to be significantly
elevated in the patient group as compared with the controls. It is concluded
that the MTHFR C677T polymorphism increases psoriasis risk in
Saudi patients.
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Affiliation(s)
| | - Fahad Al Harthi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Scientific Research Center, Medical Services Department of Armed Forces, Riyadh, Saudi Arabia
| | - Ahmad Al Khlaiwi
- Medical Services Department of Armed Forces, Riyadh, Saudi Arabia
| | - Sadaf Rizvi
- Scientific Research Center, Medical Services Department of Armed Forces, Riyadh, Saudi Arabia
| | - Abdulrahman Al-Asmari
- Scientific Research Center, Medical Services Department of Armed Forces, Riyadh, Saudi Arabia
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Manolis AA, Manolis TA, Melita H, Manolis AS. Psoriasis and cardiovascular disease: the elusive link. Int Rev Immunol 2018; 38:33-54. [PMID: 30457023 DOI: 10.1080/08830185.2018.1539084] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psoriasis, an autoimmune inflammatory disease, with its most common coexisting condition, psoriatic arthritis, seem to be more than just a local skin or joint disease, as evidence has accumulated over the years that it is associated with cardiovascular disease (CVD), which may confer an increased cardiovascular event and death rate. The data come mostly from observational studies and meta-analyses and indicate a potential pathogenetic link between these two systemic diseases, however definite proof of this detrimental relationship awaits further prospective studies. Newer anti-psoriatic biologic therapies seem to confer a cardiovascular benefit, but this needs future randomized controlled studies to confirm. All these intricate issues of a potential link between psoriasis and CVD are discussed and elaborated in this overview, in an attempt to shed further light on pivotal aspects of the association between psoriasis and CVD.
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Affiliation(s)
| | | | - Helen Melita
- c Onassis Cardiac Surgery Center , Athens , Greece
| | - Antonis S Manolis
- d Third Department of Cardiology , Athens University School of Medicine , Athens , Greece
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Tsai TY, Yen H, Huang YC. Serum homocysteine, folate and vitamin B 12 levels in patients with psoriasis: a systematic review and meta-analysis. Br J Dermatol 2018; 180:382-389. [PMID: 30074615 DOI: 10.1111/bjd.17034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients with psoriasis are at increased risk for cardiovascular comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to cardiovascular risks in patients with psoriasis but had conflicting conclusions. OBJECTIVES To perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. METHODS Online databases were searched on 15 February 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between patients with psoriasis and controls. A random effects model was adopted to estimate odds ratios for dichotomous data and standardized mean differences (SMDs) for continuous data. RESULTS A comprehensive literature search identified 24 studies eligible for inclusion. Compared with controls, patients with psoriasis had a significantly higher serum homocysteine level [SMD 0·41, 95% confidence interval (CI) 0·21-0·61; I2 = 76·7%, 18 studies], a higher prevalence of hyperhomocysteinaemia (odds ratio 3·48, 95% CI 2·08-5·83; I2 = 41·1%, seven studies) and a lower serum folate level (SMD -0·94, 95% CI -1·49 to -0·40; I2 = 95·6%, 14 studies). However, there was no difference in serum vitamin B12 levels between patients with psoriasis and the control group (SMD 0·004, 95% CI -0·49 to 0·50; I2 = 92%, 11 studies). Metaregression analysis revealed a significant inverse correlation between the SMD of homocysteine levels and folate levels. CONCLUSIONS Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.
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Affiliation(s)
- T-Y Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - H Yen
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Y-C Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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26
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Psoriasis: Which therapy for which patient: Psoriasis comorbidities and preferred systemic agents. J Am Acad Dermatol 2018; 80:27-40. [PMID: 30017705 DOI: 10.1016/j.jaad.2018.06.057] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/24/2018] [Accepted: 06/01/2018] [Indexed: 12/15/2022]
Abstract
Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities, such as psoriatic arthritis, Crohn's disease, malignancy, obesity, and cardiovascular diseases. These factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis that has led to identification of new therapeutic targets. Several new drugs have gained approval by the US Food and Drug Administration, expanding the psoriasis armamentarium, but still a large number of patients continue to be untreated or undertreated. Treatment regimens for psoriasis patients should be tailored to meet the specific needs based on disease severity, the impact on quality of life, the response to previous therapies, and the presence of comorbidities. The first article in this continuing medical education series focuses on specific comorbidities and provides insights to choose appropriate systemic treatment in patients with moderate to severe psoriasis.
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Enteropathy in Psoriasis: A Systematic Review of Gastrointestinal Disease Epidemiology and Subclinical Inflammatory and Functional Gut Alterations. CURRENT DERMATOLOGY REPORTS 2018. [DOI: 10.1007/s13671-018-0213-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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28
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Bai F, Zheng W, Dong Y, Wang J, Garstka MA, Li R, An J, Ma H. Serum levels of adipokines and cytokines in psoriasis patients: a systematic review and meta-analysis. Oncotarget 2017; 9:1266-1278. [PMID: 29416693 PMCID: PMC5787437 DOI: 10.18632/oncotarget.22260] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/04/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the association of serum levels of adipokines and cytokines with psoriasis. Materials and Methods A comprehensive literature search was performed in PubMed, ScienceDirect and Web of Science for the available relevant studies published before December 1, 2016. Differences in serum marker levels between patients and controls were pooled as standardized mean differences (SMDs) with 95% confidence interval to combine the effect estimations. We also conducted stratified analysis, meta-regression analysis and sensitivity analysis. Results Sixty-three studies containing 2876 psoriasis patients and 2237 healthy controls were included in this meta-analysis. The pooled serum levels of TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-18, IL-22, chemerin, lipocalin-2, resistin, sE-selectin, fibrinogen and C3 were higher in psoriasis patients compared with healthy controls (all P < 0.05). In contrast, adiponectin levels were lower. Serum levels of IL-1β, IL-4, IL-10, IL-12, IL-17, IL-21, IL-23, visfatin and omentin were not significantly different between psoriasis patients and controls (all P > 0.05). However, increased serum levels of IL-17 correlated with psoriasis in men. For other biomarkers, age, gender and psoriasis area and severity index did not explain the differences in effect size between the studies. Conclusions Serum levels of TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-18, IL-22, chemerin, lipocalin-2, resistin, sE-selectin, fibrinogen, complement 3, and adiponectin correlate with psoriasis and can be used as potential biomarkers for psoriasis and response to the treatment. Future studies are needed to identify additional players involved in the pathogenesis of psoriasis and to fully decipher the underlying mechanism.
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Affiliation(s)
- Fan Bai
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wen Zheng
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Dong
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Wang
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | | | - Ruilian Li
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jingang An
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huiqun Ma
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Zhao JV, Schooling CM. Homocysteine-reducing B vitamins and ischemic heart disease: a separate-sample Mendelian randomization analysis. Eur J Clin Nutr 2016; 71:267-273. [PMID: 27901035 DOI: 10.1038/ejcn.2016.246] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/30/2016] [Accepted: 09/10/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Observationally, homocysteine is positively associated with ischemic heart disease (IHD) and unhealthy lipids; folate and vitamin B12, which reduce homocysteine, are associated with lower IHD risk and healthy lipids. Randomized controlled trials have shown no benefits of folate and vitamin B12 for IHD. To clarify the role of these potential targets of intervention in IHD we assessed how genetically determined homocysteine, folate and vitamin-B12-affected IHD and lipids. SUBJECTS/METHODS Separate-sample instrumental variable analysis with genetic instruments, that is, Mendelian randomization, was used to obtain unconfounded estimates (based on strongly related single-nucleotide polymorphisms (SNPs)) using CARDIoGRAMplusC4D, a large coronary artery disease/myocardial infarction (CAD/MI) case (n=64 374)-control (n=130 681) study with extensive genotyping, and the Global Lipids Genetics Consortium Results (n=196 475). RESULTS Homocysteine was unrelated to CAD/MI (odds ratio (OR) 1.07 per log-transformed s.d., 95% confidence interval (CI) 0.96 to 1.19) based on 14 SNPs, as was folate (OR 1.18 per s.d., 95% CI 0.80 to 1.75) based on rs153734, and vitamin B12 (OR 0.98 per log-transformed s.d., 95% CI 0.85 to 1.14) based on rs602662, rs9473555, rs526934 and rs11254363. Homocysteine and folate were not clearly associated with lipids, vitamin B12 was associated with higher inverse normal transformed low-density lipoprotein cholesterol (0.07, 95% CI 0.02 to 0.12) and triglycerides (0.05, 95% CI 0.004 to 0.09). CONCLUSIONS Our findings do not corroborate the observed positive association of homocysteine or negative associations of folate and vitamin B12 with CAD/MI. Vitamin B12 might be associated with an unfavorable lipid profile.
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Affiliation(s)
- J V Zhao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C M Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,City University of New York, School of Public Health and Health Policy, New York, NY, USA
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30
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Mean Platelet Volume in Mycobacterium tuberculosis Infection. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7508763. [PMID: 27419136 PMCID: PMC4933846 DOI: 10.1155/2016/7508763] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 12/24/2022]
Abstract
Introduction. Mean platelet volume (MPV) has been thought as a useful index of platelet activation. It is supposed that MPV is also associated with several inflammatory and infectious diseases. Korea still has a high incidence of tuberculosis (TB). The aim of this study was to investigate MPV as an inflammatory marker in TB patients. Materials and Methods. MPV were determined in 221 patients with TB and 143 individuals for control group. MPV was estimated by an Advia 2120 (Siemens Healthcare Diagnostics, Tarrytown, NY, USA). Results. In the TB patient group, a positive correlation was found between CRP and MPV. Age and MPV had a positive correlation in TB patient group. Conclusions. We conclude that there is a significant relation between MPV and inflammatory conditions. MPV can be an inflammatory marker to determine the disease activity in TB patients.
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Coimbra S, Catarino C, Santos-Silva A. The triad psoriasis-obesity-adipokine profile. J Eur Acad Dermatol Venereol 2016; 30:1876-1885. [PMID: 27230733 DOI: 10.1111/jdv.13701] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/25/2016] [Indexed: 12/17/2022]
Abstract
Psoriasis is a chronic inflammatory skin disease, often associated with overweight/obesity. The adipose tissue is a complex organ that secretes several adipokines, involved in the regulation of some metabolic processes, such as lipid metabolism, glucose homeostasis, angiogenesis, blood pressure and inflammation. In obesity, the distribution and function of adipose tissue, and the adipokine profile are altered. The unbalanced production of pro- and anti-inflammatory adipokines in obesity, contributes to the development of a chronic low-grade inflammation state, which seems to favour worsening of psoriasis lesion and a poorer response to treatment. In this review, we will debate published data concerning the current knowledge about the triad psoriasis-obesity-adipokine profile.
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Affiliation(s)
- S Coimbra
- UCIBIO\REQUIMTE, Departamento de Ciências Biológicas, Laboratório de Bioquímica, Faculdade de Farmácia, Universidade do Porto (FFUP), Porto, Portugal. .,CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, GRD-Paredes, Portugal.
| | - C Catarino
- UCIBIO\REQUIMTE, Departamento de Ciências Biológicas, Laboratório de Bioquímica, Faculdade de Farmácia, Universidade do Porto (FFUP), Porto, Portugal
| | - A Santos-Silva
- UCIBIO\REQUIMTE, Departamento de Ciências Biológicas, Laboratório de Bioquímica, Faculdade de Farmácia, Universidade do Porto (FFUP), Porto, Portugal.
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32
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Vadakayil AR, Dandekeri S, Kambil SM, Ali NM. Role of C-reactive protein as a marker of disease severity and cardiovascular risk in patients with psoriasis. Indian Dermatol Online J 2015; 6:322-5. [PMID: 26500861 PMCID: PMC4594390 DOI: 10.4103/2229-5178.164483] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background: There is a paucity of studies addressing the elevation of C-reactive protein (CRP) among psoriatic patients and the role of this marker in assessment of disease severity and association with cardiovascular diseases (CVDs). Objective: To assess the difference in CRP levels between psoriatic patients and healthy population and to determine their role in disease severity. Also to compare CRP levels in psoriatic patients with and without the metabolic syndrome. Materials and Methods: A total of hundred patients with chronic plaque psoriasis and an equal number of age- and gender-matched healthy controls were enrolled in the study over a period of one year. Serum CRP levels of both cases and controls were estimated. Metabolic syndrome was identified among psoriasis patients using National Cholesterol Education Program's Adult Panel III (ATP III) guidelines. Clinical activity of psoriasis was evaluated using Psoriasis Area and Severity Index Score. Results: Patients with psoriasis reported significantly higher levels of CRP than healthy controls (P value 0.001). Patients with severe disease had significantly higher levels of CRP (P value < 0.003). Elevated level of CRP was observed among psoriatic patients with the metabolic syndrome than patients without the metabolic syndrome and the difference was statistically significant (P value = 0.001). Conclusion: CRP may be considered as a useful marker of psoriasis severity that could be used to monitor psoriasis and its treatment. Elevated levels of CRP may be an independent risk factor for CVD in patients with psoriasis.
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Affiliation(s)
- Asha Ramay Vadakayil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Sukumar Dandekeri
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Srinath M Kambil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Neema M Ali
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
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Miller IM, Johansen ME, Mogensen UB, Zarchi K, Ellervik C, Jemec GBE. Coagulation Status in Hidradenitis Suppurativa: A Danish Population- and Hospital-Based Cross-Sectional Study. Dermatology 2015; 231:119-26. [PMID: 26138620 DOI: 10.1159/000430910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/21/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic inflammatory diseases other than hidradenitis suppurativa (HS) have been associated with prothrombotic/hypercoagulable status. OBJECTIVE To investigate a possible association between the chronic inflammatory skin disease HS and prothrombotic/hypercoagulable state. METHODS We performed a hospital- and population-based cross-sectional study investigating the coagulation status (thrombocytes, mean platelet volume [MPV], international normalized ratio [INR] and activated partial thromboplastin time [APTT]). RESULTS 32 hospital HS subjects, 430 population HS subjects and 20,780 population non-HS control subjects were identified. The adjusted analyses showed no differences in the levels of thrombocytes, MPV, INR or APTT between the HS groups (hospital HS group, population HS group) when compared to controls (p = 0.089, p = 0.3078; p = 0.5499, p = 0.0659; p = 0.0932; p = 0.3432). CONCLUSION We did not find an association between HS and prothrombotic/hypercoagulable status. Thus, thrombocytes may not be activated in HS. Furthermore, INR may not be affected in HS, suggesting that intrinsic and vitamin K-dependent coagulation factors appear unaffected.
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Affiliation(s)
- Iben Marie Miller
- Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
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Giannoni M, Consales V, Campanati A, Ganzetti G, Giuliodori K, Postacchini V, Liberati G, Azzaretto L, Vichi S, Guanciarossa F, Offidani A. Homocysteine plasma levels in psoriasis patients: our experience and review of the literature. J Eur Acad Dermatol Venereol 2015; 29:1781-5. [PMID: 25809089 DOI: 10.1111/jdv.13023] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/12/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND People with psoriasis are at higher cardiovascular risk. Plasma levels of homocysteine over the normal range have been recognized as marker of cardiovascular risk. Psoriasis patients express higher levels of plasma homocysteine than healthy people. OBJECTIVE Our study aims to investigate the correlation between homocysteinaemia, severity and duration of psoriasis and psoriasis arthritis, and to evaluate the effect of a 12-week administration of a target therapy for psoriasis on homocysteinaemia. METHODS Fifty-two psoriasis patients (study group) submitted to different kind of therapy for psoriasis (biological, systemic not biological and topical) and 24 healthy Italian subject (control group) were evaluated for their plasmatic homocysteine levels, both at baseline (T0) and 12 weeks after they a specific therapy for psoriasis. RESULTS A significant difference between the homocysteinaemia of psoriasis patients (mean 19.71 ± 11.16) and control group (13.90 ± 11.18), P < 0.05 (Fig. 1), was found at baseline (T0). The mean plasma levels of homocysteine were directly correlated with disease severity (P = 0.0401), but not with disease duration (P = 0.6018) or presence of arthritis (P = 0.6221) at baseline. None among the treatments administered to psoriasis patients caused a significant reduction in homocysteinaemia after 12 weeks of treatment. CONCLUSION Our results confirm that psoriasis patients with more severe disease, can have hyperhomocysteinaemia, without regard to disease duration or joint involvement. Hyperhomocysteinaemia is not influenced by a target therapy for psoriasis and it is as greater as psoriasis severity. However, limitation of our study is the relatively small number of cases. Homocysteine plasmatic levels should be advisable as a further independent risk factor for cardiovascular disease in psoriasis patients.
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Affiliation(s)
- M Giannoni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - V Consales
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - A Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - G Ganzetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - K Giuliodori
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - V Postacchini
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - G Liberati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - L Azzaretto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - S Vichi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - F Guanciarossa
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - A Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
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Serum homocysteine, asymmetric dimethyl arginine (ADMA) and other arginine-NO pathway metabolite levels in patients with psoriasis. Arch Dermatol Res 2015; 307:439-44. [PMID: 25708188 DOI: 10.1007/s00403-015-1553-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/10/2015] [Accepted: 02/14/2015] [Indexed: 10/24/2022]
Abstract
Hyperhomocysteinemia, a well-known and independent risk factor for cardiovascular disease, has been related in several studies with psoriasis patients. It has been suggested that homocysteine leads to endothelial dysfunction by causing an accumulation of asymmetrical dimethyl arginine (ADMA), a potent endogenous nitric oxide (NO) synthase inhibitor of the L-arginine-NO pathway. However, limited data is available regarding the psoriasis and ADMA relationship. In this study, we aimed to investigate the serum levels of homocysteine, ADMA and other metabolites from the L-arginine-NO pathway in psoriasis patients. Forty-two patients with chronic plaque psoriasis and 48 controls were enrolled in the study. Serum homocysteine, ADMA, L-monomethyl-L-arginine (L-NMMA), symmetric dimethylarginine (SDMA) and L-arginine levels, and L-arginine/ADMA ratios of psoriasis patients and the control group were measured. The severity of psoriasis was assessed by the psoriasis area and severity index (PASI). The mean ADMA and homocysteine values were significantly higher, and citrulline and L-arginine/ADMA values were significantly lower in psoriasis patients compared to control subjects. However, there were no significant differences among the patient and control groups with respect to mean SDMA, L-NMMA and L-arginine values. PASI scores strongly correlated with the ADMA level and moderately correlated with L-arginine/ADMA ratio. This study suggests that the L-arginine-NO pathway metabolites, especially ADMA, may play an important role in the pathogenesis of psoriasis. Additionally, serum ADMA levels of psoriasis patients may be an indicator of the disease severity.
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Murzaku EC, Bronsnick T, Rao BK. Diet in dermatology: Part II. Melanoma, chronic urticaria, and psoriasis. J Am Acad Dermatol 2014; 71:1053.e1-1053.e16. [PMID: 25454037 DOI: 10.1016/j.jaad.2014.06.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 06/04/2014] [Accepted: 06/09/2014] [Indexed: 02/07/2023]
Abstract
The roles of dietary factors in aggravating, preventing, or treating skin diseases are common questions encountered in dermatology practice. Part II of this two-part series reviews dietary modifications that can potentially be utilized in the management of melanoma, chronic urticaria, and psoriasis patients. Specifically, we examine the effect of alcohol consumption and supplementation with vitamins D and E, polyunsaturated fatty acids, selenium, green tea, resveratrol, and lycopene on melanoma risk. The relationships between chronic urticaria symptoms and dietary pseudoallergens, gluten, and vitamin D are analyzed. We explore weight loss, reduced alcohol consumption, and gluten avoidance as means of reducing psoriasis-associated morbidity, as well as the possible utility of supplementation with polyunsaturated fatty acids, folic acid, vitamin D, and antioxidants. With proper knowledge of the role of diet in these cutaneous disease processes, dermatologists can better answer patient inquiries and consider implementation of dietary modifications as adjuncts to other treatments and preventative measures.
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Affiliation(s)
- Era Caterina Murzaku
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Tara Bronsnick
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey.
| | - Babar K Rao
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
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Demir E, Izol V, Aridogan IA, Paydas S, Tansug Z, Erken U. Immediate and long-term high levels of plasma homocysteine after extracorporeal shock wave lithotripsy in patients with renal stone disease. Clin Exp Nephrol 2014; 18:623-5. [PMID: 24865596 DOI: 10.1007/s10157-013-0884-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 09/27/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Plasma homocysteine levels increase in patients with chronic renal failure. Numerous studies have demonstrated that kidney function is one of the most important determinants of plasma total homocysteine (tHcy) concentration. In this study we aimed to evaluate the relationship between tHcy levels and extracorporeal shock wave lithotripsy (ESWL) for patients with renal stones and to see if the change in homocysteine levels continued if renal dysfunction improved. MATERIALS AND METHODS The study consisted of 20 patients who underwent first-time ESWL for renal stones. Every patient gave 3 blood samples at 24 h before surgery and at 2 days and at 3 months after ESWL for measurement of plasma levels of tHcy, creatinine, vitamin B6, and vitamin B12. RESULTS The 20 patients (12 male, 8 female) had a mean age of 42.8 ± 11.7 years. tHcy levels showed a statistically significant increase from 9.4 ± 1.4 to 18 ± 4.8 and 11.2 ± 2.1 at 2 days and at 3 months, respectively. Serum creatinine also showed a statistically significant increase compared to baseline at 2 days and at 3 months after ESWL. CONCLUSION After first-time ESWL, the increase in serum levels of creatinine and tHcy due to renal injury, such as ischemia/reperfusion injury, may be severe and continue for a long period, such as 3 months. According to baseline levels, the increase in homocysteine levels as an indicator of oxidant stress was more severe than the creatinine levels after ESWL for renal stones. Our patients were first-time ESWL patients; however, in patients who undergo EWSL more than once long-term high tHcy levels should also be considered as renal.
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Affiliation(s)
- Erkan Demir
- Department of Urology, Faculty of Medicine, University of Çukurova, 01330, Adana, Turkey
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Optimization and Application of FL-HPLC for Folates Analysis in 20 Species of Mediterranean Wild Vegetables. FOOD ANAL METHOD 2014. [DOI: 10.1007/s12161-014-9887-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Psoriasis is a chronic inflammatory skin disease affecting approximately 2% of the population worldwide. In the past decade, many studies have drawn attention to comorbid conditions in psoriasis. This literature review examines the epidemiological evidence, pathophysiological commonalities, and therapeutic implications for different comorbidities of psoriasis. Cardiovascular disease, obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome, nonalcoholic fatty liver disease, cancer, anxiety and depression, and inflammatory bowel disease have been found at a higher prevalence in psoriasis patients compared to the general population. Because of the wide range of comorbid conditions associated with psoriasis, comprehensive screening and treatment must be implemented to most effectively manage psoriasis patients.
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Affiliation(s)
- Catherine Ni
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Melvin W Chiu
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
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Abstract
Psoriasis is a chronic inflammatory skin disease affecting approximately 2% of the population worldwide. In the past decade, many studies have drawn attention to comorbid conditions in psoriasis. This literature review examines the epidemiological evidence, pathophysiological commonalities, and therapeutic implications for different comorbidities of psoriasis. Cardiovascular disease, obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome, nonalcoholic fatty liver disease, cancer, anxiety and depression, and inflammatory bowel disease have been found at a higher prevalence in psoriasis patients compared to the general population. Because of the wide range of comorbid conditions associated with psoriasis, comprehensive screening and treatment must be implemented to most effectively manage psoriasis patients.
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Affiliation(s)
- Catherine Ni
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Melvin W Chiu
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
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Assessment of lipocalin 2, clusterin, soluble tumor necrosis factor receptor-1, interleukin-6, homocysteine, and uric acid levels in patients with psoriasis. DISEASE MARKERS 2014; 2014:541709. [PMID: 24803721 PMCID: PMC3996950 DOI: 10.1155/2014/541709] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 03/12/2014] [Indexed: 01/21/2023]
Abstract
Background. Chronic inflammation may play a role in psoriasis pathogenesis. Lipocalin 2, clusterin, soluble tumor necrosis factor receptor-1 (sTNFR-1), interleukin-6, homocysteine, and uric acid are inflammatory and/or biochemical markers. However, both the roles of these markers and the pathogenesis of psoriasis are unknown. Objective. The aim of this study was to investigate serum levels of lipocalin 2, clusterin, sTNFR-1, interleukin-6, homocysteine, and uric acid in patients and controls groups. Methods. Fifty-six patients with psoriasis and 33 healthy controls were included in the study. Serum concentrations of the markers were evaluated by ELISA. The Psoriasis Area and Severity Index (PASI) was evaluated in all psoriasis patients. Body mass index (BMI) was calculated by dividing weight (kg) by height (m) squared. Results. The serum value of lipocalin and sTNFR-1 were significantly higher in psoriasis patients than in controls (resp., P < 0.001, P < 0.05). The others showed no significant differences between psoriasis and the control groups (all of them P > 0.05). The mean PASI score in the patient group was 8.3 ± 6.5. Conclusions. These findings suggest that lipocalin 2 and sTNFR-1 might play a role in the pathogenesis of psoriasis and can be used as markers of the disease.
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Apolipoprotein E gene polymorphism and serum lipid profile in Saudi patients with psoriasis. DISEASE MARKERS 2014; 2014:239645. [PMID: 24782577 PMCID: PMC3981009 DOI: 10.1155/2014/239645] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 02/16/2014] [Accepted: 02/21/2014] [Indexed: 11/18/2022]
Abstract
Background/Aim. Apolipoprotein E (APOE) gene variants have been reported to influence psoriasis risk. However, data is limited to a few ethnicities and no similar study has been performed in middle eastern populations. We investigated this association in Saudi psoriasis patients. Methods. Saudi subjects (294) were genotyped for APOE gene using APOE StripAssay kit. Results. The frequencies of alleles ε2, ε4, and genotypes ε3/ε4 and ε3/ε2 were significantly higher in psoriasis patients compared with those in controls. The frequency of ε3 allele and ε3/ε3 genotype was significantly lower in patients. Other genotypes, ε2/ε4, ε2/ε2, and ε4/ε4, were absent in both groups. The serum cholesterol, triglycerides, and LDL levels were significantly higher in psoriasis patients contrary to HDL level. Patients with APOE ε4 had significantly higher levels of total cholesterol and LDL cholesterol, whereas those with the ε2 had higher HDL cholesterol, and triglycerides. Conclusion. APOE alleles ε2, ε4, and genotypes ε2/ε3 and ε4/ε3 are associated with psoriasis and can be a risk factor while allele ε3 and genotype ε3/ε3 may be protective for psoriasis in Saudis. Results of lipid profile support that psoriasis is one of the independent risk factors for hyperlipidemia and emphasize the need of screening cardiovascular diseases in psoriatic patients.
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Dowlatshahi EA, van der Voort EAM, Arends LR, Nijsten T. Markers of systemic inflammation in psoriasis: a systematic review and meta-analysis. Br J Dermatol 2014; 169:266-82. [PMID: 23550658 DOI: 10.1111/bjd.12355] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 12/15/2022]
Abstract
Studies investigating systemic inflammation in psoriasis use different serum markers and report discrepant results. We set out to determine whether systemic inflammation is elevated in patients with psoriasis compared with healthy controls, and to measure the extent of this elevation, by summarizing available data on serum inflammatory markers. PubMed, Embase and Web of Science were searched from inception to March 2011. We included studies comparing the serum inflammatory markers interleukin (IL)-1β, IL-6, IL-10, C-reactive protein (CRP), intracellular adhesion molecule (ICAM)-1, E-selectin and tumour necrosis factor (TNF)-α in patients with psoriasis and healthy controls. Differences in serum marker levels between patients and controls were pooled as standardized mean differences (SMDs; Cohen's d) using a random-effects model. Seventy-eight studies were eligible. Of the 7852 individuals included, 3085 had (severe plaque) psoriasis. The pooled SMDs were higher in patients with psoriasis than in healthy controls for IL-6 [d = 1·32, 95% confidence interval (CI) 0·83-1·81], CRP (d = 1·83, 95% CI 0·76-2·90), TNF-α (d = 1·32, 95% CI 0·86-1·79), E-selectin (d = 1·78, 95% CI 1·32-2·25) and ICAM-1 (d = 1·77, 95% CI 1·15-2·39). The SMD between cases and controls for IL-1β and IL-10 was not significant. Age had a significant effect on the SMD for IL-6 and TNF-α. For IL-6 the effect size was higher for plaque psoriasis studies (d = 1·98). The effect size was not influenced by the Psoriasis Area and Severity Index, measurement method or quality assessment. The pooled analyses suggest modest but significantly elevated levels of the proinflammatory cytokines in the serum of patients with psoriasis with predominantly severe disease. To what extent this modest increment is clinically relevant could be investigated in a synthesis of all studies measuring inflammation before and after antipsoriatic therapy.
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Affiliation(s)
- E A Dowlatshahi
- Department of Dermatology , Erasmus Medical Centre, Rotterdam, the Netherlands
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Akcali C, Buyukcelik B, Kirtak N, Inaloz S. Clinical and laboratory parameters associated with metabolic syndrome in Turkish patients with psoriasis. J Int Med Res 2014; 42:386-94. [PMID: 24445696 DOI: 10.1177/0300060513502891] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess clinical and laboratory parameters associated with metabolic syndrome in Turkish patients with moderate or severe plaque-type psoriasis and nonpsoriatic controls. METHODS Patients with moderate or severe plaque psoriasis (patient group) or with nonpsoriatic dermatological disease (controls) were included. Waist circumference, weight, height and arterial blood pressure were measured, together with fasting blood glucose, triglyceride, high density lipoprotein (HDL), fibrinogen, homocysteine and adiponectin levels. Metabolic syndrome was diagnosed using National Cholesterol Education Program-Adult Treatment Panel III criteria. RESULTS Out of 90 patients (50 with psoriasis; 40 controls), metabolic syndrome was more frequent in the patient group than in controls. In terms of metabolic syndrome parameters, only hypertension was more frequent in patients with psoriasis compared with controls. There was no statistically significant difference between the patient and control groups for obesity, hypertriglyceridaemia, HDL levels or hyperglycaemia. Fibrinogen levels were increased and adiponectin levels were decreased in the psoriasis group. No between-group difference in homocysteine levels was found. CONCLUSION In this small study, metabolic syndrome was found to be more frequently identified in Turkish patients with psoriasis than in controls; metabolic syndrome could lead to increased cardiovascular disease risk in patients with moderate to severe psoriasis.
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Affiliation(s)
- Cenk Akcali
- Department of Dermatology, School of Medicine, Research and Trainign Hospital, Gaziantep University, Gaziantep, Turkey
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Jeon YJ, Kim YR, Lee BE, Choi YS, Kim JH, Shin JE, Rah H, Cha SH, Lee WS, Kim NK. Genetic association of five plasminogen activator inhibitor-1 (PAI-1) polymorphisms and idiopathic recurrent pregnancy loss in Korean women. Thromb Haemost 2013; 110:742-50. [PMID: 23903286 DOI: 10.1160/th13-03-0242] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 07/03/2013] [Indexed: 11/05/2022]
Abstract
Plasminogen activator inhibitor-1 (PAI-1) is important for maintaining pregnancy. Aberrantly increased PAI-1 levels may contribute to thrombosis and inflammation, leading to pregnancy loss. This study investigated the association of PAI-1 polymorphisms (PAI-1 rs2227631 [-844G>A], rs1799889 [-675 4G/5G], rs6092 [43G>A], rs2227694 [9785G>A], and rs7242 [11053T>G]) with idiopathic recurrent pregnancy loss (RPL) in Korean women. We screened 308 RPL patients and 227 control participants for five PAI-1 polymorphisms. Genotyping of PAI-1 was performed by polymerase chain reaction-restriction fragment length polymorphism assay. PAI-1 4G4G and -844AA/4G4G/11053GG genotypes were associated with RPL. PAI-1 -844A/4G/43G/9785G/11053G haplotype was connected to hypofibrinolytic status (i.e. increased levels of plasma PAI-1, increased numbers of platelets, reduced prothrombin time, and reduced activated partial thromboplastin time). Moreover, PAI-1 11053TG+GG frequency was positively related to plasma homocysteine and urate levels, whereas -844AA frequency was associated with plasma folate concentrations according to ordinal logistic regression analysis. Based on these results, we propose that PAI-1 -844G>A, 4G/5G, and 11053T>G polymorphisms are markers of RPL.
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Affiliation(s)
- Young Joo Jeon
- Nam Keun Kim, PhD, Institute for Clinical Research, CHA Bundang Medical Center, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam 463-712, South Korea, Tel.: +82 31 780 5762, Fax: +82 31 780 5766, E-mail:
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Gaeta M, Castelvecchio S, Ricci C, Pigatto P, Pellissero G, Cappato R. Role of psoriasis as independent predictor of cardiovascular disease: a meta-regression analysis. Int J Cardiol 2013; 168:2282-8. [PMID: 23490084 DOI: 10.1016/j.ijcard.2013.01.197] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 11/19/2012] [Accepted: 01/18/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Despite the proved association between psoriasis and cardiovascular risk exposure, there are no data about the role of psoriasis as an independent predictor of such risk. The aim of this study was to investigate whether any association between psoriasis and excess cardiovascular risk exposure is independent from confounding factors. METHODS Meta-analysis and meta-regression analysis were performed using data extracted from observational studies (identified by MEDLINE, EMBASE and CINAHL) investigating the relationship between psoriasis and cardiovascular disease with at least 6 points on the New Castle-Ottawa quality scale. Two reviewers with methodological expertise conducted data extraction independently. RESULTS Thirteen studies including patients with psoriasis showed an increased risk of cardiovascular disease (RR=1.24 [1.18-1.31]; P=0.0001). These patients still presented a significantly larger cardiovascular risk in the presence of smoking (RR=1.14 [CI=1.13-1.15] P<0.0001), obesity (RR=1.11 [CI=1.07-1.14] P=0.0003) and hyperlipidemia (RR=1.05 [CI=1.03-1.07] P=0.0006), but not in the presence of hypertension (RR=1.03 [CI=0.98-1.09] P=0.4647) and diabetes (RR=0.95 [CI=0.90-1.01] P=0.6502). CONCLUSIONS Patients with psoriasis carry an about 25% increased relative risk of cardiovascular disease. This risk appears to be independent of smoking, obesity and hyperlipidemia.
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Affiliation(s)
- Maddalena Gaeta
- Department of Preventive, Occupational and Community Medicine, University of Pavia, Italy
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Daudén E, Castañeda S, Suárez C, García-Campayo J, Blasco A, Aguilar M, Ferrándiz C, Puig L, Sánchez-Carazo J. Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis. J Eur Acad Dermatol Venereol 2012; 27:1387-404. [DOI: 10.1111/jdv.12024] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Ghiasi M, Nouri M, Abbasi A, Hatami P, Abbasi MA, Nourijelyani K. Psoriasis and increased prevalence of hypertension and diabetes mellitus. Indian J Dermatol 2012; 56:533-6. [PMID: 22121272 PMCID: PMC3221217 DOI: 10.4103/0019-5154.87149] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Psoriasis is an autoimmune skin disease and associated with other diseases such as cardiovascular, hypertension, and diabetes mellitus. Aim: Our aim was to explore the prevalence of diabetes mellitus and hypertension in psoriatic patients. Materials and Methods: Between April 2008 and May 2010, a total of 304 psoriatic and 300 nonpsoriatic patients were enrolled in this cross sectional study. Data were obtained on age, sex, weight, heights, etc; documented medical history of diabetes mellitus and hypertension; family history of diabetes mellitus and hypertension in first relatives, history of smoking. Results: There was no significant difference in age and gender distribution between two groups. There was also no difference in body mass index between two groups. Within psoriatic group, 79.3% of patients present with plaque type of the disease and 20.7% present with other types. The results showed that within psoriatic patients, the prevalence of diabetes in women is significantly higher than in men (OR=1.93, CI95%: 1.1–3.6, P=0.004) but this difference is not present in nonpsoriatic patients. The results also showed that the prevalence of diabetes in psoriatic patients is significantly higher than nonpsoriatic patients (OR=1.76, CI95%: 1.11–2.8, P=0.015). The data showed that psoriatic patients were more likely to develop hypertension compared with nonpsoriatic patients (OR=2.2, CI95%: 1.2–4.6, P=0.003). According to results, although smoking rate within psoriatic patients is higher than the other group but the difference was not significant. Conclusion: Psoriatic patients have an increased risk of developing metabolic syndrome and hypertension in comparison to nonpsoriatic patients.
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Affiliation(s)
- Maryam Ghiasi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Nemati H, Khodarahmi R, Rahmani A, Ebrahimi A, Amani M, Eftekhari K. Serum lipid profile in psoriatic patients: correlation between vascular adhesion protein 1 and lipoprotein (a). Cell Biochem Funct 2012; 31:36-40. [PMID: 22753196 DOI: 10.1002/cbf.2857] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 04/21/2012] [Accepted: 06/08/2012] [Indexed: 11/09/2022]
Abstract
Psoriasis is a chronic inflammatory skin disease characterized by excessive cellular replication. Apolipoproteins are genetically determined molecule whose role has been implied in cardiovascular pathology. Vascular adhesion protein-1 (VAP-1) is an adhesion molecule with an enzymatic activity that partakes in the migration process of lymphocytes into sites of inflammation. Our purpose was to evaluate the plasma lipid profiles, apolipoproteins (A1, B) and Lp (a) and VAP-1 in order to compare the lipid profile in psoriatic patients with non-affected persons and correlation between VAP-1 and Lp (a). We determined serum concentrations of lipids, lipoproteins , apolipoproteins and VAP-1 in 90 patients with psoriasis and 90 age matched controls. Serum Lp (a), apo A1 and apo B were measured by immunoprecipitation assays, and the lipids and lipoproteins were measured by enzymatic methods.The VAP-1 were measured by ELISA method. The mean levels of total cholesterol, LDL, apo B and VAP-1 in patients with psoriasis were found to be significantly higher than those of healthy subjects (P<0.05. In psoriatic patients, elevation of VAP-1 correlated with elevation of Lp (a) (p = 0.025). This study shows that high serum lipid level and VAP-1, is significantly more common in psoriasis. This fact may be responsible for higher prevalence of cardiovascular accident in psoriatic patients.
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Affiliation(s)
- Houshang Nemati
- Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Abnormal isoaspartyl residues in erythrocyte membranes from psoriatic patients. Arch Dermatol Res 2012; 304:475-9. [PMID: 22648381 DOI: 10.1007/s00403-012-1247-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 05/04/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022]
Abstract
Spontaneous protein deamidation of labile asparagines (Asn), generating abnormal isoaspartyl residues (IsoAsp), is associated with cell aging and enhanced by an oxidative microenvironment. The presence of isopeptide bonds impairs protein structure/function and can trigger autoimmune responses. To minimize the damage, IsoAsp can be "repaired" by a specific L-isoaspartate-(D-aspartate)-protein-O-methyltransferase. The condition of chronic oxidative stress reported in psoriatic patients, and the potential etiological role of unknown self-antigens, prompted us to investigate Asn deamidation in psoriatic tissues. Erythrocytes (RBC) were selected as the model system since, lacking protein synthesis apparatus, they are unable to replace damaged proteins. Blood samples were obtained from 36 patients and 34 controls. L-isoAsp content was highly increased in RBC membrane proteins from psoriatic patients. Deamidated species included ankyrin, band 4.1, band 4.2 and the integral membrane protein band 3. A functional analysis demonstrated that this result was unrelated to a reduced efficiency of the S-adenosylmethionine-dependent repair system suggesting an increased protein instability at Asn sites, responsible for IsoAsp accumulation in psoriatic patients.
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