1
|
Scala E, Mercurio L, Albanesi C, Madonna S. The Intersection of the Pathogenic Processes Underlying Psoriasis and the Comorbid Condition of Obesity. Life (Basel) 2024; 14:733. [PMID: 38929716 PMCID: PMC11204971 DOI: 10.3390/life14060733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/20/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
In the past decade, our understanding of psoriasis pathogenesis has made significant steps forward, leading to the development of multiple game-changing therapies. While psoriasis primarily affects the skin, it is increasingly recognized as a systemic disease that can have effects beyond the skin. Obesity is associated with more severe forms of psoriasis and can potentially worsen the systemic inflammation and metabolic dysfunction seen in psoriatic patients. The exact mechanisms underlying the link between these two conditions are not fully understood, but it is believed that chronic inflammation and immune dysregulation play a role. In this review, we examine the existing body of knowledge regarding the intersection of pathogenic processes responsible for psoriasis and obesity. The ability of biological therapies to reduce systemic and obesity-related inflammation in patients with psoriasis will be also discussed.
Collapse
|
2
|
Constantin C, Surcel M, Munteanu A, Neagu M. Insights into Nutritional Strategies in Psoriasis. Nutrients 2023; 15:3528. [PMID: 37630719 PMCID: PMC10458768 DOI: 10.3390/nu15163528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Psoriasis, an autoimmune chronic inflammatory skin condition, has a high incidence in the general population, reaching 2-4%. Its pathogenesis involves an interplay of genetic factors, immune disturbances, and environmental factors. Within the environmental factors that aid the appearance of this autoimmune skin disease, the Western lifestyle and overall diet play important roles in the steady growth in psoriasis prevalence. Furthermore, psoriasis is associated with comorbidities such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, and obesity. Accumulating evidence suggests that obesity is an important risk factor for psoriasis. Moreover, obesity aggravates established psoriasis, and a reduction in the body mass index can improve the clinical outcomes of psoriasis and increase the efficacy of standard psoriasis therapies. The possible connection between this autoimmune disease and obesity relies on the fact that white adipose tissue is an essential endocrine organ that secretes an array of immune mediators and inflammatory and metabolic factors with pro-inflammatory action. Thus, immune-mediated mechanisms in both psoriasis and obesity conditions are common factors. This paper describes the factors that link obesity with skin autoimmune disease and highlights the importance of the stimulatory or regulatory effects of nutrients and food in psoriasis and the possible improvement of psoriasis through nutritional strategies.
Collapse
Affiliation(s)
- Carolina Constantin
- Immunology Department, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania; (C.C.); (M.S.); (A.M.)
- Pathology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Mihaela Surcel
- Immunology Department, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania; (C.C.); (M.S.); (A.M.)
| | - Adriana Munteanu
- Immunology Department, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania; (C.C.); (M.S.); (A.M.)
| | - Monica Neagu
- Immunology Department, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania; (C.C.); (M.S.); (A.M.)
- Pathology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Doctoral School, Faculty of Biology, University of Bucharest, 050107 Bucharest, Romania
| |
Collapse
|
3
|
Souza-Silva IM, Steckelings UM, Assersen KB. The role of vasoactive peptides in skin homeostasis-focus on adiponectin and the kallikrein-kinin system. Am J Physiol Cell Physiol 2023; 324:C741-C756. [PMID: 36745527 DOI: 10.1152/ajpcell.00269.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Vasoactive peptides often serve a multitude of functions aside from their direct effects on vasodynamics. This article will review the existing literature on two vasoactive peptides and their involvement in skin homeostasis: adiponectin and-as the main representative of the kallikrein-kinin system-bradykinin. Adiponectin is the most abundantly expressed adipokine in the human organism, where it is mainly localized in fat depots including subcutaneous adipose tissue, from where adiponectin can exert paracrine effects. The involvement of adiponectin in skin homeostasis is supported by a number of studies reporting the effects of adiponectin in isolated human keratinocytes, sebocytes, fibroblasts, melanocytes, and immune cells. Regarding skin pathology, the potential involvement of adiponectin in psoriasis, atopic dermatitis, scleroderma, keloid, and melanogenesis is discussed in this article. The kallikrein-kinin system is composed of a variety of enzymes and peptides, most of which have been identified to be expressed in the skin. This also includes the expression of bradykinin receptors on most skin cells. Bradykinin is one of the very few hormones that is targeted by treatment in routine clinical use in dermatology-in this case for the treatment of hereditary angioedema. The potential involvement of bradykinin in wound healing, psoriasis, and melanoma is further discussed in this article. This review concludes with a call for additional preclinical and clinical studies to further explore the therapeutic potential of adiponectin supplementation (for psoriasis, atopic dermatitis, wound healing, scleroderma, and keloid) or pharmacological interference with the kallikrein-kinin system (for wound healing, psoriasis, and melanoma).
Collapse
Affiliation(s)
- Igor M Souza-Silva
- Department of Cardiovascular & Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - U Muscha Steckelings
- Department of Cardiovascular & Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Kasper Bostlund Assersen
- Department of Cardiovascular & Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,Department of Dermatology, Odense University Hospital, Odense, Denmark
| |
Collapse
|
4
|
Sun X, Zhao H, Wang R, Li H, Wu Y, Ze K, Su Y, Li B, Li X. Psoriasis complicated with metabolic disorder is associated with traditional Chinese medicine syndrome types: a hospital-based retrospective case-control study. Curr Med Res Opin 2023; 39:19-25. [PMID: 36189747 DOI: 10.1080/03007995.2022.2129803] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To explore the distribution law of traditional Chinese medicine (TCM) syndrome types in patients with psoriasis vulgaris complicated by metabolic disorders based on the same pathogenic factors as blood-heat and blood-stasis in the pathogenesis of psoriasis and metabolic disorders and to further analyze the correlation between adiponectin and the distribution law. METHODS From 1 January 2018 to 31 December 2019, patients diagnosed with psoriasis in the inpatient or outpatient department of Dermatology Ward of Shanghai Yueyang Hospital and normal participants who underwent physical examination in the physical examination center over the same period were retrospectively reviewed. Demographic data, medical history, metabolic disorder indices, and TCM syndrome indices of psoriasis patients and healthy volunteers were evaluated. RESULTS We included 307 patients with psoriasis and 613 healthy controls. On analyzing past medical history, the proportion of overweight and obesity and the comorbidity of diabetes in the psoriasis group (53.42 and 14.66%) were significantly higher than in the control group (43.88 and 7.67%, respectively; p < .05). The abnormal rates of triglyceride (34.20%), high-density lipoprotein cholesterol (50.49%), and HbA1c (18.57%) levels in the psoriasis group were higher than those in the normal control group (26.75, 17.13, and 12.56%, respectively). Overall, the incidence of metabolic disorders in psoriasis patients (267/307, 86.97%) was higher than that in the normal controls (484/613, 78.96%). Among the different syndrome types, the blood-stasis group had significantly higher rates of hypertension, diabetes, and abnormal glycosylated hemoglobin (46.07, 19.10, and 24.72%, respectively) than those of the control group (27.57, 7.67, and 12.56%; p < .05). Patients with blood stasis syndrome had the highest metabolic disorder comorbidity rate (93.26%) and lowest adiponectin level (p < .05). CONCLUSIONS TCM syndrome differentiation of psoriasis, especially the diagnosis of blood-stasis syndrome, prompts the early screening of patients with metabolic comorbidities. For patients with psoriasis with metabolic disorder, TCM for promoting blood circulation and removing blood stasis can be compatibly applied without contraindications. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov (Trial ID: NCT03942185).
Collapse
Affiliation(s)
- Xiaoying Sun
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Huaibo Zhao
- Dermatology of TCM, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Ruiping Wang
- Office of Clinical Research Center, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Hongjin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yong Wu
- Second Department of Preventive Treatment, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kan Ze
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yonghua Su
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Bin Li
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Dermatology of TCM, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
5
|
Can Biological Drugs Diminish the Risk of Sarcopenia in Psoriatic Patients? Life (Basel) 2022; 12:life12030435. [PMID: 35330186 PMCID: PMC8952562 DOI: 10.3390/life12030435] [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: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022] Open
Abstract
Sarcopenia and psoriasis are different inflammatory diseases that share common comorbidities (e.g., cardiovascular diseases, metabolic syndrome, obesity, autoimmune diseases, depression). Psoriasis is a dermatosis involving the skin, joints, and nails. Its estimated prevalence is 2–4%, and the possibility of progression to psoriatic arthritis reaches 6–42%. Sarcopenia is defined as reduced muscle strength, muscle quantity, and physical performance due to non-ageing related causes. It affects up to 10% of the general population. We conducted a review of the literature to provide up-to-date information about the risk of sarcopenia in psoriasis and to identify risk factors that increase this risk. The search of the literature allowed us to include 51 publications, but only five cross-sectional studies provided quantitative results on the rates of sarcopenia in psoriasis. The prevalence of sarcopenia in psoriasis varied from 9.1% to 61.7%. This wide range was caused by different definitions of sarcopenia and different cut-off values across studies. Prognostic factors include lean mass and fat mass. Further research based on the European Working Group on Sarcopenia in Older People guidelines is required. Such studies should include not only muscle mass and strength but also other factors that may influence the occurrence of sarcopenia and inflammatory markers.
Collapse
|
6
|
Ruiyang B, Panayi A, Ruifang W, Peng Z, Siqi F. Adiponectin in psoriasis and its comorbidities: a review. Lipids Health Dis 2021; 20:87. [PMID: 34372872 PMCID: PMC8353790 DOI: 10.1186/s12944-021-01510-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/20/2021] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory skin disease characterized by abnormal T cell activation and excessive proliferation of keratinocytes. In addition to skin manifestations, psoriasis has been associated with multiple metabolic comorbidities, such as obesity, insulin resistance, and diabetes. An increasing amount of evidence has highlighted the core role of adipokines in adipose tissue and the immune system. This review focus on the role of adiponectin in the pathophysiology of psoriasis and its comorbidities, highlighting the future research avenues.
Collapse
Affiliation(s)
- Bai Ruiyang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Adriana Panayi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St., Boston, MA, 02115, USA
| | - Wu Ruifang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Zhang Peng
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
| | - Fu Siqi
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
| |
Collapse
|
7
|
The Effect of Antioxidant and Anti-Inflammatory Capacity of Diet on Psoriasis and Psoriatic Arthritis Phenotype: Nutrition as Therapeutic Tool? Antioxidants (Basel) 2021; 10:antiox10020157. [PMID: 33499118 PMCID: PMC7912156 DOI: 10.3390/antiox10020157] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic inflammation and increased oxidative stress are contributing factors to many non-communicable diseases. A growing body of evidence indicates that dietary nutrients can activate the immune system and may lead to the overproduction of pro-inflammatory cytokines. Fatty acids as macronutrients are key players for immunomodulation, with n-3 polyunsaturated fatty acids having the most beneficial effect, while polyphenols and carotenoids seem to be the most promising antioxidants. Psoriasis is a chronic, immune-mediated inflammatory disease with multifactorial etiology. Obesity is a major risk factor for psoriasis, which leads to worse clinical outcomes. Weight loss interventions and, generally, dietary regimens such as gluten-free and Mediterranean diet or supplement use may potentially improve psoriasis’ natural course and response to therapy. However, data about more sophisticated nutritional patterns, such as ketogenic, very low-carb or specific macro- and micro-nutrient substitution, are scarce. This review aims to present the effect of strictly structured dietary nutrients, that are known to affect glucose/lipid metabolism and insulin responses, on chronic inflammation and immunity, and to discuss the utility of nutritional regimens as possible therapeutic tools for psoriasis and psoriatic arthritis.
Collapse
|
8
|
Paroutoglou K, Papadavid E, Christodoulatos GS, Dalamaga M. Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations. Curr Obes Rep 2020; 9:165-178. [PMID: 32418186 DOI: 10.1007/s13679-020-00380-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Obesity and psoriasis represent chronic inflammatory states that are interconnected in a vicious cycle, sharing also a degree of synergy. In this review, we aim to decipher the various lines of evidence supporting the bidirectional association between psoriasis and obesity highlighting their pathophysiologic connections as well as we attempt to strategize a therapeutic holistic approach for obese psoriatic patients. RECENT FINDINGS Recent meta-analyses have shown that (1) genetically higher BMI increased the odds of psoriasis occurrence; (2) obesity is associated with higher incidence and prevalence of psoriasis as well as psoriasis severity; (3) obesity is associated with lower efficacy to anti-TNF agents and may predict biologic treatment discontinuation; and (4) weight loss through diet and physical exercise may improve pre-existing psoriasis and prevent from de novo psoriasis. Methotrexate, acitretin, and cyclosporine could worsen hypertension, liver steatosis, and dyslipidemia. Since infliximab and ustekinumab are weight adjusted, they may be ideal drugs to treat obese psoriatic patients. IL-17 inhibitors are very effective independently from body weight; however, they tend to present better clearance rates in normal weight patients. There is a paucity on weight data regarding the efficacious IL-23 inhibitors. Apremilast may induce weight loss as an adverse effect presenting also some beneficial metabolic actions. Finally, simvastatin and some antidiabetic drugs could decrease psoriasis severity. More mechanistic, observational studies and well-conducted RCTs are necessary to decipher the enigmatic link between psoriasis and obesity, and to provide evidence-based specific guidelines for the screening and management of obese psoriatic patients.
Collapse
Affiliation(s)
- Kyriaki Paroutoglou
- 2nd Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Attikon General University Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece
| | - Evangelia Papadavid
- 2nd Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Attikon General University Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece
| | - Gerasimos Socrates Christodoulatos
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens Medical School, 27 Mikras Asias Street, Goudi, 11527, Athens, Greece
| | - Maria Dalamaga
- 2nd Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Attikon General University Hospital, 1 Rimini Street, Chaidari, 12462, Athens, Greece.
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens Medical School, 27 Mikras Asias Street, Goudi, 11527, Athens, Greece.
| |
Collapse
|
9
|
Kong Y, Zhang S, Wu R, Su X, Peng D, Zhao M, Su Y. New insights into different adipokines in linking the pathophysiology of obesity and psoriasis. Lipids Health Dis 2019; 18:171. [PMID: 31521168 PMCID: PMC6745073 DOI: 10.1186/s12944-019-1115-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022] Open
Abstract
Psoriasis is a chronic, systemic, hyper-proliferative immune-mediated inflammatory skin disease. The results of epidemiological investigations have shown that psoriasis affects around 2% of the general population worldwide, and the total number of psoriasis patients is more than 6 million in China. Apart from the skin manifestations, psoriasis has been verified to associate with several metabolic comorbidities, such as insulin resistance, diabetes and obesity. However, the underlying mechanism is still not elucidated. Adipocytes, considered as the active endocrine cells, are dysfunctional in obesity which displays increased synthesis and secretion of adipokines with other modified metabolic properties. Currently, growing evidence has pointed to the central role of adipokines in adipose tissue and the immune system, providing new insights into the effect of adipokines in linking the pathophysiology of obesity and psoriasis. In this review, we summarize the current understanding of the pathological role of adipokines and the potential mechanisms whereby different adipokines link obesity and psoriasis. Furthermore, we also provide evidence which identifies a potential therapeutic target aiming at adipokines for the management of these two diseases.
Collapse
Affiliation(s)
- Yi Kong
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Suhan Zhang
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ruifang Wu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Xin Su
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Daoquan Peng
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ming Zhao
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
| | - Yuwen Su
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
| |
Collapse
|
10
|
Risk Factors for the Development of Psoriasis. Int J Mol Sci 2019; 20:ijms20184347. [PMID: 31491865 PMCID: PMC6769762 DOI: 10.3390/ijms20184347] [Citation(s) in RCA: 257] [Impact Index Per Article: 51.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is an immune-mediated genetic skin disease. The underlying pathomechanisms involve complex interaction between the innate and adaptive immune system. T cells interact with dendritic cells, macrophages, and keratinocytes, which can be mediated by their secreted cytokines. In the past decade, biologics targeting tumor necrosis factor-α, interleukin (IL)-23, and IL-17 have been developed and approved for the treatment of psoriasis. These biologics have dramatically changed the treatment and management of psoriasis. In contrast, various triggering factors can elicit the disease in genetically predisposed individuals. Recent studies suggest that the exacerbation of psoriasis can lead to systemic inflammation and cardiovascular comorbidity. In addition, psoriasis may be associated with other auto-inflammatory and auto-immune diseases. In this review, we summarize the risk factors, which can be divided into two groups (namely, extrinsic and intrinsic risk factors), responsible for the onset and exacerbation of psoriasis in order to facilitate its prevention.
Collapse
|
11
|
Kong Y, Zhang S, Su X, Peng D, Su Y. Serum levels of YKL-40 are increased in patients with psoriasis: a meta-analysis. Postgrad Med 2019; 131:405-412. [PMID: 31298974 DOI: 10.1080/00325481.2019.1643634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yi Kong
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomes, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Suhan Zhang
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomes, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xin Su
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Daoquan Peng
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yuwen Su
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomes, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|
12
|
Cataldi C, Mari NL, Lozovoy MAB, Martins LMM, Reiche EMV, Maes M, Dichi I, Simão ANC. Proinflammatory and anti-inflammatory cytokine profiles in psoriasis: use as laboratory biomarkers and disease predictors. Inflamm Res 2019; 68:557-567. [PMID: 31062065 DOI: 10.1007/s00011-019-01238-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The objectives of this study were to delineate the pro and anti-inflammatory cytokine profiles of psoriasis and cytokine profile models that externally validate the diagnosis. SUBJECTS AND METHODS This study recruited 70 patients with psoriasis and 76 healthy controls. Cytokine profiles were evaluated, including pro-inflammatory M1 (IL-1 + IL-6 + TNF-α), Th1 (IL-2 + IL-12 + IFN-γ), Th17 (IL-6 + IL-17), and immune-inflammatory response system (IRS = M1 + Th1 + Th17) profiles. Moreover, the anti-inflammatory potential included Th2 (IL-4), Th2 + T regulatory (Th2 + Treg, namely IL-4 + IL-10 + TGF-β), anti-inflammatory (Th2 + Treg + adiponectin), and the pro-inflammatory/anti-inflammatory index. RESULTS There was a highly significant association between psoriasis and cytokine levels with an effect size of 0.829 and a particularly strong impact on IL-2 (0.463), IL-12 (0.451), IL-10 (0.532) and adiponectin (0.401). TGF-β and adiponectin were significantly lower while all other cytokines (except IFN-γ) were significantly higher in psoriasis than in controls. In addition, M1, Th1, Th17, Th2 + Treg, and IRS/Anti-inflammatory index were significantly higher in psoriasis patients than in controls. The IRS index, Th2 + Treg, and adiponectin predicted psoriasis with 97.1% sensitivity and 94% specificity. CONCLUSION In conclusion, psoriasis is characterized by increased M1, Th1, Th2 and Th17 profiles together with lowered TGF-β and adiponectin. In addition, we propose a model based on a higher IRS and Th2 + Treg index coupled with lower adiponectin values, which may be used to externally validate the diagnosis of psoriasis. The most important single biomarker of psoriasis is adiponectin. Because the latter may play a role in the modulation of the chronic inflammatory response in psoriasis, adiponectin could be a new drug target to treat psoriasis.
Collapse
Affiliation(s)
- Camila Cataldi
- Laboratory of Research in Applied Immunology, University of Londrina, Londrina, PR, Brazil
| | - Naiara Lourenço Mari
- Laboratory of Research in Applied Immunology, University of Londrina, Londrina, PR, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Laboratory of Research in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Rua Robert Koch, n 60, Londrina, Paraná, 86038-440, Brazil
| | | | - Edna Maria Vissoci Reiche
- Laboratory of Research in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Rua Robert Koch, n 60, Londrina, Paraná, 86038-440, Brazil
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Isaias Dichi
- Laboratory of Research in Applied Immunology, Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil
| | - Andréa Name Colado Simão
- Laboratory of Research in Applied Immunology, Department of Pathology, Clinical Analysis and Toxicology, University of Londrina, Rua Robert Koch, n 60, Londrina, Paraná, 86038-440, Brazil.
| |
Collapse
|
13
|
Bavoso NC, Pinto JM, Soares MMS, Diniz MDS, Teixeira Júnior AL. Psoriasis in obesity: comparison of serum levels of leptin and adiponectin in obese subjects - cases and controls. An Bras Dermatol 2019; 94:192-197. [PMID: 31090824 PMCID: PMC6486065 DOI: 10.1590/abd1806-4841.20197716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/21/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Psoriasis and obesity are somewhat related to a low-grade systemic inflammatory response. OBJECTIVES To determine leptin and adiponectin levels in psoriasis patients compared to control patients matched for weight. METHODS A case-control study was performed, evaluating 113 psoriasis patients and 41 controls with other dermatologic diseases. RESULTS The prevalence of obesity was 33% in cases and 21.9% in controls. All evaluated comorbidities were more prevalent among cases. When stratified by weight, the comorbidities were more frequent in overweight patients. We found no correlation between being overweight (p=0.25), leptin (p=0.18) or adiponectin (p=0.762) levels and psoriasis severity. When overweight cases and controls were compared, we found differences in the adiponectin values (p= 0.04). The overweight cases had lower adiponectin levels than the overweight controls. We found no differences in the leptin dosage between cases and controls. The overweight cases had higher leptin values than the normal weight cases (p<0.001). STUDY LIMITATIONS Several patients used systemic anti-inflammatory medication. CONCLUSIONS The prevalence of obesity among psoriasis cases (33%) was higher than in the general population (17.4%). We did not find any correlation between severity of psoriasis and inflammatory cytokines and the condition of being overweight. The overweight cases had lower values of adiponectin than the overweight controls. It seems, therefore, that there is a relationship between adiponectin and psoriasis, but this relationship depends on the presence of obesity.
Collapse
Affiliation(s)
- Nádia Couto Bavoso
- Dermatology Service, Santa Casa de Misericórdia
de Belo Horizonte, Belo Horizonte (MG), Brazil
| | - Jackson Machado Pinto
- Dermatology Service, Santa Casa de Misericórdia
de Belo Horizonte, Belo Horizonte (MG), Brazil
| | | | | | - Antônio Lúcio Teixeira Júnior
- Discipline of Neurology, Faculdade de Medicina,
Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
- Interdisciplinary Laboratory of Medical Investigation,
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG),
Brazil
| |
Collapse
|
14
|
Kyriakou A, Patsatsi A, Sotiriadis D, Goulis DG. Effects of treatment for psoriasis on circulating levels of leptin, adiponectin and resistin: a systematic review and meta-analysis. Br J Dermatol 2018; 179:273-281. [PMID: 29432655 DOI: 10.1111/bjd.16437] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Metabolic syndrome, a risk factor of cardiovascular disease, is more common in patients with psoriasis than in the general population. Circulating adipokine concentrations are altered in patients with psoriasis and are suggested to represent the pathophysiological link between psoriatic lesions and metabolic alterations. OBJECTIVES To perform a systematic review of the literature for studies that investigated possible differences in circulating levels of leptin, adiponectin or resistin in patients with psoriasis before and after any treatment intervention, and to meta-analyse the best evidence available. METHODS A search was conducted in three databases (PubMed, Central and Embase). Eligible for the review were studies that assessed leptin, adiponectin or resistin concentrations in patients with psoriasis before and after any topical or systemic treatment. RESULTS After treatment, blood concentrations of leptin were similar to those before treatment [standardized mean difference (SMD) 0·06, 95% confidence interval (CI) -0·09 to 0·20], with no heterogeneity among studies (I2 = 0%, P = 0·88). After treatment, blood concentrations of adiponectin were similar to those before treatment (SMD -0·14, 95% CI -0·34 to 0·05), with significant heterogeneity among studies (I2 = 36·8%, P = 0·032). After treatment, blood concentrations of resistin were significantly lower than those before treatment (SMD 0·50, 95% CI 0·20-0·79), with significant heterogeneity among studies (I2 = 61·4%, P < 0·001). CONCLUSIONS There is no evidence that treatment for psoriasis modifies leptin and adiponectin concentrations. However, treatment intervention reduces resistin concentrations, a finding that is expected to be of clinical importance.
Collapse
Affiliation(s)
- A Kyriakou
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Patsatsi
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Sotiriadis
- 2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
15
|
Furue M, Kadono T. Psoriasis: Behind the scenes. J Dermatol 2016; 43:4-8. [DOI: 10.1111/1346-8138.13186] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 09/16/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Masutaka Furue
- Department of Dermatology; Kyushu University; Fukuoka Japan
| | - Takafumi Kadono
- Department of Dermatology; St Marianna University School of Medicine; Kawasaki Japan
| |
Collapse
|
16
|
Association of Trabecular Bone Score with Inflammation and Adiposity in Patients with Psoriasis: Effect of Adalimumab Therapy. J Osteoporos 2016; 2016:5747852. [PMID: 27293954 PMCID: PMC4880682 DOI: 10.1155/2016/5747852] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/21/2016] [Indexed: 12/27/2022] Open
Abstract
Studies on trabecular bone score (TBS) in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p = 0.02) and leptin (p = 0.01) and a positive correlation with adiponectin were found (p = 0.01). The best set of predictors for TBS values at baseline were female sex (p = 0.015), age (p = 0.05), and BMI (p = 0.001). The best set of predictors for TBS following 6 months of biologic therapy were age (p = 0.001), BMI (p < 0.0001), and serum adiponectin levels (p = 0.027). In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy.
Collapse
|
17
|
Kondelkova K, Borska L, Andrys C, Krejsek J, Hamakova K, Rendarova S, Rehacek V, Kremlacek J, Fiala Z. Selected Inflammatory and Metabolic Markers in Psoriatic Patients Treated with Goeckerman Therapy. Mediators Inflamm 2015; 2015:979526. [PMID: 26166954 PMCID: PMC4475730 DOI: 10.1155/2015/979526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/11/2015] [Accepted: 05/31/2015] [Indexed: 12/21/2022] Open
Abstract
Psoriasis is associated with metabolic activity of adipose tissue which produces pro- and anti-inflammatory adipokines. Goeckerman therapy (GT) represents an effective treatment of psoriasis. This study evaluated variation of selected inflammatory and metabolic markers during GT and the relationships between the markers, severity of the disease (PASI score), body mass, and the basic characteristics of the therapy. The study was conducted on a group of patients (n = 32) and on a control group (n = 24). Before GT, we found significantly elevated levels of proinflammatory CRP (p < 0.001) and leptin (p < 0.05) in psoriatic patients (compared to the controls). The therapy significantly decreased the levels of CRP and adiponectin. We found positive correlations between CRP and total duration of GT (p < 0.05) and CRP and the time of UV exposure (p < 0.01) and negative correlations between adiponectin and the total duration of GT (p < 0.05) and adiponectin and the application of CCT ointment (p < 0.001). From our results, we can conclude that GT causes partial reduction of both proinflammatory and anti-inflammatory markers. However, the levels of proinflammatory CRP and leptin remained significantly higher in the patients than in the control group.
Collapse
Affiliation(s)
- Katerina Kondelkova
- Institute of Clinical Immunology and Allergology, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Lenka Borska
- Institute of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Ctirad Andrys
- Institute of Clinical Immunology and Allergology, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Jan Krejsek
- Institute of Clinical Immunology and Allergology, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Kvetoslava Hamakova
- Department of Dermatology and Venereal Diseases, University Hospital Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Simona Rendarova
- Department of Dermatology and Venereal Diseases, University Hospital Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Vit Rehacek
- Department of Transfusion Medicine, University Hospital Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Jan Kremlacek
- Institute of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| | - Zdenek Fiala
- Institute of Hygiene and Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Sokolska 581, 50005 Hradec Kralove, Czech Republic
| |
Collapse
|
18
|
Obesity in autoimmune diseases: Not a passive bystander. Autoimmun Rev 2014; 13:981-1000. [DOI: 10.1016/j.autrev.2014.07.001] [Citation(s) in RCA: 415] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/20/2014] [Indexed: 02/06/2023]
|
19
|
Coimbra S, Santos-Silva A. Biomarkers of psoriasis severity and therapy monitoring. World J Dermatol 2014; 3:15-27. [DOI: 10.5314/wjd.v3.i2.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/13/2014] [Accepted: 02/18/2014] [Indexed: 02/06/2023] Open
Abstract
Psoriasis is a chronic, recurrent inflammatory cutaneous disease. Psoriasis patients alternate between periods of remission and periods of exacerbation of the disease. Usually, psoriasis severity is clinically evaluated using tools like Psoriasis Area and Severity Index that present some limitations and subjectivity. Clinicians select the therapy according to psoriasis severity, aiming that patients achieve longer remission periods and improve their quality of life. Biological markers for diagnosis and prognosis of psoriasis help to establish its severity and to monitor the therapeutic response; moreover, biomarkers of psoriasis assist clinicians in their therapeutic decision to treat psoriasis and to choose earlier and more adequate therapeutic strategies, avoiding or minimising worsening of psoriasis. With these markers, they would be able to monitor therapeutics, avoiding unnecessary therapeutic surcharge or changes to a more aggressive therapy. As any attempt to identify these biomarkers should be encouraged, in this review, we will debate published data concerning the proposal of biomarkers to evaluate severity and response to treatment of psoriasis vulgaris.
Collapse
|