Erythrocyte membrane fluidity changes in psoriasis: an EPR study

Oxidative Imbalance in Psoriasis with an Emphasis on Psoriatic Arthritis: Therapeutic Antioxidant Targets

Psoriasis and psoriatic arthritis (PsA) are chronic autoimmune diseases characterized by persistent inflammation and oxidative imbalance. Oxidative stress, caused by excessive production of reactive oxygen species (ROS) and dysfunction in antioxidant mechanisms, plays a critical role in the pathogenesis of both conditions, leading to increased inflammatory processes and tissue damage. This study aims to review current antioxidant-based therapeutic options and analyze oxidative stress biomarkers in the context of psoriasis and PsA. Based on available literature, key biomarkers, such as malondialdehyde (MDA), advanced glycation end-products (AGEs), and advanced oxidation protein products (AOPP), were identified as being elevated in patients with psoriasis and PsA. Conversely, antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), showed reduced activity, correlating with symptom severity. The study also examines the efficacy of various antioxidant therapies, including curcumin, resveratrol, coenzyme Q10, and vitamins C and E, which may aid in reducing oxidative stress and alleviating inflammation. The findings indicated that antioxidants can play a significant role in alleviating symptoms and slowing the progression of psoriasis and PsA through modulation of redox mechanisms and reduction of ROS levels. Antioxidant-based therapies offer a promising direction in treating autoimmune diseases, highlighting the need for further research on their efficacy and potential clinical application.

Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and other hematological parameters in psoriasis patients

Background

Psoriasis is a chronic immune‐mediated skin disorder. Systemic inflammation plays an important role in the pathogenesis of psoriasis.

Methods

A total of 477 patients with psoriasis vulgaris (PsV, n = 347), generalized pustular psoriasis (GPP, n = 37), erythrodermic psoriasis (PsE, n = 45), arthritic psoriasis (PsA, n = 25) and mixed psoriasis (n = 23), and 954 healthy control subjects were included in the study. Demographic, clinical, and laboratory information were collected and compared between subgroups.

Results

Compared with the healthy control group, patients with psoriasis had higher total white blood cell (WBC), neutrophil, platelet counts, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), but lower hemoglobin (Hb) levels, lymphocyte and red blood cell (RBC) counts. NLR values in the PsV group were significantly lower than those in the GPP, PsE, and PsA groups, with GPP group being the highest. PLR values in the PsV group were significantly lower than those in the GPP, PsE, and PsA groups. There was no significant correlation between the psoriasis area severity index (PASI) score and either the NLR or PLR in the PsV group.

Conclusions

Elevated NLR and PLR were associated with psoriasis and differed between subtypes, suggesting that they could be used as markers of systemic inflammation in psoriasis patients.

Changes in the Physicochemical Properties of Blood and Skin Cell Membranes as a Result of Psoriasis Vulgaris and Psoriatic Arthritis Development

Psoriasis is accompanied by disturbed redox homeostasis, with systemic and local oxidative stress promoting the modification of basic components of cellular membranes. Therefore, the aim of the study was to investigate the effect of development of psoriasis vulgaris and psoriatic arthritis on the composition and physicochemical properties of skin cell membranes (keratinocytes and fibroblasts) and blood cells (lymphocytes, granulocytes and erythrocytes). Both forms of psoriasis are characterized by decreased levels and changes in the localization of membrane phospholipids, and an increased level of sialic acid as well as the lipid peroxidation product (malondialdehyde), which resulted in an increase in the zeta potential of skin cells and blood cells, with granulocytes and lymphocytes affected more than erythrocytes. Using theoretical equations and the dependence of the cell membrane surface charge density as a function of pH, it was shown that patients with psoriatic arthritis have a greater increase in the concentration of negatively charged groups on the membrane surface and reduced the value of the association constant with H⁺ compared to patients with psoriasis vulgaris. Therefore, it can be suggested that the physicochemical parameters of membranes, skin and blood cells, especially lymphocytes, can be used to assess the severity of the disease.

Oxidative Stress as an Important Contributor to the Pathogenesis of Psoriasis

This review discusses how oxidative stress (OS), an imbalance between oxidants and antioxidants in favor of the oxidants, increased production of reactive oxygen species (ROS)/reactive nitrogen species (RNS), and decreased concentration/activity of antioxidants affect the pathogenesis or cause the enhancement of psoriasis (Ps). Here, we also consider how ROS/RNS-induced stress modulates the activity of transcriptional factors and regulates numerous protein kinase cascades that participate in the regulation of crosstalk between autophagy, apoptosis, and regeneration. Answers to these questions will likely uncover novel strategies for the treatment of Ps. Action in the field will avoid destructive effects of ROS/RNS-mediated OS resulting in cellular dysfunction and cell death. The combination of the fragmentary information on the role of OS can provide evidence to extend the full picture of Ps.

The serum levels of malondialdehyde, vitamin e and erythrocyte catalase activity in psoriasis patients

BACKGROUND

Psoriasis is a common skin disease which is characterized by increased epidermal proliferation and dermal inflammation affecting 0.1-3% of general population. Most of the psoriasis patients are young or middle aged adults, although no age exempted. The oxidative stress develops due to imbalance in oxidants and antioxidants, which was proposed to have role in psoriasis.

AIMS AND OBJECTIVES

The presented research work was planned to evaluate oxidative stress by measuring serum malondialdehyde (MDA) as oxidant and serum vitamin E, erythrocyte catalase (CAT) activity as antioxidants in psoriasis patients.

MATERIALS AND METHODS

Total 90 clinically diagnosed psoriasis patients of age group of 20 to 60 years and without any drug therapy for preceding two months and 90 matched healthy controls were included in the presented study. The severity of psoriasis was determined by PASI score. The fasting blood sample collected and accessed for serum MDA, serum vitamin E and erythrocyte catalase activity.

RESULTS

The study results were compiled and statistical analysis was done using students t-test. Our results showed significantly increased levels of serum MDA (p<0.001) and significantly decreased serum vitamin E (p<0.001) as well as erythrocyte catalase activity (p<0.001) in psoriasis patients as compared to controls.

CONCLUSION

The presented study concluded the oxidative stress in psoriasis, indicated by increased serum MDA and decreased Vitamin E, erythrocyte catalase activity. Our study also supports the possibility of involvement of oxidative stress in pathogenesis of psoriasis.

Impact of methotrexate on oxidative stress and apoptosis markers in psoriatic patients

Methotrexate (MTX), a cytotoxic chemotherapeutic agent, is considered an effective drug in the treatment of psoriasis. The aim of this study was to find out whether the effect of MTX treatment in psoriasis is due to oxidative stress-induced apoptosis. Psoriasis vulgaris patients (58 in number) were recruited for this study. Healthy volunteers (45 in number) served as control. Samples of psoriatic patients were collected and analyzed for total reactive oxygen species (ROS), malondialdehyde (MDA) levels, nitrite, nitrate levels and the activities of antioxidants like superoxide dismutase (SOD), catalase (CAT) and total antioxidant status (TAS) and also the protein expression of caspase-3, before (Day 0) and after (at the end of 6 and 12 weeks) MTX treatment. Our results show a significant increase in tissue ROS and plasma MDA after MTX treatment when compared with before MTX treatment in psoriasis patients (p < 0.001). The levels of serum nitrite and nitrate were decreased significantly after MTX treatment (p < 0.001). The activities of plasma SOD, TAS and serum CAT levels were decreased, but not significantly after 12 weeks of treatment. The expression of caspase-3 was increased after MTX treatment. In conclusion, MTX induce apoptosis through oxidative stress by reducing NO and increasing caspase-3 levels. MTX-induced apoptosis may account for the beneficial effect of MTX treatment in psoriasis patients, which is characterized by acanthosis.

Potential role of neurogenic inflammatory factors in the pathogenesis of vitiligo

BACKGROUND

Vitiligo is a highly complex multifactorial condition of the skin that has an unclear mechanism of pathogenesis.

OBJECTIVE

This review summarizes the role of various neurogenic inflammatory factors significantly upregulated in vitiligo.

METHODS

A literature review was conducted of all pertinent data regarding neuropeptides that are altered in vitiligo and their possible role in the destruction of melanocytes.

RESULTS

The close associations between the skin, immune system, and nervous system, along with specific changes demonstrated in vitiligo patients, support a pathogenic mechanism of vitiligo that involves neuroimmunologic factors, the release of which can be governed by mental stress.

CONCLUSION

Neuropeptides and nerve growth factors are critical regulators of emotional response and may precipitate the onset and development of vitiligo in certain predisposed individuals. More studies are required to investigate whether a direct link exists between genetics, mental stress, and neurogenic factors in vitiligo.

Abnormal isoaspartyl residues in erythrocyte membranes from psoriatic patients

Spontaneous protein deamidation of labile asparagines (Asn), generating abnormal isoaspartyl residues (IsoAsp), is associated with cell aging and enhanced by an oxidative microenvironment. The presence of isopeptide bonds impairs protein structure/function and can trigger autoimmune responses. To minimize the damage, IsoAsp can be "repaired" by a specific L-isoaspartate-(D-aspartate)-protein-O-methyltransferase. The condition of chronic oxidative stress reported in psoriatic patients, and the potential etiological role of unknown self-antigens, prompted us to investigate Asn deamidation in psoriatic tissues. Erythrocytes (RBC) were selected as the model system since, lacking protein synthesis apparatus, they are unable to replace damaged proteins. Blood samples were obtained from 36 patients and 34 controls. L-isoAsp content was highly increased in RBC membrane proteins from psoriatic patients. Deamidated species included ankyrin, band 4.1, band 4.2 and the integral membrane protein band 3. A functional analysis demonstrated that this result was unrelated to a reduced efficiency of the S-adenosylmethionine-dependent repair system suggesting an increased protein instability at Asn sites, responsible for IsoAsp accumulation in psoriatic patients.

Role of cellular oxidative stress and cytochrome c in the pathogenesis of psoriasis

Oxidative-free radicals and apoptosis have linked to chronic skin diseases. Higher levels of oxidative radicals and the release of mitochondrial cytochrome c may have a role in the pathogenesis of psoriasis. We investigated the possible role of cellular oxidative stress and release of cytochrome c of mitochondria in the pathogenesis of psoriasis. Disease severity was assessed by psoriasis area severity index score (PASI) of 55 psoriasis patients, they grouped as mild (11), moderate (20) and severe (24), also 20 healthy individuals used as controls. All groups were subjected for serum malondialdehyde (MDA), nitric oxide (NO·), superoxide dismutase (SOD), catalase (CAT), total antioxidant status (TAS) and serum cytochrome c concentrations. We found that, (1) Severity wise increase in MDA and NO·, and decrease in SOD, CAT and TAS levels in all patients with different degrees of psoriasis; (2) PASI showed positive correlation with the increase in MDA and NO·, and negatively with decreased SOD, CAT and TAS levels; (3) significant increase in cytochrome c level was observed among psoriasis patients which showed negative correlation to MDA and NO· levels in mild and positively with moderate and severe groups. The release of mitochondrial cytochrome c indicates the induction of apoptosis mediated via oxidative stress which ultimately plays role in the pathogenesis of psoriasis.

Erythroid disturbances before and after treatment of Portuguese psoriasis vulgaris patients: a cross-sectional and longitudinal study

BACKGROUND

A few studies in psoriasis vulgaris patients have reported changes suggesting red blood cell (RBC) damage is linked to neutrophil activation, oxidative stress, and psoriasis worsening.

OBJECTIVE

The aim of this study was to evaluate erythroid disturbances in Portuguese psoriasis vulgaris patients, before, during, and after treatment.

METHODS

A cross-sectional study (n = 73 patients vs 40 healthy control subjects) followed by a longitudinal study (n = 47 patients) was performed, with assessments before, and at 3, 6, and 12 weeks of therapy (10 patients started topical treatment, 17 narrow-band UVB, and 20 photochemotherapy [psoralen plus UVA; PUVA]). Evaluations included hematologic data, total bilirubin levels, membrane-bound hemoglobin (MBH), membrane protein band 3 profile, total plasma antioxidant status (TAS), lipid peroxidation (thiobarbituric acid [TBA] assay), elastase, lactoferrin, and C-reactive protein (CRP).

RESULTS

Before treatment, patients presented with higher leukocyte/neutrophil and reticulocyte counts, elastase, lactoferrin, TBA, TBA/TAS, reticulocyte production index, total bilirubin and MBH values, lower RBC and hematocrit, higher percentages of high-molecular-weight aggregates, and lower percentages of band 3 monomer. After treatment, we observed a reversal in most of the parameters. However, patients still presented with values suggestive of accelerated RBC damage, removal, and production, as most of the parameters were still higher than those in the control group; the same occurred with CRP.

CONCLUSION

Our data suggest that psoriasis vulgaris triggers an inflammatory response, with release of acute-phase reactants, reactive oxygen species, cationic proteins, and proteases, leading to enhanced RBC damage/aging and, ultimately, to enhanced RBC removal. These assumptions were strengthened by the observation that, with treatment, all of these changes were reversed, the inflammation was reduced, the production of reticulocytes was increased, and the RBCs presented changes usually observed in younger/less damaged RBCs. These erythroid changes were enhanced with PUVA therapy, probably due to the more pronounced clearing of the lesions, as suggested by Psoriasis Area and Severity Index (PASI) scores. Finally, after treatment, a residual inflammation still persisted that might contribute to the observed erythroid disturbances.

Electron paramagnetic resonance spectroscopy in radiation research: Current status and perspectives

Exposure to radiation leads to a number of health-related malfunctions. Ionizing radiation is more harmful than non-ionizing radiation, as it causes both direct and indirect effects. Irradiation with ionizing radiation results in free radical-induced oxidative stress. Free radical-mediated oxidative stress has been implicated in a plethora of diseased states, including cancer, arthritis, aging, Parkinson's disease, and so on. Electron Paramagnetic Resonance (EPR) spectroscopy has various applications to measure free radicals, in radiation research. Free radicals disintegrate immediately in aqueous environment. Free radicals can be detected indirectly by the EPR spin trapping technique in which these forms stabilize the radical adduct and produce characteristic EPR spectra for specific radicals. Ionizing radiation-induced free radicals in calcified tissues, for example, teeth, bone, and fingernail, can be detected directly by EPR spectroscopy, due to their extended stability. Various applications of EPR in radiation research studies are discussed in this review.

Role of oxidative stress in various stages of psoriasis

Psoriasis is a chronic inflammatory, proliferative skin disease characterized by pathological skin lesions due to various exogenous and endogenous factors. It is associated with a number of biochemical and immunological disturbances. Recently, it has been suggested that increased reactive oxygen species (ROS) production and compromised function of antioxidant system may be involved in the pathogenesis of this disease. In the present study, 90 psoriasis patients were selected. Disease severity was assessed by psoriasis area severity index score and grouped as mild, moderate and severe (each group consists of 30 subjects) and compared with 30 healthy controls. Serum levels of malondialdehyde, nitric oxide end products and the activities of antioxidant enzymes such as erythrocyte-superoxide dismutase, catalase and total antioxidant status were investigated in these groups/subjects. As compared to controls, we found severitywise significantly increased serum malondialdehyde, nitric oxide end products with decrease in erythrocyte-superoxide dismutase activity, catalase activity and total antioxidant status in patients with psoriasis suggesting worsening of the disease. It seems to be linked with the enhancement of Reactive Oxygen Species production and decreased antioxidant potential in psoriasis.

Electron paramagnetic resonance as a unique tool for skin and hair research

Electron paramagnetic resonance (EPR) spectroscopy and imaging (EPRI) are deeply rooted in the basic and quantum physics, but the spectrum of their applications in modern experimental and clinical dermatology and cosmetology is surprisingly wide. The main aim of this review was to show the physical foundation, technical limitations and versatility of this method in skin studies. Free radical and metal ion detection, EPR dosimetry, melanin study, spin trapping, spin labelling, oximetry and NO-metry, EPR imaging, new generation methods of EPR and EPR/NMR hybrid technology used under ex vivo and in vivo regime are portrayed in the context of clinical and experimental skin research to study problems such as oxidative and nitrosative stress generated by UV or inflammation, skin oxygenation, hydration of corneal layer of epidermis, transport and metabolism of drugs and cosmeceutics, skin carcinogenesis, skin tumors and many others. A part of the paper is devoted to hair and nail research. The review of dermatological applications of EPR is supplemented with a handful of advice concerning practical aspects of EPR experimentation and usage of EPR reagents.

The hemolysis kinetics of psoriatic red blood cells

Psoriasis has been reported to be associated with several red blood cell (RBC) membrane alterations including: a membrane fluidity decrease, a significant elevation of Na(+)-K(+)and quantitative changes of erythrocyte membrane proteins that may indicate red cell cytoskeleton impairment. The aim of the present study was to analyse the hemolytic behaviour of psoriatic RBCs. The osmotic behaviour of RBCs was examined by analysing the kinetics of hemolysis. The method is based on the measurement of the transmitted light (lambda=700 nm) scattered by a suspension of red blood cells subjected to osmotic stress in the stopped-flow regime. The transmittance as a function of time, which describes the lysis kinetics, can be satisfactorily fitted with a mathematical model which assumes three cell populations in each sample: cells that do not lyse in the experimental conditions and cells that undergo fast and slow lysis. A comparison of the erythrocyte hemolytic kinetics of blood samples from psoriatic patients and healthy subjects showed distinct differences. The fraction of hemolyzed erythrocytes for control samples was about 20%; for psoriatic ones 12.6% (P<0.001). In control blood samples the fraction of fast-breaking cells was greater (about 61% of lysed cells) than in psoriatic ones (about 56%). The parameter T(fast), describing the time of fast kinetics and T(slow), which reflects the rupturing time of cells belonging to the fraction of slow hemolysing cells were significantly higher for psoriatic erythrocytes than for control cells (P<0.001). It was shown that the psoriatic erythrocyte has a low propensity for hemolysis and that its plasma membrane is distinctly more resistant to osmotic stress, probably related to decreased bilayer fluidity and low cell deformability. The results of this study showed that the kinetics of hemolysis may be a promising method for detecting erythrocytes with defective plasma membrane components and/or defective cytoskeleton organization and indirectly can provide some information on cell function.

Effects of selenium on peripheral blood mononuclear cell membrane fluidity, interleukin-2 production and interleukin-2 receptor expression in patients with chronic hepatitis

AIM: To study the effect of selenium on peripheral blood mononuclear cell (PBMC) membrane fluidity and immune function in patients with chronic hepatitis.

METHODS: PBMCs were pretreated with selenium (1.156 × 10^-7 mol/L) for 6 h in vitro or extracted directly from patients after administration of selenium-yeast continuously for 8-12 wk (200 μg/d), and then exposed to Con-A for 48 h. The membrane fluidity, interleukin-2 (IL-2) production and interleukin-2 receptor (IL-2R) expression in PBMCs and malondialdehyde (MDA) concentration in medium and lipid peroxide (LPO) in plasma were determined.

RESULTS: The PBMC membrane fluidity, IL-2 production and IL-2R expression in patients with chronic hepatitis were significantly lower than those in healthy blood donators (particle adhesive degree R, 0.17 ± 0.01 vs 0.14 ± 0.01, P < 0.01; IL-2, 40.26 ± 9.55 vs 72.96 ± 11.36, P < 0.01; IL-2R, 31.05 ± 5.09 vs 60.58 ± 10.56, P < 0.01), and the MDA concentration in medium in patients with chronic hepatitis was significantly higher than that in healthy blood donators (1.44 ± 0.08 vs 0.93 ± 0.08, P < 0.01). Both in vitro and in vivo administration of selenium could reverse the above parameters.

CONCLUSION: Supplement of selenium can suppress lipid peroxidation, and improve PBMC membrane fluidity and immune function in patients with chronic hepatitis.

Changes in erythrocyte microrheology in patients with psoriasis

Erythrocyte deformability (ED), the ability of red blood cells to change shape during flow in the microcirculation, is the basic rheological property of erythrocytes. It is determined by the surface area to volume ratio, viscoelastic properties of the membrane, and intracellular viscosity. The aim of the present study was to determine changes in erythrocyte microrheology in patients with psoriasis. The whole red cell deformability was measured by flow-channel diffractometry. To assess the contribution of different factors influencing changes in ED, measurements were also made of the biophysical state of the phospholipid bilayer, using an osmotic haemolysis technique, and internal viscosity, using electron paramagnetic resonance spectroscopy. The results showed a significant decrease in ED in patients with psoriasis in comparison with controls, and suggested that the main cause of this may be alterations in intracellular viscosity and membrane viscoelastic behaviour.

Erythrocyte damage in mild and severe psoriasis

BACKGROUND

Psoriasis is a common chronic and recurrent inflammatory skin disorder. Oxygen metabolites and proteases released by activated inflammatory cells may induce oxidative and proteolytic damage to plasma constituents and red blood cells (RBCs). RBCs have a limited biosynthesis capacity and poor repair mechanisms.

OBJECTIVES

To study RBCs as a potential cumulative marker of oxidative and proteolytic stress in psoriasis, and as a marker of worsening of the disease.

METHODS

The study was performed in 70 patients with mild or severe psoriasis and in 40 control individuals. We evaluated total and differential leucocyte count and, as markers of leucocyte activation, plasma elastase and lactoferrin. Besides the basic RBC study (RBC count, haematocrit, haemoglobin concentration and haematimetric indices) we evaluated antioxidant defences (catalase, superoxide dismutase, glutathione peroxidase and selenium), osmotic fragility and reticulocyte count; in the RBC membrane we evaluated lipid peroxidation and susceptibility to lipid peroxidation, membrane fluidity, levels of cholesterol and phospholipids, membrane-bound haemoglobin, band 3 profile and levels of vitamin E; serum levels of bilirubin, total plasma antioxidant capacity, lipid profile and lipid peroxidation were also evaluated.

RESULTS

Psoriasis patients showed a rise in leucocytes, mainly neutrophils, which was associated with a rise in elastase and lactoferrin. Patients had a reduced RBC count, antioxidant defences and membrane fluidity, elevated membrane lipid peroxidation, membrane-bound haemoglobin, osmotic fragility and reticulocyte count, and a different band 3 profile. Most of these modifications were enhanced in severe psoriasis.

CONCLUSIONS

In summary, our data show that the RBCs are at a lower number in psoriasis patients, and present several changes denoting an enhanced damage and/or ageing process, which seem to be strongly connected with neutrophil activation, oxidative stress and worsening of psoriasis.

Domain structure of erythrocyte membranes in psoriasis: an EPR study

Membrane fluidity of erythrocytes from psoriatic patients in active and inactive period of the disease was studied by electron paramagnetic resonance (EPR). Comparison of simulated and experimental EPR spectra of erythrocyte membranes from controls and psoriatics showed that they are essentially superimposition of three components; two regions with a high degree of order of the lipid acyl chains and one region with poor alignments of hydrocarbon chains (with a small order parameter). In psoriatic erythrocytes not only the portion of the most rigid domain was enlarged, but also the order parameter of this domain was increased, while the order parameters of two other domains were the same than in normal erythrocytes. Results obtained in this article showed that the portion of the most rigid domain (W(A)) better correlated with polymorphonuclear elastase (PMN elastase) than with PASI score. Additionally, correlation between PMN elastase and W(A) in the active period of the disease was observed to be higher than in the inactive period. Therefore, portion of the most ordered domain (W(A)) seems to be a good marker for evaluation of the disease activity in psoriatic patients.