1
|
Stephan B, Rustenbach SJ, Ben-Anaya N, Augustin M, Boehncke WH, Hertl M, Mrowietz U, Staubach-Renz P, Thaçi D, von Kiedrowski R, Sorbe C. Basic Susceptibility of Patients with Psoriasis under Systemic Therapy for Respiratory Infections: Data from the German Psoriasis Registry PsoBest. J Clin Med 2024; 13:3713. [PMID: 38999279 PMCID: PMC11242749 DOI: 10.3390/jcm13133713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Patients with psoriasis under systemic treatments are in focus regarding their susceptibility to respiratory infections. To analyse real-world data for respiratory infections in patients with psoriasis under systemic treatments. Methods: We analysed data of the prospective, non-interventional German Psoriasis Registry PsoBest and compared rates for respiratory infections of 13,823 patients on systemic treatments for psoriasis and/or psoriatic arthritis in different therapy cohorts before the COVID-19 pandemic. Results: In total, 1415 respiratory infections were observed in 970 patients. Significant differences were observed between biologics and non-biologics, but not within these groups. The highest event rates (events/100 patient years) were identified for TNF-α inhibitors, 8.1, (CI 7.4-8.9), followed by 7.0 for IL-17 inhibitors (6.2-7.9), 5.7 for IL-12/23 and IL-23 inhibitors (5.1-6.5), 4.8 for methotrexate (4.3-5.4), 3.7 for small molecules (3.3-4.2), and 2.7 for retinoids (1.2-5.1). Conclusions: Overall, the susceptibility for respiratory infections in patients under systemic therapy for psoriasis is low compared to published study data and is sufficient as comparative data for COVID-19 studies.
Collapse
Affiliation(s)
- Brigitte Stephan
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Stephan Jeff Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Nesrine Ben-Anaya
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| | - Wolf-Henning Boehncke
- Department of Dermatology and Venereology, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Michael Hertl
- Department of Dermatology, University Hospital Marburg, 35043 Marburg, Germany;
| | - Ulrich Mrowietz
- Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany;
| | - Petra Staubach-Renz
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany;
| | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, 23562 Lübeck, Germany;
| | | | - Christina Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (S.J.R.); (N.B.-A.); (M.A.); (C.S.)
| |
Collapse
|
2
|
Hsu BW, Chen BS. Genetic and Epigenetic Host-Virus Network to Investigate Pathogenesis and Identify Biomarkers for Drug Repurposing of Human Respiratory Syncytial Virus via Real-World Two-Side RNA-Seq Data: Systems Biology and Deep-Learning Approach. Biomedicines 2023; 11:1531. [PMID: 37371627 DOI: 10.3390/biomedicines11061531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Human respiratory syncytial virus (hRSV) affects more than 33 million people each year, but there are currently no effective drugs or vaccines approved. In this study, we first constructed a candidate host-pathogen interspecies genome-wide genetic and epigenetic network (HPI-GWGEN) via big-data mining. Then, we employed reversed dynamic methods via two-side host-pathogen RNA-seq time-profile data to prune false positives in candidate HPI-GWGEN to obtain the real HPI-GWGEN. With the aid of principal-network projection and the annotation of KEGG pathways, we can extract core signaling pathways during hRSV infection to investigate the pathogenic mechanism of hRSV infection and select the corresponding significant biomarkers as drug targets, i.e., TRAF6, STAT3, IRF3, TYK2, and MAVS. Finally, in order to discover potential molecular drugs, we trained a DNN-based DTI model by drug-target interaction databases to predict candidate molecular drugs for these drug targets. After screening these candidate molecular drugs by three drug design specifications simultaneously, i.e., regulation ability, sensitivity, and toxicity. We finally selected acitretin, RS-67333, and phenformin to combine as a potential multimolecule drug for the therapeutic treatment of hRSV infection.
Collapse
Affiliation(s)
- Bo-Wei Hsu
- Laboratory of Automatic Control, Signal Processing and Systems Biology, Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Bor-Sen Chen
- Laboratory of Automatic Control, Signal Processing and Systems Biology, Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| |
Collapse
|
3
|
Meena A, Sarkar R. Acitretin in dermatology. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_145_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
|
4
|
Correa TL, Quitete MAC, de Azevedo LT, Fraga IAC, Teixeira LC. Infarctus du myocarde, accident vasculaire cérébral et psoriasis: une revue systématique des études observationnelles. Ann Cardiol Angeiol (Paris) 2022; 72:101574. [PMID: 36529545 DOI: 10.1016/j.ancard.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/16/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
Patients with psoriasis can have higher rates of hypertension, diabetes mellitus 2, and dyslipidemia. This study aimed to assess the association between psoriasis, myocardial infarction (MI), and stroke. A systematic review was carried out using PubMed/Medline, EMBASE, and LILACS databases searching for observational studies that assessed stroke and/or MI in patients diagnosed with psoriasis vulgaris compared to non-psoriatic patients. A total of 649 articles were identified but only 15 were included in the study. Although there were studies that have observed a significant positive association between psoriasis and MI or stroke, an almost equal number of studies showed no statistically significant association. The relationship between psoriasis and ischemic cardiovascular events is still controversial and it is difficult to establish psoriasis as the etiology of these events.
Collapse
Affiliation(s)
- Tulio Loyola Correa
- Faculty of Medicine, Federal University of Pelotas, Av. Duque de Caxias 250, Pelotas, RS, 96030-000, Brazil..
| | | | | | | | - Luísa Coutinho Teixeira
- Department of Dermatology, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, Brazil
| |
Collapse
|
5
|
Zhang L, Zeng Q, Li J, Chen N, Tang H, Lei X, Wu J, Cheng Q. ALA-PDT combined with oral acitretin in the treatment of refractory condyloma acuminatum in anal canal. Photodiagnosis Photodyn Ther 2022; 40:103048. [PMID: 36183481 DOI: 10.1016/j.pdpdt.2022.103048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Condyloma acuminatum (CA) of the anal canal is difficult to treat and subject to relapse.. We investigated the effects of aminolevulinic acid-based photodynamic therapy (ALA-PDT) combined with oral acitretin during therapy of refractory CA in the anal canal. We also conducted a clinical retrospective study for the treatment of intra-anal CA. METHODS A total of 101 patients diagnosed with intra-anal CA were enrolled. All patients underwent liquid nitrogen cryotherapy as a basic treatment until visible wart clearance. Patients were divided into two groups depending on the treatment modality after cryotherapy. ALA-PDT group with 51 patients was given ALA-PDT treatment, and ALA-PDT plus acitretin group with 50 patients was given ALA-PDT treatment combined with oral acitretin. The cure rate, recurrence rate, and adverse reactions of the two groups were analyzed and recorded. RESULTS The cure rate in the ALA-PDT plus acitretin group was 94% (47/50), which was significantly higher than 80.4% (41/51) in ALA-PDT group. The recurrence rate in the ALA-PDT plus acitretin group was 6% (3/50), which was lower than 19.6% (10/51) in ALA-PDT group (P<0.05). CONCLUSION ALA-PDT combined with oral acitretin is effective and safe in the treatment of refractory CA in anal canal, and with further study may become an option for these patients.
Collapse
Affiliation(s)
- Long Zhang
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Qianwen Zeng
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jinzhuo Li
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Nian Chen
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Hui Tang
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jinjin Wu
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China.
| | - Qionghui Cheng
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China.
| |
Collapse
|
6
|
Yu J, Zhao Q, Wang X, Zhou H, Hu J, Gu L, Hu Y, Zeng F, Zhao F, Yue C, Zhou P, Li G, Li Y, Wu W, Zhou Y, Li J. Pathogenesis, multi-omics research, and clinical treatment of psoriasis. J Autoimmun 2022; 133:102916. [PMID: 36209691 DOI: 10.1016/j.jaut.2022.102916] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/07/2022]
Abstract
Psoriasis is a common inflammatory skin disease involving interactions between keratinocytes and immune cells that significantly affects the quality of life. It is characterized by hyperproliferation and abnormal differentiation of keratinocytes and excessive infiltration of immune cells in the dermis and epidermis. The immune mechanism underlying this disease has been elucidated in the past few years. Research shows that psoriasis is regulated by the complex interactions among immune cells, such as keratinocytes, dendritic cells, T lymphocytes, neutrophils, macrophages, natural killer cells, mast cells, and other immune cells. An increasing number of signaling pathways have been found to be involved in the pathogenesis of psoriasis, which has prompted the search for new treatment targets. In the past decades, studies on the pathogenesis of psoriasis have focused on the development of targeted and highly effective therapies. In this review, we have discussed the relationship between various types of immune cells and psoriasis and summarized the major signaling pathways involved in the pathogenesis of psoriasis, including the PI3K/AKT/mTOR, JAK-STAT, JNK, and WNT pathways. In addition, we have discussed the results of the latest omics research on psoriasis and the epigenetics of the disease, which provide insights regarding its pathogenesis and therapeutic prospects; we have also summarized its treatment strategies and observations of clinical trials. In this paper, the various aspects of psoriasis are described in detail, and the limitations of the current treatment methods are emphasized. It is necessary to improve and innovate treatment methods from the molecular level of pathogenesis, and further provide new ideas for the treatment and research of psoriasis.
Collapse
Affiliation(s)
- Jiadong Yu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Qixiang Zhao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Xiaoyan Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Hong Zhou
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Jing Hu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Linna Gu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Yawen Hu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Fanlian Zeng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Fulei Zhao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Chengcheng Yue
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Pei Zhou
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Guolin Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Ya Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Wenling Wu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Yifan Zhou
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China
| | - Jiong Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, High Technological Development Zone, Chengdu, Sichuan, 610041, China.
| |
Collapse
|
7
|
Vu A, Maloney V, Gordon KB. Deucravacitinib in moderate-to-severe psoriasis. Immunotherapy 2022; 14:1279-1290. [DOI: 10.2217/imt-2022-0109] [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 a chronic inflammatory disease that affects up to 1 in 20 people worldwide. A patient's quality of life and health can be drastically affected by psoriasis. The number of therapies for patients with moderate to severe psoriasis has steadily grown over the past two decades, with biologic immunotherapies being the primary agents developed. However, new small-molecule oral therapies have lagged in development. Deucravacitinib is an oral small molecule that inhibits the activity of TYK2, a member of the JAK family. Deucravacitinib works by allosterically inhibiting TYK2, increasing the specificity of this agent for TYK2 rather than other members of this kinase family. Deucravacitinib has demonstrated safety and efficacy in moderate to severe plaque psoriasis in clinical trial development, with >50% of patients on deucravacitinib 6 mg daily achieving ≥75% reduction in Psoriasis Area and Severity Index score from baseline at 16 weeks versus 9–13% on placebo and 35–41% on apremilast 30 mg twice daily in phase III clinical trials.
Collapse
Affiliation(s)
- Alan Vu
- Department of Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Victoria Maloney
- Department of Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Kenneth B Gordon
- Department of Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| |
Collapse
|
8
|
Pignolo RJ, Baujat G, Hsiao EC, Keen R, Wilson A, Packman J, Strahs AL, Grogan DR, Kaplan FS. Palovarotene for Fibrodysplasia Ossificans Progressiva (FOP): Results of a Randomized, Placebo-Controlled, Double-Blind Phase 2 Trial. J Bone Miner Res 2022; 37:1891-1902. [PMID: 35854638 PMCID: PMC9804935 DOI: 10.1002/jbmr.4655] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 06/15/2022] [Accepted: 07/16/2022] [Indexed: 01/07/2023]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic disorder characterized by progressive heterotopic ossification (HO), often heralded by flare-ups, leading to reduced movement and life expectancy. This placebo-controlled, double-blind trial (NCT02190747) evaluated palovarotene, an orally bioavailable selective retinoic acid receptor gamma agonist, for prevention of HO in patients with FOP. Patients experiencing a flare-up were enrolled in two cohorts: (1) patients ≥15 years were randomized 3:1 to palovarotene 10/5 mg (weeks 1-2/3-6) or placebo; (2) patients ≥6 years were randomized 3:3:2 to palovarotene 10/5 mg, palovarotene 5/2.5 mg (weeks 1-2/3-6), or placebo. Cohort data were pooled. The primary endpoint was the proportion of responders (no/minimal new HO at flare-up body region by plain radiograph) at week 6. Change from baseline in HO volume and new HO incidence were assessed by computed tomography (CT) at week 12. Tissue edema was assessed by magnetic resonance imaging (MRI) or ultrasound. Forty patients (aged 7-53 years) were enrolled (placebo: n = 10; palovarotene 5/2.5 mg: n = 9; palovarotene 10/5 mg: n = 21). Disease history was similar between groups. In the per-protocol population, the proportion of responders at week 6 by plain radiograph was 100% with palovarotene 10/5 mg; 88.9% with palovarotene 5/2.5 mg; 88.9% with placebo (Cochran-Armitage trend test: p = 0.17). At week 12, the proportions were 95.0% with palovarotene 10/5 mg; 88.9% with palovarotene 5/2.5 mg; 77.8% with placebo (Cochran-Armitage trend test: p = 0.15). Week 12 least-squares mean (LSmean) new HO volume, assessed by CT, was 3.8 × 103 mm3 with palovarotene 10/5 mg; 1.3 × 103 mm3 with palovarotene 5/2.5 mg; 18.0 × 103 mm3 with placebo (pairwise tests versus placebo: p ≤ 0.12). Palovarotene was well-tolerated. No patients discontinued treatment or required dose reduction; one patient had dose interruption due to elevated lipase. Although these findings were not statistically significant, they support further evaluation of palovarotene for prevention of HO in FOP in larger studies. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Robert J Pignolo
- Department of Medicine, Divisions of Geriatric Medicine and Gerontology, Hospital Internal Medicine, and Endocrinology, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
| | - Geneviève Baujat
- Departement de Genetique, Institut IMAGINE and Hôpital Necker-Enfants Malades, Paris, France
| | - Edward C Hsiao
- Division of Endocrinology and Metabolism, UCSF Metabolic Bone Clinic, Institute for Human Genetics, Institute for Regeneration Medicine, and the Program for Craniofacial Biology, University of California-San Francisco, San Francisco, CA, USA
| | - Richard Keen
- Consultant Rheumatologist & Honorary Senior Lecturer in Metabolic Bone Disease, The Royal National Orthopaedic Hospital, Stanmore, UK
| | | | | | | | | | - Frederick S Kaplan
- Departments of Orthopaedic Surgery and Medicine, and The Center for Research in FOP and Related Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
9
|
Wu MN, Zhou LJM, Zhou DM. Xiyanping injection combined with acitretin for psoriasis vulgaris: A systematic review and meta-analysis. Front Pharmacol 2022; 13:971715. [PMID: 36147319 PMCID: PMC9486393 DOI: 10.3389/fphar.2022.971715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Psoriasis represents the chronic, recurrent and inflammatory disorder. The Traditional Chinese Medicine Xiyanping injection (XYP) is extensively applied in China for treating diverse inflammatory disorders, such as bronchitis, viral pneumonia or upper respiratory tract infection. XYP may offer a potential treatment for psoriasis vulgaris (PV). This study focused on analyzing whether XYP combined with acitretin was effective and safe. Methods: The present meta-analysis was carried out in line with guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This systematic review was registered in PROSPERO (CRD42022333273). Besides, relevant randomized controlled trials (RCTs) that compared XYP plus acitretin with acitretin alone for treating PV were searched from several databases from their inception till May 2022. In addition, this work utilized RevMan5.4 to conduct risk assessment as well as meta-analysis. Results: This meta-analysis selected altogether 10 RCTs including 815 subjects. Upon quality assessment, the RCTs mainly had low or unclear risk. According to our meta-analysis results, relative to acitretin monotherapy, XYP plus acitretin increased the total clinical effective rate, as evidenced by Psoriasis area and severity index score (PASI)-20, PASI-30 and PASI-60 in patients with PV [risk ratio (RR) = 1.23 Z = 4.87, p < 0.00001, 95% confidence interval (CI): 1.13–1.34; RR = 1.29, Z = 3.89, p = 0.009, 95% CI: 1.07 to 1.55; and RR = 1.31, Z = 3.89, p = 0.0001, 95% CI: 1.14–1.49]; the reduced levels of TNF-α, MCP-1 and RANTES, the alleviated side effects resulting from acitretin like itchiness (RR = 0.54, 95% CI: 0.4 to 0.74, Z = 3.94, p < 0.0001), and the increased levels of aminotransferases and dyslipidemia (RR = 0.5, 95%CI = 0.29, 0.86, p = 0.01; and RR = 0.41, 95% CI = 0.23, 0.75, p = 0.004). Conclusion: As suggested in the present meta-analysis, XYP combined with acitretin effectively and safely treats PV. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022333273, identifier PROSPERO 2022 CRD42022333273.
Collapse
|
10
|
Clowse M, Fischer-Betz R, Nelson-Piercy C, Scheuerle AE, Stephan B, Dubinsky M, Kumke T, Kasliwal R, Lauwerys B, Förger F. Pharmacovigilance pregnancy data in a large population of patients with chronic inflammatory disease exposed to certolizumab pegol. Ther Adv Musculoskelet Dis 2022; 14:1759720X221087650. [PMID: 35464812 PMCID: PMC9023886 DOI: 10.1177/1759720x221087650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/15/2022] [Indexed: 12/29/2022] Open
Abstract
Introduction: Chronic inflammatory diseases (CIDs), including rheumatic diseases and other inflammatory conditions, often affect women of reproductive age. Tumor necrosis factor inhibitors (TNFi) are widely used to treat CID, but there is limited information on outcomes of TNFi-exposed pregnancies. We evaluated pregnancy outcomes from 1392 prospectively reported pregnancies exposed to certolizumab pegol (CZP), a PEGylated, Fc-free TNFi with no to minimal placental transfer. Methods: CZP-exposed pregnancies in patients with CID from the UCB Pharmacovigilance global safety database were reviewed from the start of CZP clinical development (July 2001) to 1 November 2020. To limit bias, the analysis focused on prospectively reported cases with known pregnancy outcomes. Results: In total, 1392 prospective pregnancies with maternal CZP exposure and known pregnancy outcomes (n = 1425) were reported; 1021 had at least first-trimester CZP exposure. Live birth was reported in 1259/1425 (88.4%) of all prospective outcomes. There were 150/1425 (10.5%) pregnancy losses before 20 weeks (miscarriage/induced abortion), 11/1425 (0.8%) stillbirths, and 5/1392 (0.4%) ectopic pregnancies. Congenital malformations were present in 30/1259 (2.4%) live-born infants, of which 26 (2.1%) were considered major according to the Metropolitan Atlanta Congenital Defects Program criteria. There was no pattern of congenital malformations. Discussion and conclusion: No signal for adverse pregnancy outcomes or congenital malformations was observed in CZP-exposed pregnancies. Although the limitations of data collected through this methodology (including underreporting, missing information, and absence of a comparator group) should be considered, these data provide reassurance for women with CID who require CZP treatment during pregnancy, and their treating physicians.
Collapse
Affiliation(s)
- Megan Clowse
- Division of Rheumatology, Duke University Medical Center, 3535, Durham, NC 27710, USA
| | - Rebecca Fischer-Betz
- Department for Rheumatology and Hiller Research Institute, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Angela E. Scheuerle
- Department of Pediatrics, Division of Genetics and Metabolism, UT Southwestern Medical Center, Dallas, TX, USA
| | - Brigitte Stephan
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marla Dubinsky
- The Susan and Leonard Feinstein IBD Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | | | | | | | - Frauke Förger
- Department of Rheumatology and Immunology, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| |
Collapse
|
11
|
Mahajan M, Kaur M, Thakur S, Singh A, Shahtaghi NR, Shivgotra R, Bhardwaj N, Saini S, Jain SK. Solid Lipid Nanoparticles as Carrier to Increase Local Bioavailability of Acitretin After Topical Administration in Psoriasis Treatment. J Pharm Innov 2022. [DOI: 10.1007/s12247-022-09635-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
12
|
Lan J, Li Y, Wen J, Chen Y, Yang J, Zhao L, Xia Y, Du H, Tao J, Li Y, Zhu J. Acitretin-Conjugated Dextran Nanoparticles Ameliorate Psoriasis-like Skin Disease at Low Dosages. Front Bioeng Biotechnol 2022; 9:816757. [PMID: 35071218 PMCID: PMC8777251 DOI: 10.3389/fbioe.2021.816757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/17/2021] [Indexed: 12/31/2022] Open
Abstract
Psoriasis is a common chronic inflammatory skin disease mainly characterized by keratinocyte hyperproliferation and massive infiltration of inflammatory immune cells. Acitretin (ACT), an FDA-approved first-line systemic drug for psoriasis treatment, could suppress the proliferation of keratinocytes and downregulate the expression of inflammatory cytokines by modulating signal transducer and activator of transcription (STAT) signaling pathways. However, dose-dependent side effects of ACT limit its long-term administration in the clinic. Therefore, improving the therapeutic efficacy of ACT to reduce clinical dosage will benefit the patients. Here, we develop ACT-conjugated dextran nanoparticles (ACT-Dex NPs) and evaluated the potential for psoriasis treatment. Our results indicate that ACT-Dex NPs ameliorate psoriasis-like skin disease significantly at a low dosage which does not cause side effects, while neat ACT drugs at an equivalent dosage provide much less benefit. Moreover, we demonstrate that ACT-Dex NPs suppress keratinocyte proliferation more efficiently than neat ACT by enhancing the inhibitory effect on STAT3 phosphorylation. Thus, the proposed ACT-Dex NPs provide an effective and safe option for psoriasis treatment.
Collapse
Affiliation(s)
- Jiajia Lan
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Yuce Li
- Hubei Engineering Research Center for Biomaterials and Medical Protective Materials, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, China.,State Key Laboratory of Materials Processing and Mold Technology, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jingjing Wen
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Yu Chen
- Hubei Engineering Research Center for Biomaterials and Medical Protective Materials, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, China.,State Key Laboratory of Materials Processing and Mold Technology, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jing Yang
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Liang Zhao
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Yuting Xia
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Hongyao Du
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Juan Tao
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Yan Li
- Department of Dermatology and Venereology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center of Skin Disease Theranostics and Health, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jintao Zhu
- Hubei Engineering Research Center for Biomaterials and Medical Protective Materials, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, China.,State Key Laboratory of Materials Processing and Mold Technology, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, China
| |
Collapse
|
13
|
Efe OE, Aydos TR, Emre Aydingoz S. Mechanism of acitretin-induced relaxations in isolated rat thoracic aorta preparations. Can J Physiol Pharmacol 2022; 100:35-42. [PMID: 34411501 DOI: 10.1139/cjpp-2021-0206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Acitretin is a member of vitamin A-derived retinoids, and its effect on vascular smooth muscle had not yet been studied. The aim of this study is to investigate the effect of acitretin, a retinoid, on vascular smooth muscle contractility. Thoracic aorta preparations obtained from 34 male Sprague-Dawley rats (355 ± 15 g) were studied in isolated organ baths containing Krebs-Henseleit solution. The relaxation responses were obtained with acitretin (10-12-10-4 M) in endothelium-preserved and endothelium-denuded aorta preparations precontracted with submaximal concentration of phenylephrine (10-6 M). The role of retinoic acid receptors (RARs), nitric oxide, adenylyl, and guanylyl cyclase enzymes, and potassium channels in these relaxation responses were investigated. Acitretin produced concentration-dependent relaxations, which were independent of its solvent dimethylsulfoxide (DMSO), in endothelium-denuded phenylephrine-precontracted thoracic aorta preparations. While incubation with the RAR antagonist (AGN193109, 10-5 M) had no effect on these relaxations; nitric oxide synthase inhibitor (L-NG-Nitro arginine methyl ester (L-NAME), 10-4 M), adenylyl cyclase inhibitor (SQ2253, 10-5 M), guanylyl cyclase inhibitor (oxadiazolo [4,3-a] quinoxalin-1-one (ODQ), 10-6 M), and potassium channel blocker (tetraethylammonium (TEA), 10-2 M) significantly eliminated the relaxation responses induced by acitretin. Acitretin induces relaxation in rat isolated thoracic aorta preparations without endothelium, which may be mediated by nitric oxide, cyclic adenosine monophosphate, and cyclic guanosine monophosphate-dependent kinases and potassium channels.
Collapse
Affiliation(s)
- Oğuzhan Ekin Efe
- Baskent University, Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
- Baskent University, Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
| | - Tolga Reşat Aydos
- Baskent University, Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
- Baskent University, Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
| | - Selda Emre Aydingoz
- Baskent University, Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
- Baskent University, Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
| |
Collapse
|
14
|
Sharma K, Choudhary S, Silakari O. Portraying molecular modulation and therapeutic aspects of psoriasis: Retrospection and current status. J Mol Struct 2021. [DOI: 10.1016/j.molstruc.2021.130770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
15
|
Goh Y, Kwan Z, Han WH, Iqbal T, Yahya F, Khang TF, Singh S. Ocular surface disease in psoriatic patients in a developing country. Int Ophthalmol 2021; 41:2139-2147. [PMID: 33788072 DOI: 10.1007/s10792-021-01771-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate ocular surface changes among patients with psoriasis in Malaysia, a developing country in Southeast Asia. METHODS An interdisciplinary case-control study (60 psoriasis patients and 40 control subjects) to look at the differences in ocular surface manifestations between patients with psoriasis and a group of age-, gender- and ethnicity-matched healthy controls. RESULTS One hundred and twenty eyes of 60 patients with psoriasis and 80 eyes of 40 healthy controls without psoriasis were included in the study. Mild-to-moderate psoriasis was found in 42 patients (70%), while 18 patients (30%) had severe psoriasis. Psoriatic arthritis was found in 19 patients (32%). Of the 60 psoriatic patients, the prevalence of ocular involvement was 65% (39/60), in which 32% (19/60) had dry eyes, 27% (16/60) had lid margin abnormalities, 33% (20/60) had cataract, and one had history of anterior uveitis. Compared to controls, ocular surface of psoriatic patients showed more eyelid margin abnormalities, higher meibomian gland loss and lower tear film break-up time. The estimated odds ratio for dry eyes in the psoriasis group was 2.2 (95% CI: 0.8-6.9). CONCLUSION Ocular surface disorders encompassing eyelid margin abnormalities, meibomian gland loss and tear dysfunction occur at an earlier and higher rate among psoriatic patients.
Collapse
Affiliation(s)
- Yihui Goh
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Winn Hui Han
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tajunisah Iqbal
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Fariz Yahya
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tsung Fei Khang
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.,Institute of Mathematical Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Sujaya Singh
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.
| |
Collapse
|
16
|
Kara Polat A, Oguz Topal I, Aslan Kayıran M, Koku Aksu AE, Aytekin S, Topaloglu Demir F, Ozkok Akbulut T, Kıvanc Altunay I, Ozkur E, Karadag AS. Drug survival and safety profile of acitretin monotherapy in patients with psoriasis: A multicenter retrospective study. Dermatol Ther 2021; 34:e14834. [PMID: 33527603 DOI: 10.1111/dth.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 12/01/2022]
Abstract
Acitretin is a nonimmunosuppresive systemic agent used in the treatment of psoriasis. Despite its frequent use, research on drug survival and adverse effects is limited. This study aims to evaluate drug survival, factors associated with survival, and adverse effects. Database of the six tertiary referral center for psoriasis patients treated with acitretin between November 2014 and April 2020 were retrospectively analyzed. Demographics of patients, adverse effects, and also drug survival were analyzed. Of 412 patients, 61.2% were male, and 38.8% were female. Common clinical adverse effects were cheilitis (71.4%), dry skin (62.5%), and palmoplantar skin peeling (37.2%). High triglyceride and high total cholesterol levels were observed in 50.0% and 49.5% of patients, respectively. Median survival time (95% confidence interval [CI]) was 18 (13.6-22.4) months. Statistically significant risk factors affecting drug discontinuation were having psoriatic arthritis, age under 65, and receiving previous systemic treatment. Drug survival rates were 56.6%, 25.9%, and 19.8% at 1, 5, and 8 years, respectively. Although mucocutaneous adverse effects of the acitretin were quite frequent, severe, life-treatining ones were infrequent. This old, relatively inexpensive and safe treatment remains a good alternative for the treatment of psoriasis.
Collapse
Affiliation(s)
- Asude Kara Polat
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ilteris Oguz Topal
- Department of Dermatology, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ayse Esra Koku Aksu
- Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Sema Aytekin
- Department of Dermatology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Filiz Topaloglu Demir
- Department of Dermatology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Tugba Ozkok Akbulut
- Department of Dermatology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Kıvanc Altunay
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Ozkur
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | |
Collapse
|
17
|
Suo L, VanBuren C, Hovland ED, Kedishvili NY, Sundberg JP, Everts HB. Dietary Vitamin A Impacts Refractory Telogen. Front Cell Dev Biol 2021; 9:571474. [PMID: 33614636 PMCID: PMC7892905 DOI: 10.3389/fcell.2021.571474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/13/2021] [Indexed: 12/11/2022] Open
Abstract
Hair follicles cycle through periods of growth (anagen), regression (catagen), rest (telogen), and release (exogen). Telogen is further divided into refractory and competent telogen based on expression of bone morphogenetic protein 4 (BMP4) and wingless-related MMTV integration site 7A (WNT7A). During refractory telogen hair follicle stem cells (HFSC) are inhibited. Retinoic acid synthesis proteins localized to the hair follicle and this localization pattern changed throughout the hair cycle. In addition, excess retinyl esters arrested hair follicles in telogen. The purpose of this study was to further define these hair cycle changes. BMP4 and WNT7A expression was also used to distinguish refractory from competent telogen in C57BL/6J mice fed different levels of retinyl esters from two previous studies. These two studies produced opposite results; and differed in the amount of retinyl esters the dams consumed and the age of the mice when the different diet began. There were a greater percentage of hair follicles in refractory telogen both when mice were bred on an unpurified diet containing copious levels of retinyl esters (study 1) and consumed excess levels of retinyl esters starting at 12 weeks of age, as well as when mice were bred on a purified diet containing adequate levels of retinyl esters (study 2) and remained on this diet at 6 weeks of age. WNT7A expression was consistent with these results. Next, the localization of vitamin A metabolism proteins in the two stages of telogen was examined. Keratin 6 (KRT6) and cellular retinoic acid binding protein 2 (CRABP2) localized almost exclusively to refractory telogen hair follicles in study 1. However, KRT6 and CRABP2 localized to both competent and refractory telogen hair follicles in mice fed adequate and high levels of retinyl esters in study 2. In mice bred and fed an unpurified diet retinol dehydrogenase SDR16C5, retinal dehydrogenase 2 (ALDH1A2), and cytochrome p450 26B1 (CYP26B1), enzymes and proteins involved in RA metabolism, localized to BMP4 positive refractory telogen hair follicles. This suggests that vitamin A may contribute to the inhibition of HFSC during refractory telogen in a dose dependent manner.
Collapse
Affiliation(s)
- Liye Suo
- Department of Human Nutrition, The Ohio State University, Columbus, OH, United States
| | - Christine VanBuren
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX, United States
| | - Eylul Damla Hovland
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX, United States
| | - Natalia Y Kedishvili
- Department of Biochemistry and Molecular Genetics, Schools of Medicine and Dentistry, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Helen B Everts
- Department of Human Nutrition, The Ohio State University, Columbus, OH, United States.,Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX, United States
| |
Collapse
|
18
|
Nast A, Smith C, Spuls P, Avila Valle G, Bata‐Csörgö Z, Boonen H, De Jong E, Garcia‐Doval I, Gisondi P, Kaur‐Knudsen D, Mahil S, Mälkönen T, Maul J, Mburu S, Mrowietz U, Reich K, Remenyik E, Rønholt K, Sator P, Schmitt‐Egenolf M, Sikora M, Strömer K, Sundnes O, Trigos D, Van Der Kraaij G, Yawalkar N, Dressler C. EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations. J Eur Acad Dermatol Venereol 2021; 35:281-317. [DOI: 10.1111/jdv.16926] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022]
Affiliation(s)
- A. Nast
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Department of Dermatology, Venereology and Allergology Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - C. Smith
- St John’s Institute of Dermatology London UK
| | - P.I. Spuls
- Academic Medical Centre Amsterdam Amsterdam Netherlands
| | - G. Avila Valle
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Department of Dermatology, Venereology and Allergology Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | | | - H. Boonen
- Office‐Based Dermatology Practice Geel Belgium
| | - E. De Jong
- Radboud University Medical Centre Nijmegen Nijmegen Netherlands
| | - I. Garcia‐Doval
- Unidad de Investigación. Fundación Piel Sana AEDV Madrid Spain
| | | | | | - S. Mahil
- Guy's and St Thomas' NHS Foundation Trust London UK
| | - T. Mälkönen
- Helsinki University Central Hospital Helsinki Finland
| | - J.T. Maul
- Department of Dermatology University Hospital of Zürich Zürich Switzerland
| | - S. Mburu
- International Federation of Psoriasis Associations (IFPA)
| | - U. Mrowietz
- Universitätsklinikum Schleswig‐Holstein Kiel Germany
| | - K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | | | | | - P.G. Sator
- Municipal Hospital Hietzing Vienna Austria
| | - M. Schmitt‐Egenolf
- Dermatology Department of Public Health & Clinical Medicine Umeå University Umeå Sweden
| | - M. Sikora
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - K. Strömer
- Office‐Based Dermatology Practice Mönchengladbach Germany
| | | | - D. Trigos
- International Federation of Psoriasis Associations (IFPA)
| | | | - N. Yawalkar
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - C. Dressler
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Department of Dermatology, Venereology and Allergology Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| |
Collapse
|
19
|
Tomlinson CWE, Cornish KAS, Whiting A, Pohl E. Structure-functional relationship of cellular retinoic acid-binding proteins I and II interacting with natural and synthetic ligands. Acta Crystallogr D Struct Biol 2021; 77:164-175. [PMID: 33559606 PMCID: PMC7869897 DOI: 10.1107/s2059798320015247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/16/2020] [Indexed: 11/11/2022] Open
Abstract
A detailed understanding of the interactions between small-molecule ligands and their proposed binding targets is of the utmost importance for modern drug-development programs. Cellular retinoic acid-binding proteins I and II (CRABPI and CRABPII) facilitate a number of vital retinoid signalling pathways in mammalian cells and offer a gateway to manipulation of signalling that could potentially reduce phenotypes in serious diseases, including cancer and neurodegeneration. Although structurally very similar, the two proteins possess distinctly different biological functions, with their signalling influence being exerted through both genomic and nongenomic pathways. In this article, crystal structures are presented of the L29C mutant of Homo sapiens CRABPI in complex with naturally occurring fatty acids (1.64 Å resolution) and with the synthetic retinoid DC645 (2.41 Å resolution), and of CRABPII in complex with the ligands DC479 (1.80 Å resolution) and DC645 (1.71 Å resolution). DC645 and DC479 are two potential drug compounds identified in a recent synthetic retinoid development program. In particular, DC645 has recently been shown to have disease-modifying capabilities in neurodegenerative disease models by activating both genomic and nongenomic signalling pathways. These co-crystal structures demonstrate a canonical binding behaviour akin to that exhibited with all-trans-retinoic acid and help to explain how the compounds are able to exert an influence on part of the retinoid signalling cascade.
Collapse
Affiliation(s)
- Charles W. E. Tomlinson
- Department of Chemistry, Durham University, Lower Mountjoy, South Road, Durham DH1 3LE, United Kingdom
| | - Katy A. S. Cornish
- Department of Chemistry, Durham University, Lower Mountjoy, South Road, Durham DH1 3LE, United Kingdom
| | - Andrew Whiting
- Department of Chemistry, Durham University, Lower Mountjoy, South Road, Durham DH1 3LE, United Kingdom
| | - Ehmke Pohl
- Department of Chemistry, Durham University, Lower Mountjoy, South Road, Durham DH1 3LE, United Kingdom
- Department of Biosciences, Durham University, Upper Mountjoy, South Road, Durham DH1 3LE, United Kingdom
| |
Collapse
|
20
|
Development, characterization and evaluation of nanocarrier based formulations of antipsoriatic drug “acitretin” for skin targeting. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.102010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
21
|
Bahtaoui W, El Fetoiki FZ, Hali F, Chiheb S. Pancréatite aiguë sous acitrétine. Ann Dermatol Venereol 2020; 147:530-534. [DOI: 10.1016/j.annder.2020.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/29/2019] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
|
22
|
Balak DMW, Gerdes S, Parodi A, Salgado-Boquete L. Long-term Safety of Oral Systemic Therapies for Psoriasis: A Comprehensive Review of the Literature. Dermatol Ther (Heidelb) 2020; 10:589-613. [PMID: 32529393 PMCID: PMC7367959 DOI: 10.1007/s13555-020-00409-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Indexed: 01/10/2023] Open
Abstract
Oral systemic therapies are important treatment options for patients with moderate-to-severe psoriasis, either as monotherapy or in therapy-recalcitrant cases as combination therapy with phototherapy, other oral systemics or biologics. Long-term treatment is needed to maintain sufficient disease control in psoriasis, but continuous use of systemic treatments is limited by adverse events (AEs) and cumulative toxicity risks. The primary aim of this comprehensive literature review was to examine the long-term safety profiles of oral agents commonly used in the treatment of adults with psoriasis. Searches were conducted in EMBASE and PubMed up to November 2018, and 157 relevant publications were included. Long-term treatment with acitretin could be associated with skeletal toxicity and hepatotoxicity, although evidence for skeletal toxicity is mixed and hepatotoxicity is rare, particularly at low doses. Other safety issues include hyperlipidaemia and potential for teratogenicity up to 2-3 years after discontinuation of treatment. There is a paucity of data on long-term treatment with apremilast. Continued exposure to apremilast does not seem to increase the incidence of common AEs, such as gastrointestinal (GI) AEs, upper respiratory tract infections and headache, while the long-term risks for depression, suicidal thoughts and weight loss are unknown. Long-term ciclosporin treatment is associated with renal toxicity, hypertension, non-melanoma skin cancer, neurological AEs and GI AEs. Long-term methotrexate treatment is associated with hepatotoxicity, GI AEs, haematological toxicity, renal toxicity and alopecia. Finally, long-term treatment with fumaric acid esters (FAE) is associated with GI AEs, flushing, lymphocytopenia, proteinuria and elevated liver enzymes. Median drug survival estimates varied considerably: ~ 2.9-9.7 months for apremilast; ~ 5.4 months for ciclosporin; ~ 8.6 months for acitretin; ~ 12.1-21.6 months for methotrexate; and ~ 54.8 months for FAE. These long-term safety profiles may help to guide clinicians to select the optimal oral systemic treatment for the long-term treatment of psoriasis in adults.
Collapse
Affiliation(s)
- Deepak M W Balak
- Department of Dermatology, LangeLand Ziekenhuis, Zoetermeer, the Netherlands.
| | - Sascha Gerdes
- Department of Dermatology, Psoriasis-Center, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Aurora Parodi
- DiSSal Section of Dermatology, University of Genoa-Ospedale-Policlinico San Martino IRCCS, Genoa, Italy
| | - Laura Salgado-Boquete
- Department of Dermatology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| |
Collapse
|
23
|
Choudhary S, Patel R, Pradhan D, Deval R, Singh H, Thomas G, Jain AK. Psoriasis and cardiovascular disorders: association or epiphenomenon? Meta-analysis of observational studies. 3 Biotech 2020; 10:104. [PMID: 32099745 DOI: 10.1007/s13205-020-2089-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/21/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease believed to be correlated with numerous cardiovascular risk factors including increased blood pressure, elevated blood cholesterol level, diabetes, inactivity, high body mass index (obesity) and dyslipidaemia. The present meta-analysis intends to assess the association between psoriasis and cardiovascular risk factors. Three hundred and fifty articles were primarily screened using NCBI MEDLINE/PubMed and Cochrane library from its inception until June 30, 2018. Of these, 26 observational studies depending upon the inclusion and exclusion criteria were included in the study with 17,672 psoriasis patients and 66,407 non-psoriasis subjects. The psoriasis patients were found to be at significantly increased risk of systolic blood pressure (SBP) [ORs 2.31 (95% CI 1.12, 4.74)], diastolic blood pressure (DBP) [ORs 2.31 (95% CI 1.58, 3.38)], abdominal obesity [ORs 1.90 (95% CI 1.45, 2.50)] and triglycerides [ORs 1.80 (95% CI 1.29, 2.51)] as compared to non-psoriasis subjects. The subgroup analyses of studies based on the continents revealed that psoriasis patients from Middle East are prone to higher risk factors of CVD including increased levels of triglyceride, cholesterol, DBP, SBP, fasting blood sugar, body mass index and decreased HDL levels, whereas psoriasis patients from European population reported increased LDL-C and waist circumference. The present study supports a significant association between psoriasis and incidence of major adverse cardiovascular events. Contrary to the previous literature, our finding suggests that hypertension is a highly associative condition in psoriasis. The findings of this study could be validated amongst well-defined cohorts of patients with psoriasis individually in different regions to confirm the implication of the study.
Collapse
|
24
|
Pai VV, Phadke D, Shukla P, Naik K. Fixed Tapering Dosage of Acitretin in Patients with Psoriasis: A Short-Term Analysis of Clinical Efficacy and its Effects on Biochemical Parameters. Indian J Dermatol 2019; 64:213-216. [PMID: 31148860 PMCID: PMC6537684 DOI: 10.4103/ijd.ijd_300_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Acitretin is a widely used systemic retinoid in the treatment of psoriasis. Dosage of acitretin in not weight adjusted due to certain interindividual variations. OBJECTIVE To evaluate the clinical efficacy and effects on biochemical parameters of fixed tapering dosage of acitretin in patients with psoriasis administered over a period of 4 weeks. MATERIALS AND METHODS This was an observational study. The study included patients of psoriasis vulgaris in the age group of 18 and 65 years with a psoriasis area severity index (PASI) score of >10 which was not responsive to topical therapy and phototherapy. Patients were given oral acitretin daily at a dose of 25 mg BD for 2 weeks, which was later tapered to 25 mg OD for another 2 weeks. The clinical efficacy and biochemical parameters were assessed. RESULTS Out of the 18 patients, PASI 75 was achieved in 66% of the patients by the end of the third week. Significant elevations were noted in serum lipids during 4 weeks, which returned to normal limits or near baseline levels at the end of 4 weeks. CONCLUSION Fixed tapering dose of acitretin is effective in psoriasis with minimal clinical and biochemical adverse events.
Collapse
Affiliation(s)
- Varadraj V Pai
- From the Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| | - Diksha Phadke
- From the Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| | - Pankaj Shukla
- From the Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| | - Krupeksha Naik
- From the Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| |
Collapse
|
25
|
Reyes Bueno J, Reyes Garrido V, León A, Bustamante R. Intracranial hypertension syndrome in a patient with psoriasis receiving ustekinumab. NEUROLOGÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.nrleng.2017.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
26
|
Reyes Bueno J, Reyes Garrido V, León A, Bustamante R. Síndrome de hipertensión intracraneal en una paciente con psoriasis tratada con ustekinumab. Neurologia 2019; 34:281-282. [DOI: 10.1016/j.nrl.2017.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 05/02/2017] [Accepted: 05/12/2017] [Indexed: 12/01/2022] Open
|
27
|
|
28
|
Caine EA, Scheaffer SM, Arora N, Zaitsev K, Artyomov MN, Coyne CB, Moley KH, Diamond MS. Interferon lambda protects the female reproductive tract against Zika virus infection. Nat Commun 2019; 10:280. [PMID: 30655513 PMCID: PMC6336786 DOI: 10.1038/s41467-018-07993-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/30/2018] [Indexed: 02/08/2023] Open
Abstract
Although Zika virus (ZIKV) can be transmitted sexually and cause congenital birth defects, immune control mechanisms in the female reproductive tract (FRT) are not well characterized. Here we show that treatment of primary human vaginal and cervical epithelial cells with interferon (IFN)-α/β or IFN-λ induces host defense transcriptional signatures and inhibits ZIKV infection. We also assess the effects of IFNs on intravaginal infection of the FRT using ovariectomized mice treated with reproductive hormones. We find that mice receiving estradiol are protected against intravaginal ZIKV infection, independently of IFN-α/β or IFN-λ signaling. In contrast, mice lacking IFN-λ signaling sustain greater FRT infection when progesterone is administered. Exogenous IFN-λ treatment confers an antiviral effect when mice receive both estradiol and progesterone, but not progesterone alone. Our results identify a hormonal stage-dependent role for IFN-λ in controlling ZIKV infection in the FRT and suggest a path for minimizing sexual transmission of ZIKV in women.
Collapse
Affiliation(s)
- Elizabeth A Caine
- Departments of Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Suzanne M Scheaffer
- Obstetrics and Gynecology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Nitin Arora
- Departments of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15224, USA
- The Center for Microbial Pathogenesis, Children's Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15224, USA
- Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Konstantin Zaitsev
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- Computer Technologies Department, ITMO University, St. Petersburg, 197101, Russia
| | - Maxim N Artyomov
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Carolyn B Coyne
- Departments of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15224, USA.
- The Center for Microbial Pathogenesis, Children's Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15224, USA.
| | - Kelle H Moley
- Obstetrics and Gynecology, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- Department of Cell Biology and Physiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
| | - Michael S Diamond
- Departments of Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
| |
Collapse
|
29
|
Duarte GV, Calmon H, Radel G, de Fátima Paim de Oliveira M. Psoriasis and sexual dysfunction: links, risks, and management challenges. PSORIASIS (AUCKLAND, N.Z.) 2018; 8:93-99. [PMID: 30574453 PMCID: PMC6292237 DOI: 10.2147/ptt.s159916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
According to the WHO, sexual health is not merely the absence of disease. Sexual dysfunction may be present in 40.8% of psoriasis patients, furthermore, 68% prevalence was found in Brazilian women with psoriasis. The moderate prevalence of psoriatic lesions in the genital area (35%-42%) does not explain the alarming prevalence of sexual dysfunction. Other factors, such as anxiety, depression, and also psoriasis treatment may contribute to its development. Likewise, atherosclerosis of the pelvic vasculature is involved in the pathogenesis of erectile dysfunction. Risk factors for erectile dysfunction tend to be confused with the comorbidities seen in psoriasis patients. We also highlight that it may serve as a marker of cardiovascular risk.
Collapse
Affiliation(s)
- Gleison V Duarte
- Department of Dermatology, Instituto Bahiano de Imunoterapias (IBIS), Bahia, Brazil,
| | | | | | | |
Collapse
|
30
|
Dattilo G, Borgia F, Guarneri C, Casale M, Bitto R, Morabito C, Signorelli S, Katsiki N, Cannavò SP. Cardiovascular Risk in Psoriasis: Current State of the Art. Curr Vasc Pharmacol 2018; 17:85-91. [DOI: 10.2174/1570161115666171116163816] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 02/07/2023]
Abstract
Psoriasis (Pso) is a chronic inflammatory immune-mediated skin disease associated with
several comorbidities. Despite the growing number of studies providing evidence for the link between
Pso and Cardiovascular (CV) disorders, there are still many unsolved questions, dealing with the role of
the skin disease as an independent risk factor for CV events, the influence of Pso severity and duration
on CV damage, the presence of Psoriatic Arthritis (PsA) as a predictor of increased CV mortality and
morbidity and the detection of reliable clinical, laboratory and/or instrumental parameters to stratify CV
risk in psoriatic patients. Moreover, it remains to clarify if the early treatment of the dermatosis may
lower CV risk. In this paper we will try to provide answers to these queries in the light of the updated
data of the literature.
Collapse
Affiliation(s)
- Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Claudio Guarneri
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Matteo Casale
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Roberto Bitto
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Claudia Morabito
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Messina, Italy
| | - Salvatore Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Serafinello P. Cannavò
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| |
Collapse
|
31
|
Kim IW, Jeong HS, Kwon NS, Baek KJ, Yun HY, Kim DS. LGI3 promotes human keratinocyte differentiation via the Akt pathway. Exp Dermatol 2018; 27:1224-1229. [DOI: 10.1111/exd.13766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/23/2018] [Accepted: 08/06/2018] [Indexed: 01/01/2023]
Affiliation(s)
- In Wook Kim
- Department of Biochemistry; Chung-Ang University College of Medicine; Seoul Korea
| | - Hyo-Soon Jeong
- Department of Biochemistry; Chung-Ang University College of Medicine; Seoul Korea
| | - Nyoun Soo Kwon
- Department of Biochemistry; Chung-Ang University College of Medicine; Seoul Korea
| | - Kwang Jin Baek
- Department of Biochemistry; Chung-Ang University College of Medicine; Seoul Korea
| | - Hye-Young Yun
- Department of Biochemistry; Chung-Ang University College of Medicine; Seoul Korea
| | - Dong-Seok Kim
- Department of Biochemistry; Chung-Ang University College of Medicine; Seoul Korea
| |
Collapse
|
32
|
Decryption of Active Constituents and Action Mechanism of the Traditional Uighur Prescription (BXXTR) Alleviating IMQ-Induced Psoriasis-Like Skin Inflammation in BALB/c Mice. Int J Mol Sci 2018; 19:ijms19071822. [PMID: 29933541 PMCID: PMC6073889 DOI: 10.3390/ijms19071822] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/04/2018] [Accepted: 06/09/2018] [Indexed: 02/07/2023] Open
Abstract
Bai Xuan Xia Ta Re Pian (BXXTR) is a traditional Uighur medicine ancient prescription in China widely used in the treatment of psoriasis, presenting a high curative rate and few side effects. Given that the active constituents and action mechanism still remain unclear, the aim of this study is to explore the potential active constituents and mechanism of antipsoriasis of BXXTR. Psoriasis-like lesions model in BALB/c mice was induced by Imiquimod (IMQ), including five treatment groups: control group, IMQ-treated group, IMQ-ACITRETIN group (Positive control group), IMQ-BXXTR low dose group, IMQ-BXXTR medium dose group and IMQ-BXXTR high dose group. The Psoriasis Area and Severity Index (PASI) score, skin and ear thickness, and histologic section were collected. The differentially expressed genes were determined by using RNAseq technology and the relevant pathways were analyzed by KEGG database. The ELISA kit and western blot assays were used to detect the related protein expression levels. In addition, the chemical constituents of BXXTR were determined by UPLC-TOF-MS analysis and the potential active constituents were predicted by SEA DOCK and Gene Ontology (GO). The data demonstrated that BXXTR significantly alleviated IMQ-induced psoriasis. RNA-seq analysis showed that BXXTR induced the expression levels of 31 genes; the KEGG analysis suggested that BXXTR could significantly change IL-17-related inflammatory pathways. The ELISA kit confirmed that the expression level of IL-17A protein was significantly reduced. 75 compounds of BXXTR were determined by UPLC-TOF-MS analysis, 11 of 75 compounds were identified as potential active compounds by similarity ensemble approach docking (SEA DOCK) and Gene Ontology (GO). BXXTR reduced the severity of skin lesions by inhibiting IL-17-related inflammatory pathways. The results indicated that BXXTR could suppress psoriasis inflammation by multiple-constituents-regulated multiple targets synergistically. Collectively, this study could provide important guidance for the elucidation of the active constituents and action mechanism of BXXTR for the treatment of psoriasis.
Collapse
|
33
|
Zhou X, Zhu W, Shen M, He Y, Peng C, Kuang Y, Su J, Zhao S, Chen X, Chen W. Frizzled-related proteins 4 (SFRP4) rs1802073G allele predicts the elevated serum lipid levels during acitretin treatment in psoriatic patients from Hunan, China. PeerJ 2018; 6:e4637. [PMID: 29666772 PMCID: PMC5900929 DOI: 10.7717/peerj.4637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/27/2018] [Indexed: 12/14/2022] Open
Abstract
Background Acitretin is a second-generation synthetic retinoid, and is widely used for treating the severe psoriasis vulgaris. However, it should be chosen with caution for its cardiovascular risk, and it is reported that acitretin may increase the serum lipids. The purpose of this study is to investigate the relationship between the Frizzled-related proteins 4 (SFRP4) rs1802073 polymorphism and the changes of serum lipids in Chinese psoriatic patients during the treatment with acitretin. Methods In our study, 100 psoriatic patients were recruited systematically treated with acitretin (30 mg/day) for at least eight weeks. Data of the patients’ demographic and clinical characteristics and the results of serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were collected pre- and post-treatment. Results A total of 84 psoriatic patients were enrolled and divided into three groups by SFRP4 rs1802073 genotypes. The patients who carried with TT genotype had maintained levels of TG and LDL-C after acitretin treatment, while patients with GG/GT genotypes had significantly elevated levels of serum TG and LDL-C compared to the TT genotype (ΔTG%: 27.53 ± 59.13 vs −1.47 ± 37.79, p = 0.026, ΔLDL-C%: 10.62 ± 26.57 vs −1.29 ± 17.07, p = 0.042). The association of rs1802073 with TG and LDL-C profiles remained significant after adjusting for age, gender, and body mass index. Although without significance, the pre-post change in serum level of TC across rs1802073 GG/GT genotypes demonstrated a trend similar to TG and LDL, and the serum level of HDL-C demonstrated a trend opposite to TG, TC and LDL. Conclusions Our results demonstrated that SFRP4 rs1802073 polymorphism was found to be associated with elevated serum lipid levels after acitretin treatment, and it may serve as a genetic marker of safe and precise treatment for individual psoriatic patients.
Collapse
Affiliation(s)
- Xingchen Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Yijing He
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Cong Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Wangqing Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| |
Collapse
|
34
|
Abu Hashim II, Abo El-Magd NF, El-Sheakh AR, Hamed MF, Abd El-Gawad AEGH. Pivotal role of Acitretin nanovesicular gel for effective treatment of psoriasis: ex vivo-in vivo evaluation study. Int J Nanomedicine 2018; 13:1059-1079. [PMID: 29503541 PMCID: PMC5824759 DOI: 10.2147/ijn.s156412] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The goal of the current study was to explore the potential benefits of Acitretin (Act) nanovesicular gel as a prospective antipsoriatic topical delivery system counteracting the drug challenges in terms of its extremely low aqueous solubility, instability, skin irritation, and serious systemic adverse effects. Act-loaded niosomes were successfully developed, entirely characterized, and optimized. Further evaluation of the optimized formula was conducted regarding its stability and ex vivo cytotoxicity on different cell lines. The optimized niosomal vesicles were then incorporated in gel base matrix and investigated by sequential ex vivo (skin permeation and deposition) and in vivo (skin irritation and antipsoriatic activity using mouse tail model) experiments. The optimized Act-loaded niosomes (span 60:cholesterol molar ratio 1:1) were spherical in shape and exhibited the highest entrapment efficiency (90.32±3.80%) with appropriate nanosize and zeta potential of 369.73±45.45 nm and -36.33±1.80 mV, respectively. Encapsulation of the drug in the nanovesicles was further emphasized by differential scanning calorimetric and powder X-ray diffraction studies. After 3 months storage at 4±1°C, the optimized formula preserved its stability. Act nano niosomal gel produced a remarkable enhanced ex vivo permeation profile up to 30 h and significant drug deposition in the viable epidermal-dermal layers compared with those of Act gel. The pronounced antipsoriatic activity of the medicated nano niosomes was proved ex vivo in HaCaT cells (a keratinocyte cell line). Topical application of Act nano niosomal gel to mouse tail model further established its distinct in vivo antipsoriatic superiority in terms of significantly higher orthokeratosis, drug activity, and reduction in epidermal thickness compared with the control and other gel formulations. Also, negligible skin irritation and better skin tolerability of Act nanovesicular gel were revealed by primary irritation index and histopathologic examination.
Collapse
Affiliation(s)
| | | | - Ahmed Ramadan El-Sheakh
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Mohammed Fawzy Hamed
- Department of Pathology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | | |
Collapse
|
35
|
Fiore M, Leone S, Maraolo AE, Berti E, Damiani G. Liver Illness and Psoriatic Patients. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3140983. [PMID: 29546055 PMCID: PMC5818942 DOI: 10.1155/2018/3140983] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/30/2017] [Accepted: 01/04/2018] [Indexed: 12/12/2022]
Abstract
Psoriasis is a chronic inflammatory disease of the skin affecting approximately 2% of the world's population. Systemic treatments, including methotrexate and cyclosporin, are associated with potential hepatotoxicity, due to either direct liver damage or immunosuppression or both immunomediated and a direct liver injury; therefore, treatment of patients with psoriasis poses a therapeutic challenge. The aim of this minireview is to help clinicians in the management of psoriatic patients who develop signs of liver dysfunction. To find relevant articles, a comprehensive search was performed on PubMed, EMBASE, and Cochrane with appropriate combinations of the following keywords being considered: viral hepatitis, nonalcoholic fatty liver disease, psoriasis, hepatotoxicity, drug toxicity, cholestasis, and autoimmune liver diseases.
Collapse
Affiliation(s)
- Marco Fiore
- Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Sebastiano Leone
- Department of Medicine, Division of Infectious Diseases, “San Giuseppe Moscati” Hospital, Avellino, Italy
| | - Alberto Enrico Maraolo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Emilio Berti
- Department of Pathophysiology and Transplantation, Dermatology Unit, IRCCS Ca' Granda, University of Milan, Milan, Italy
| | - Giovanni Damiani
- Department of Pathophysiology and Transplantation, Dermatology Unit, IRCCS Ca' Granda, University of Milan, Milan, Italy
- Study Center of Young Dermatologists Italian Network (YDIN), Bergamo, Italy
| |
Collapse
|
36
|
Subedi S, Yu Q, Chen Z, Shi Y. Management of pediatric psoriasis with acitretin: A review. Dermatol Ther 2017; 31. [PMID: 29094450 DOI: 10.1111/dth.12571] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Abstract
Psoriasis is a chronic inflammatory disease of the skin which can occur at any age-group. Psoriasis in childhood is not uncommon and has genetic susceptibility but usually, an environmental trigger such as infection is thought to initiate the disease process. Pediatric psoriasis has profound effects on both physical and psychosocial health of the patient. Treatment of mild psoriasis can be done with topical therapies but those which do not respond to topical therapies can be treated with phototherapy and systemic therapies. The use of systemic therapies in childhood is mainly based on the published data, case series, expert opinion and the experience as there is the lack of controlled trials in the age group. Based on the experience retinoids are probably the second line drugs for the treatment of pediatric psoriasis which do not respond to topical therapies and phototherapy. Using acitretin in a low dose and with proper physical examinations and laboratory investigations will reduce the hazard of potential serious adverse events. This article gives the review of the use of acitretin in pediatric psoriasis.
Collapse
Affiliation(s)
- Smriti Subedi
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Qian Yu
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Zeyu Chen
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Yuling Shi
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| |
Collapse
|
37
|
Minocha R, Damian DL, Halliday GM. Melanoma and nonmelanoma skin cancer chemoprevention: A role for nicotinamide? PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:5-12. [DOI: 10.1111/phpp.12328] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Rashi Minocha
- Discipline of Dermatology; Bosch Institute; Central Clinical School; University of Sydney; Sydney NSW Australia
- Dermatology; Sydney Cancer Centre; Royal Prince Alfred Hospital; Sydney NSW Australia
| | - Diona L. Damian
- Discipline of Dermatology; Bosch Institute; Central Clinical School; University of Sydney; Sydney NSW Australia
- Dermatology; Sydney Cancer Centre; Royal Prince Alfred Hospital; Sydney NSW Australia
- Melanoma Institute Australia; North Sydney NSW Australia
| | - Gary M. Halliday
- Discipline of Dermatology; Bosch Institute; Central Clinical School; University of Sydney; Sydney NSW Australia
- Dermatology; Sydney Cancer Centre; Royal Prince Alfred Hospital; Sydney NSW Australia
| |
Collapse
|
38
|
Mahé E. Cushing's Syndrome Induced by High-Potency Topical Corticosteroids in Two Children with Palmoplantar Psoriasis Taking Acitretin. Pediatr Dermatol 2017; 34:219-220. [PMID: 28297143 DOI: 10.1111/pde.13033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil, France
| |
Collapse
|
39
|
Greb JE, Goldminz AM, Elder JT, Lebwohl MG, Gladman DD, Wu JJ, Mehta NN, Finlay AY, Gottlieb AB. Psoriasis. Nat Rev Dis Primers 2016; 2:16082. [PMID: 27883001 DOI: 10.1038/nrdp.2016.82] [Citation(s) in RCA: 530] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative effects on patient quality of life. Psoriasis has a strong, albeit polygenic, genetic basis. Whereas approximately half of the accountable genetic effect of psoriasis maps to the major histocompatibility complex, >70 other loci have been identified, many of which implicate nuclear factor-κB, interferon signalling and the IL-23-IL-23 receptor axis. Psoriasis pathophysiology is characterized by abnormal keratinocyte proliferation and immune cell infiltration in the dermis and epidermis involving the innate and adaptive immune systems, with important roles for dendritic cells and T cells, among other cells. Frequent comorbidities are rheumatological and cardiovascular in nature, in particular, psoriatic arthritis. Current treatments for psoriasis include topical agents, photo-based therapies, traditional systemic drugs and biologic agents. Treatments can be used in combination or as monotherapy. Biologic therapies that target specific disease mediators have become a mainstay in the treatment of moderate-to-severe disease, whereas advances in the treatment of mild-to-moderate disease have been limited.
Collapse
Affiliation(s)
- Jacqueline E Greb
- Tufts University School of Medicine, Boston, Massachusetts, USA.,Tufts Medical Center, Department of Dermatology, Boston, Massachusetts, USA
| | - Ari M Goldminz
- Tufts Medical Center, Department of Dermatology, Boston, Massachusetts, USA
| | - James T Elder
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dafna D Gladman
- University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Jashin J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Alice B Gottlieb
- Department of Dermatology, New York Medical College, 40 Sunshine Cottage Rd, Valhalla, New York 10595, USA
| |
Collapse
|
40
|
Abstract
Background: Women comprise half of all psoriasis patients and because the majority of psoriasis cases present before age 40 the disease affects women who may become pregnant. Information regarding the heritability of psoriasis can be used in counseling patients who inquire about the potential risk to their children. Patients with psoriasis who become pregnant will likely notice an associated improvement of their symptoms if any change is noted at all. Objective: Because of potential fetal effects, the treatment of chronic psoriasis in pregnancy involves prudent consideration of whether the severity of the disease warrants treatment and selection of the safest treatments available. Conclusion: Topical corticosteroids and topical calcipotriene as well as topical anthralin and topical tacrolimus appear to be safe choices for control of localized psoriasis in pregnancy. UVB is the safest treatment for extensive psoriasis during pregnancy, particularly when topical application of other agents is not practical. Short-term use of cyclosporine during pregnancy is probably the safest option for management of severe psoriasis that has not responded to topical or UVB treatment.
Collapse
Affiliation(s)
- Amanda E. Tauscher
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Alan B. Fleischer
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kathy C. Phelps
- Department of Pharmacy, North Carolina Baptist Hospital, Winston-Salem, North Carolina, USA
| | - Steven R. Feldman
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
41
|
Chiu HY, Hsieh CF, Chiang YT, Huang WF, Tsai TF. The Risk of Chronic Pancreatitis in Patients with Psoriasis: A Population-Based Cohort Study. PLoS One 2016; 11:e0160041. [PMID: 27467265 PMCID: PMC4965214 DOI: 10.1371/journal.pone.0160041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/12/2016] [Indexed: 12/13/2022] Open
Abstract
Background Psoriasis is a chronic systemic inflammatory disorder, and studies have revealed its association with a variety of comorbidities. However, the risk of chronic pancreatitis (CP) in psoriasis has not been studied. This study aimed to investigate the risk of CP among patients with psoriasis. Methods Using the Taiwan National Health Insurance Research Database, this population-based cohort study enrolled 48430 patients with psoriasis and 193720 subjects without psoriasis. Stratified Cox proportional hazards models were used to compare the risks of CP between the patients with and without psoriasis. Results The incidence of CP was 0.61 per 1000 person-years in patients with psoriasis and 0.34 per 1000 person-years in controls during a mean 6.6-year follow-up period. Before adjustment, patients with psoriasis had a significantly higher risk of CP (crude hazard ratio (HR) = 1.81; 95% confidence interval (CI) = 1.53–2.15), and the risk remained significantly higher after adjustments for gender, age group, medications, and comorbidities (adjusted HR (aHR) = 1.76; 95% CI = 1.47–2.10). All psoriasis patient subgroups other than those with arthritis, including those with mild and severe psoriasis and those without arthritis, had significantly increased aHRs for CP, and the risk increased with increasing psoriasis severity. Psoriasis patients taking nonsteroidal anti-inflammatory drugs (aHR = 0.33; 95% CI = 0.22–0.49) and methotrexate (aHR = 0.28; 95% CI = 0.12–0.64) had a lower risk of developing CP after adjustments. Conclusions Psoriasis is associated with a significantly increased risk of CP. The results of our study call for more research to provide additional insight into the relationship between psoriasis and CP.
Collapse
Affiliation(s)
- Hsien-Yi Chiu
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Feng Hsieh
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Ting Chiang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Weng-Foung Huang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
42
|
Finet A, Viguier M, Chazouillères O, Amatore F, Paul C, Richard MA, Chosidow O, Bachelez H, Sbidian E. Liver test abnormalities in patients admitted for severe psoriasis: prevalence and associated risk factors. J Eur Acad Dermatol Venereol 2016; 30:1742-1748. [PMID: 27226222 DOI: 10.1111/jdv.13674] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/22/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Few epidemiologic data are available regarding biologic liver abnormalities during psoriasis flares. OBJECTIVES The aim of this study was to assess the prevalence of biological liver test abnormalities (LTA) in a psoriasis population and the risk factors associated with LTA. METHODS A retrospective cross-sectional study in four hospital dermatology tertiary care centres included patients admitted for severe psoriasis flare between 1st January 2010 and 31st December 2011. During the same period, a control population was selected comprising patients admitted for contact and/or atopic eczema. Data were collected on hospital records and biology software. LTA was defined as serum AST and/or ALT and/or ALP concentration above the upper normal limit (UNL) and/or GGT concentration above 2 UNL. Prevalence of LTA with 95% confidence intervals (95% CI) was compared between the psoriatic and control populations. Factors associated with LTA at P < 0.05 were considered for the final multivariate logistic regression model. RESULTS Two hundred and forty psoriasis patients and 96 eczema control patients were included. One hundred and fifty-five(64.6%) of the psoriasis patients were male, aged 55 years on average (±17.6); 192 (80.0%) had plaque-type psoriasis (PV) and 52 (21.6%) had localized (n = 32) or generalized (n = 20) pustular psoriasis (PP). Prevalence of LTA was 36% (95% CI, 30-42) in the psoriatic population, significantly higher than in controls (17%, 95% CI 9.5-25). Risk factors independently associated with LTA comprised PV (OR 3.79; 95% CI 1.48-9.65), PP (OR 3.80; 95% CI 1.40-10.25) and previously diagnosed liver disease (underlying hepatic steatosis, viral hepatitis or excessive alcohol consumption) (OR 3.88; 95% CI 2.02-7.45). No association was found with systemic antipsoriatic drug therapies. CONCLUSION In severe psoriasis, liver impacting comorbidities and/or specific psoriatic inflammation, the latter mostly in PP cases, more than drug-related liver toxicity, appears to predominantly account for LTA. Clinicians should be aware of this, to avoid unjustified withdrawal of useful systemic drugs.
Collapse
Affiliation(s)
- A Finet
- Sorbonne Paris Cité Université Paris Diderot, Paris, France
- Service de Dermatologie, AP-HP Hôpital Saint-Louis, Paris, France
| | - M Viguier
- Sorbonne Paris Cité Université Paris Diderot, Paris, France
- Service de Dermatologie, AP-HP Hôpital Saint-Louis, Paris, France
| | - O Chazouillères
- AP-HP, Hôpital Saint-Antoine, Service d'Hépatologie, Sorbonne Université, UPMC Univ Paris 06, INSERM, UMR_S 938/CDR Saint-Antoine, Paris, France
| | - F Amatore
- Département de Dermatologie, AP-HM, Hôpital La Timone, Marseille, France
| | - C Paul
- Département de Dermatologie, Hôpital Larrey, Toulouse, France
| | - M A Richard
- Département de Dermatologie, AP-HM, Hôpital La Timone, Marseille, France
| | - O Chosidow
- Inserm, Centre d'Investigation Clinique 1430, Créteil, France
- EA EpidermE 7379, Université Paris-Est Créteil, Créteil, France
- Département de Dermatologie, AP-HP, Hôpital Universitaire Henri Mondor, Créteil, France
| | - H Bachelez
- Sorbonne Paris Cité Université Paris Diderot, Paris, France
- Service de Dermatologie, AP-HP Hôpital Saint-Louis, Paris, France
- INSERMU1163, Institut Imagine, Necker Hospital, Paris, France
| | - E Sbidian
- Inserm, Centre d'Investigation Clinique 1430, Créteil, France.
- EA EpidermE 7379, Université Paris-Est Créteil, Créteil, France.
- Département de Dermatologie, AP-HP, Hôpital Universitaire Henri Mondor, Créteil, France.
| |
Collapse
|
43
|
Alamri A, Alsenaid A, Ruzicka T, Wolf R. Hypertrophic lichen planus - successful treatment with acitretin. Dermatol Ther 2016; 29:173-6. [DOI: 10.1111/dth.12337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ali Alamri
- Department of Dermatology and Allergology; Ludwig-Maximilian University Munich; Munich Germany
| | - Adel Alsenaid
- Department of Dermatology and Allergology; Ludwig-Maximilian University Munich; Munich Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergology; Ludwig-Maximilian University Munich; Munich Germany
| | - Ronald Wolf
- Department of Dermatology and Allergology; Ludwig-Maximilian University Munich; Munich Germany
| |
Collapse
|
44
|
Huen AO, Kim EJ. The Role of Systemic Retinoids in the Treatment of Cutaneous T-Cell Lymphoma. Dermatol Clin 2015; 33:715-29. [PMID: 26433844 DOI: 10.1016/j.det.2015.05.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Retinoids are natural and synthetic vitamin A analogs with effects on cell proliferation, differentiation, and apoptosis. They have significant activity in hematologic malignancies and have been studied extensively in cutaneous T-cell lymphoma. Retinoids bind to nuclear receptors and exert their effects through moderation of gene expression. Retinoic acid receptor and retinoic X receptor exert regulatory activity in vivo, binding to distinct ligands. Studies investigating systemic retinoids as monotherapy and in combination with other agents active against cutaneous lymphoma are reviewed. Side effects associated with retinoids include teratogenicity, dyslipidemias, and hypothyroidism, which should be carefully monitored in patients receiving treatment.
Collapse
Affiliation(s)
- Auris O Huen
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Suite 330S, Philadelphia, PA 19104, USA
| | - Ellen J Kim
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Suite 330S, Philadelphia, PA 19104, USA.
| |
Collapse
|
45
|
Abdelnabi M, Short J, Khoromi S, Ehrlich A. Intracranial hypertension and memory loss in a patient treated with ustekinumab. Australas J Dermatol 2015; 56:146-7. [PMID: 25900637 DOI: 10.1111/ajd.12248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mai Abdelnabi
- School of Medicine, George Washington University, Washington, District of Columbia, USA
| | | | | | | |
Collapse
|
46
|
Morris M, Schifano L, Fong R, Graff O. Safety of alitretinoin for severe refractory chronic hand eczema: Clinical studies and postmarketing surveillance. J DERMATOL TREAT 2015; 27:54-8. [DOI: 10.3109/09546634.2015.1034080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
47
|
Sauder MB, Cheung L, Beecker J. Acitretin-Induced Hepatitis: When to Monitor Cholestatic Enzymes. J Cutan Med Surg 2015; 19:115-20. [DOI: 10.2310/7750.2014.14051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Importance Acitretin is a systemic retinoid that is used in dermatology for a variety of conditions. A well-recognized potential adverse event from acitretin is elevated transaminases, indicating acute hepatocyte damage. Less well known is the possible cholestatic injury that can occur, signaled by elevated γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP). Observations Our patient presented with an acute acitretin-induced hepatitis with a mixed pattern of elevated transaminases as well as GGT and ALP. A literature review demonstrated that most cases of acitretin-induced hepatitis, outside clinical trials, describe patients with a similar mixed hepatitis pattern. Conclusions This is the first literature review on acitretin-induced hepatitis. Although acitretin-induced hepatoxicity is rare, the seemingly unusual presentation of a mixed pattern of hepatocyte injury and cholestasis may be more common than previously thought. The findings should encourage clinicians not only to monitor transaminases but also to consider measuring cholestatic enzymes (ALP/GGT) in patients with transaminase abnormalities.
Collapse
Affiliation(s)
- Maxwell B. Sauder
- From the Division of Dermatology and the Faculty of Medicine, University of Ottawa, Ottawa, ON
| | - Loretta Cheung
- From the Division of Dermatology and the Faculty of Medicine, University of Ottawa, Ottawa, ON
| | - Jennifer Beecker
- From the Division of Dermatology and the Faculty of Medicine, University of Ottawa, Ottawa, ON
| |
Collapse
|
48
|
Yiu ZZN, Warren RB, Mrowietz U, Griffiths CEM. Safety of conventional systemic therapies for psoriasis on reproductive potential and outcomes. J DERMATOL TREAT 2015; 26:329-34. [PMID: 25424052 DOI: 10.3109/09546634.2014.991673] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The effects of conventional systemic therapies for psoriasis on pregnancy outcomes, lactation, male fertility and mutagenicity are common concerns in the clinical setting. There is relatively little evidence to guide clinician and patient. In this study, we review the safety profile of the commonly used conventional systemic therapies used for psoriasis in individuals of reproductive potential. Safety data are derived from large-scale registries, adverse-event reporting databases, clinical trials and case reports. We assess the effect of each therapy on adverse pregnancy outcomes, including congenital malformations, and lactation with maternal administration. We also assess the effect of the therapies on male fertility and potential mutagenicity with paternal administration. We provide applicable guidance to inform clinician and patient before and after conception.
Collapse
Affiliation(s)
- Zenas Z N Yiu
- The Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre , Manchester , UK and
| | | | | | | |
Collapse
|
49
|
Porwal PK, Upmanyu N. Assessment by HPLC of the degradation behavior of acitretin under hydrolytic, oxidative, photolytic and thermal stress conditions. Acta Pharm Sin B 2014; 4:438-46. [PMID: 26579415 PMCID: PMC4629101 DOI: 10.1016/j.apsb.2014.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/25/2014] [Accepted: 09/09/2014] [Indexed: 11/27/2022] Open
Abstract
Acitretin is a photosensitive oral retinoid with very limited data available on its degradation. The official HPLC method for acitretin determination was insufficient to resolve the degradation products generated during stability studies. Therefore, an isocratic RP-HPLC-UV method was developed for the determination of acitretin in the presence of its related impurities and degradation products. Efficient chromatographic separation was achieved on a Thermo beta-basic column C18 (100 mm×4.6 mm, 5 μm) with mobile phase containing 0.3% (v/v) glacial acetic acid with acetonitrile (ACN) and isopropyl alcohol (IPA) in an isocratic ratio of 70:30 at a flow rate of 1.0 mL/min with the eluent monitored at 360 nm. The method was validated for specificity, linearity, precision, accuracy and robustness. The calibration plot was linear over the concentration range of 50-150 μg/mL with a correlation coefficient (r (2)) of 0.999. The proposed method was used to investigate the degradation kinetics of acitretin under the different degradative conditions. The degradation rate constant (K), half-life (t 1/2), and t 90 were calculated. Degradation of acitretin followed pseudo-first-order kinetics. The drug was found to be less stable under acidic and photolytic degradation conditions: the photolytic degradation constants for acitretin in sunlight and UV light were 0.002698% and 0.0008402% min(-1), respectively. The LOD for acitretin and the known impurities were at a level below 0.02%. The method shows consistent recoveries for ACTR (99.8%-101.2%) and also for its known impurities (97.2-101.3%). The method was found to be accurate, precise, linear, specific, sensitive, rugged, robust, and useful for characterizing the stability of this chemical.
Collapse
|
50
|
Mosca S, Gargiulo P, Balato N, Di Costanzo L, Parente A, Paolillo S, Ayala F, Trimarco B, Crea F, Perrone-Filardi P. Ischemic cardiovascular involvement in psoriasis: a systematic review. Int J Cardiol 2014; 178:191-9. [PMID: 25464252 DOI: 10.1016/j.ijcard.2014.10.092] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/21/2014] [Indexed: 12/14/2022]
Abstract
Epidemiologic studies demonstrate that psoriasis is associated with shorter life expectancy, most frequently attributable to cardiovascular (CV) events. Although increased prevalence and incidence of CV risk factors for atherosclerosis have been reported in psoriatic patients, psoriasis likely plays an independent role in the increased cardiovascular risk, presumably linked to the chronic systemic inflammatory state. Consistently, preliminary investigations suggest that anti-inflammatory therapies may improve early subclinical vascular alterations and reduce cardiovascular morbidity and mortality. This review will focus on ischemic CV involvement in psoriatic patients, summarizing the prevalence and incidence of CV risk factors and CV events, as well as evidence on mechanisms of premature atherosclerosis and on effects of systemic anti-inflammatory therapies on CV risk profile. We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and evaluated the quality of studies comparing drug treatments using Detsky score. Our review documented that psoriatic patients are at increased CV risk, related to raised prevalence and incidence of CV risk factor and to inflammatory status. However, available literature lacks of studies that establish appropriate targets for CV risk factors and assess the clinical value of screening for subclinical organ damage and the impact of disease-modifying therapies on CV risk profile in psoriatic patients. Awareness of raised CV risk in psoriatic patients should foster further research aimed at elucidating these aspects.
Collapse
Affiliation(s)
- Susanna Mosca
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Paola Gargiulo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
| | - Nicola Balato
- Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy
| | - Luisa Di Costanzo
- Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy
| | - Antonio Parente
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Filippo Crea
- Department of Cardiovascular Medicine, Policlinico A. Gemelli, "Catholic University of the Sacred Heart", Rome, Italy
| | - Pasquale Perrone-Filardi
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy.
| |
Collapse
|