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Dogra S, Kumar S, Narang T, Mehta H, Hanumanthu V, Handa S. Efficacy and safety of weekend cyclosporine treatment as maintenance therapy for preventing frequent disease exacerbations in moderate to severe chronic plaque psoriasis patients - A retrospective cohort study. Indian J Dermatol Venereol Leprol 2024; 0:1-5. [PMID: 38841924 DOI: 10.25259/ijdvl_1089_2023] [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: 10/15/2023] [Accepted: 02/15/2024] [Indexed: 06/07/2024]
Abstract
Background Psoriasis is a chronic, inflammatory, systemic disease with predominant manifestations in the skin and joints impairing patient's quality of life. A proportion of patients have frequent severe disease exacerbations requiring repeated systemic treatments. There is a scarcity of literature evaluating the role of systemic maintenance therapy in psoriasis patients in preventing such frequent disease flares. Objective To evaluate the efficacy and safety of weekend cyclosporine treatment (WCT) as maintenance therapy in moderate to severe chronic plaque psoriasis patients for the prevention of frequent disease exacerbations. Methods In this retrospective cohort study, 22 psoriasis patients with a history of frequent disease exacerbations (≥ 3 in the last 1 year) who were administered WCT (group A) were compared with the same number of matched patients (age and gender) not on WCT or any systemic maintenance therapy (group B). Results Four patients (18.2%) in group A had disease exacerbations which was significantly lower (p = 0.00, Fisher's exact test) as compared to 21 patients (95.5%) in group B during the study period. Also, patients in group A had significantly lower number of overall exacerbations [mean ± SD: 0.23 ± 0.53 vs 2.95 ± 1.43) p = 0.00, Mann-Whitney U test] as compared to group B. Four (9.1%) patients in group A encountered adverse effects (acneiform eruptions - two, mild gingival hyperplasia - one, myalgia - one) as compared to three (acneiform eruptions - two, headache - one) in group B (p = 1.00). Conclusion WCT significantly reduced the number of disease exacerbations and is a safe and effective mode of maintenance therapy in such subset of psoriasis patients.
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Affiliation(s)
- Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Hitaishi Mehta
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Hanumanthu
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Cui J, Zhang X, Deng J, Yan Y, Yao D, Deng H, Yu J, Ye S, Han L, Yu X, Lu C. Potential biomarkers for psoriasis topical treatment by in-depth serum proteomics. J DERMATOL TREAT 2023; 34:2248318. [PMID: 37621164 DOI: 10.1080/09546634.2023.2248318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Psoriasis is a chronic skin disease, and topical sequential therapy with a combination of calcipotriol and calcipotriol betamethasone is currently approved topical treatment. However, the exact mechanism by which this treatment regimen relieves psoriasis is unknown. METHOD We assembled a cohort of 65 psoriasis patients and divided post-treatment cohort into responder group and non-responder group according to the Psoriasis Area Severity Index (PASI) score after 12-week treatment. We measured the expression levels of proteins in collected 130 serum samples using our in-depth proteomics platform with a data-independent acquisition mass spectrometer and antibody microarray. We performed bioinformatics analyses of the biologic processes and signaling pathways that were changed in the responder group and constructed a proteomics landscape of psoriasis pathogenesis response to treatment. We then validated the biomarkers of disease severity in an independent cohort of 88 samples using an enzyme-linked immunosorbent assay. RESULTS We first identified 174 differentially expressed proteins (DEPs) for comparative analysis of proteins between responders and non-responders at baseline (p < 0.05). Then pathway analysis showed that the responders focused more on signaling molecules and interaction, complement and coagulation cascades, whereas the non-responders more on signal transduction and IL-17 signaling pathways. We further identified four candidate biomarkers (COLEC11, C1QA, BNC2, ITIH4) response to treatment. We also found 125 DEPs (p < 0.05) after treatment compared with before treatment in responder group. Pathway analysis showed an enrichment in pathways related to complement and coagulation cascades, phagosome, ECM-receptor interaction, cholesterol metabolism, vitamin digestion and absorption. CD14 was validated as potential biomarkers for the disease severity of psoriasis and treatment targets. CONCLUSION In this work, we analyzed the response to topical sequential therapy and finally identified four biomarkers. Additionally, we found that topical sequential therapy may alleviate psoriasis by regulating lipid metabolism and modulating the immune response by affecting the complement activation process.
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Affiliation(s)
- Jingwen Cui
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomei Zhang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing Institute of Lifeomics, Beijing, China
| | - Jingwen Deng
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Yuhong Yan
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Danni Yao
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Hao Deng
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Jingjie Yu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Shuyan Ye
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Ling Han
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Xiaobo Yu
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing Institute of Lifeomics, Beijing, China
| | - Chuanjian Lu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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Chakraborty D, Aggarwal K. Comparative evaluation of efficacy and safety of calcipotriol versus calcitriol ointment, both in combination with narrow-band ultraviolet B phototherapy in the treatment of stable plaque psoriasis. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:512-519. [PMID: 37293775 DOI: 10.1111/phpp.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/17/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Vitamin D analogues and NBUVB are both well-recognised modes of therapy in the treatment of chronic stable plaque psoriasis. The objective of this open label intraindividual, left right study was to compare two different vitamin D analogues, calcipotriol and calcitriol, in combination with NBUVB phototherapy in psoriasis. METHODS Thirty patients with stable plaque psoriasis were enrolled for a 12-week clinical trial. The target lesion on the left side was treated topically with calcitriol ointment, while that on the right side was treated with calcipotriol ointment once daily. The whole body was irradiated with narrow-band ultraviolet B phototherapy (NBUVB) three times per week. Efficacy was assessed by target plaque scoring. RESULTS Both therapies resulted in a statistically significant reduction in erythema, scaling, thickness, and target plaque score, seen as early as 2 weeks into therapy. However, the calcipotriol combination led to an earlier clearance of plaques and a lesser relapse rate than the calcitriol combination. The number of treatment sessions and cumulative NBUVB doses were significantly lower in the calcipotriol-treated group. CONCLUSION Both vitamin D analogues appear to be safe, effective, and cosmetically acceptable, with calcipotriol being more efficacious, well tolerated, with a rapid onset of action and a better maintenance of response.
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Affiliation(s)
- Disha Chakraborty
- Pandit BD Sharma University of Health Sciences, Rohtak, Rohtak, India
| | - Kamal Aggarwal
- Pandit BD Sharma University of Health Sciences, Rohtak, Rohtak, India
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Kabashima K, Matsumura T, Hayakawa Y, Kawashima M. Clinically meaningful improvements in cutaneous lesions and quality of life measures in patients with atopic dermatitis with greater pruritus reductions after treatment with 60 mg nemolizumab subcutaneously every 4 weeks: Subgroup analysis from a phase 3, randomized, controlled trial. J DERMATOL TREAT 2023; 34:2177096. [PMID: 36779675 DOI: 10.1080/09546634.2023.2177096] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Data from the Japanese phase 3 Nemolizumab-JP01 study (JapicCTI-173740) found that nemolizumab in combination with topical treatments reduced pruritus associated with atopic dermatitis inadequately controlled with current therapies. METHODS This post-hoc analysis examined associations between improvements in pruritus (visual analog scale [VAS]) and eczema (Eczema Area and Severity Index [EASI]), and achievement of other clinically relevant endpoints including the Insomnia Severity Index (ISI), Dermatology Life Quality Index (DLQI), and Patient-Oriented Eczema Measure (POEM). RESULTS Pruritus VAS responders (≥50% improvement from baseline to week 16) showed greater improvements from baseline in these additional endpoints as early as week 1, compared with non-responders. Responders also had EASI improvement, and more than 80% achieved an ISI score ≤7, or had improvement in the DLQI or POEM. The percent change from baseline in VAS and EASI scores at week 16 was in favor of nemolizumab in all subgroups based on baseline characteristics. No specific factor affecting treatment response to nemolizumab was identified. CONCLUSIONS In this post-hoc analysis, nemolizumab-treated patients who had greater pruritus reductions also showed improvements in other eczema symptoms; pruritus alleviation appeared to be responsible for the improvements in eczema, sleep and daily life.
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Affiliation(s)
- Kenji Kabashima
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto
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Seuve É, Eyraud A, Desmoulière A. Les traitements du psoriasis. ACTUALITES PHARMACEUTIQUES 2023. [DOI: 10.1016/j.actpha.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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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.
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Madani AN, Al-Saif FM, Alzamil LR, Almazroua AM, Alfurayh NA, Aldokhayel SD, Almuhaideb QA, Alballa NS, Daham NA, Alkharashi AA. Monitoring the effect of TNF-alpha inhibitors on laboratory parameters and adverse effects in different diseases: a retrospective, single-center study. Ann Saudi Med 2022; 42:309-318. [PMID: 36252145 PMCID: PMC9557780 DOI: 10.5144/0256-4947.2022.309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The introduction of biological treatments has revolutionized the management of moderate-to-severe psoriasis. Multiple clinical trials have established the efficacy of biological agents in the treatment of moderate-to-severe psoriasis. Nevertheless, there are no clear indications for optimal monitoring intervals during treatment. OBJECTIVES Collect and analyze laboratory evaluation data from patients receiving biological therapy to provide a better understanding of the need for laboratory investigations before and during treatment with biological agents, and to analyze adverse events and other factors. DESIGN Retrospective cohort SETTINGS: Tertiary care center in Riyadh, Saudi Arabia. PATIENTS AND METHODS Data were collected from the electronic medical records of patients attending the dermatology, rheumatology, and gastroenterology clinics from June 2014 to June 2019. The laboratory parameters of patients who have received one of the TNF-alpha inhibitors (adalimumab, etanercept, or infliximab) were collected starting at baseline and up to at least one year from treatment initiation. MAIN OUTCOME MEASURES The time points at which patients developed significantly abnormal laboratory results during treatment with one of the TNF-alpha inhibitors. SAMPLE SIZE 250 patients RESULTS: Most patients were treated with adalimumab (38.4%); a similar proportion (38%) with infliximab, whereas only 23.6% were treated with etanercept. The majority of the significant abnormal laboratory results occurred at baseline, 3-6 and 9-12 months. Most abnormalities were among patients using infliximab, followed by etanercept, and then adalimumab. The median number of laboratory abnormalities for dermatology patients was significantly lower than that for gastroenterology patients (P<.001), and for rheumatology patients (P=.002). CONCLUSIONS Because dermatology patients showed a lower median number of laboratory abnormalities than patients treated by other specialties in our study, we believe that dermatology patients require less frequent laboratory monitoring. Therefore, we recommend laboratory evaluation at baseline, after 3-6 months, 1 year from the beginning of treatment, and annually thereafter for patients using TNF-alpha inhibitor agents. However, more frequent testing might be warranted according to patient comorbidities, concomitant medications, and physician judgment. LIMITATIONS Single center and retrospective design. CONFLICT OF INTEREST None.
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Affiliation(s)
- Abdulaziz N Madani
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad M Al-Saif
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lama R Alzamil
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Nuha A Alfurayh
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sara D Aldokhayel
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Qais A Almuhaideb
- From the College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nouf S Alballa
- From the Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nujud A Daham
- From the Department of Dermatology, Derma Cinics, Riyadh, Saudi Arabia
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Fink C, Alt C, Schank TE, Sies K, Kilian S, Schäkel K. Multiarm study comparing patient-reported and clinical outcome measures in patients undergoing antipsoriatic therapy with non-biological systemic agents in a real-world setting. J DERMATOL TREAT 2022; 33:2997-3004. [PMID: 35763015 DOI: 10.1080/09546634.2022.2095329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Although the inclusion of patients' preferences and needs is essential for therapy adherence, the assessment of patient-reported outcome measures in clinical trials is often neglected. Therefore, the aim of this study was to quantify several patient-reported outcome measures in psoriasis patients undergoing systemic therapy in a real-life clinical setting. METHODS This clinical trial has been designed as a prospective, multiarm study to investigate the treatment satisfaction, adherence to therapy, quality of life (QoL), and clinical response in a real-life clinical setting during the initial 6 months of treatment with apremilast, methotrexate, and fumaric acids in 80 patients suffering from plaque psoriasis. RESULTS The treatment satisfaction for the three systemic therapies was rated 'sufficient' with a mean (±SD) Treatment Satisfaction Questionnaire for Medication (TSQM) score of 275.0 (±62.7). Most potential for improvement was seen in the 'effectiveness' domain (54.3 ± 21.5). The highest treatment satisfaction level in all four domains (convenience, effectiveness, global satisfaction, and side-effects) was seen in the methotrexate group with a mean TSQM score of 306.3 ± 50.9, followed by apremilast (267.1 ± 61.6) and fumaric acids (254.9 ± 65.0; p = 0.005). Analysis of the TSQM revealed a considerable discrepancy between patient-reported clinical response and the actual Psoriasis Area and Severity Index (PASI) reduction. This applies equally to the patient- vs. physician-reported side-effects. CONCLUSIONS This real-life study demonstrates that an adequate assessment of antipsoriatic drugs by PASI-reduction alone is not sufficient and underlines the importance of patient-reported outcome measures not only in clinical trials, but also for improved patient care.
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Affiliation(s)
- Christine Fink
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Christina Alt
- Department of Dermatology, University of Essen, Essen, Germany
| | - Timo E Schank
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Katharina Sies
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Samuel Kilian
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Knut Schäkel
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
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Rigopoulos D, Lazaridou E, Papadavid E, Georgiou S, Chasapi V, Sfaelos K, Cheliotis G, Ioannides D. Sub-population analysis of patients with plaque psoriasis treated with calcipotriol/betamethasone aerosol foam; effectiveness and patient satisfaction, according to baseline disease severity and prior psoriasis treatment experience, in a Greek population. Dermatol Ther 2022; 35:e15484. [PMID: 35373423 DOI: 10.1111/dth.15484] [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: 01/12/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 12/31/2022]
Abstract
Fixed combination calcipotriol/betamethasone (Cal/BD) aerosol foam has been shown to be effective in psoriasis treatment in clinical trials, but real-world evidence is currently sparse. The real-world CELSUS study in Greece found that Cal/BD aerosol foam treatment was effective and associated with satisfaction in psoriasis patients. Patients from the CELSUS study (N = 400) were stratified by baseline disease severity according to physician's global assessment (PGA) score (mild vs. moderate vs. severe) and by previous psoriasis treatment (naïve vs. treatment-experienced). Proportions of patients achieving treatment success (clear/almost clear [PGA 0/1]) after 4 weeks' treatment with Cal/BD aerosol foam were reported for each subgroup. Psoriasis area and severity index (PASI) and patient-reported itch, itch-related sleep loss, scaling, dry skin, and erythema numerical rating scores were reported by subgroup. At baseline, 216 (54%) patients were systemic-or-topical psoriasis treatment-naïve and 184 (46%) were treatment experienced. By disease severity, there were 135 versus 89 patients with mild, 69 versus 83 with moderate and 12 versus 12 with severe disease in the treatment-naïve versus treatment-experienced groups, respectively. In the treatment-naïve group, treatment success was achieved by 72.6%, 56.5%, and 66.7% of patients with mild, moderate, and severe disease, respectively, while the proportions in the treatment-experienced group were 60.7%, 42.2%, and 25%, respectively. Reduction from baseline in psoriasis symptoms was observed in all patient groups. The greatest reductions were observed in treatment-naïve patients with severe disease. Clinically relevant benefits were observed with Cal/BD aerosol foam in psoriasis patients, regardless of prior treatment-experience and disease severity at baseline.
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Affiliation(s)
| | - Elisavet Lazaridou
- 2nd Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - Evangelia Papadavid
- 2nd Department of Dermatology and Venereology, ATTIKON University Hospital, Athens, Greece
| | - Sophia Georgiou
- Department of Dermatology, Medical School, General University Hospital, University of Patras, Rio, Greece
| | - Vasiliki Chasapi
- Department of Dermatology and Venereology NHS, Andreas Syggros Hospital, Athens, Greece
| | | | | | - Dimitrios Ioannides
- First Department of Dermatology-Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Chen XM, Yao DN, Wang MJ, Wu XD, Deng JW, Deng H, Huang RY, Lu CJ. Deep Sequencing of Plasma Exosomal microRNA Level in Psoriasis Vulgaris Patients. Front Med (Lausanne) 2022; 9:895564. [PMID: 35665333 PMCID: PMC9160332 DOI: 10.3389/fmed.2022.895564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/27/2022] [Indexed: 12/29/2022] Open
Abstract
Psoriasis is a chronic skin disease affecting 1% to 3% of the world population. Psoriasis vulgaris (PV) is the most common form of psoriasis. PV patients suffer from inflamed, pruritic and painful lesions for years (even a lifetime). However, conventional drugs for PV are costly. Considering the need for long-term treatment of PV, it is urgent to discover novel biomarkers and therapeutic targets. Plasma exosomal miRNAs have been identified as the reliable biomarkers and therapy targets of human diseases. Here, we described the levels of serum exosomal miRNAs in PV patients and analyzed the functional features of differently expressed miRNAs and their potential target genes for the first time. We identified 1182 miRNAs including 336 novel miRNAs and 246 differently expressed miRNAs in serum exosomes of healthy people and PV patients. Furthermore, the functional analysis found differently expressed miRNA-regulated target genes enriched for specific GO terms including primary metabolic process, cellular metabolic process, metabolic process, organic substance metabolic process, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway containing cellular processes, human diseases, metabolic pathways, metabolism and organismal systems. In addition, we found that some predicted target genes of differentially expressed miRNAs, such as CREB1, RUNX2, EGFR, are both involved in inflammatory response and metabolism. In summary, our study identifies many candidate miRNAs involved in PV, which could provide potential biomarkers for diagnosis of PV and targets for clinical therapies against PV.
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Affiliation(s)
- Xiu-Min Chen
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dan-Ni Yao
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Mao-Jie Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao-Dong Wu
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Jing-Wen Deng
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Hao Deng
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Run-Yue Huang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuan-Jian Lu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, China
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Zhu J, Wang Z, Tao L, Han L, Huang Q, Fang X, Yang K, Huang G, Zheng Z, Yawalkar N, Zhang Z, Yan K. MTHFR Gene Polymorphism Association With Psoriatic Arthritis Risk and the Efficacy and Hepatotoxicity of Methotrexate in Psoriasis. Front Med (Lausanne) 2022; 9:869912. [PMID: 35479943 PMCID: PMC9035632 DOI: 10.3389/fmed.2022.869912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Aims To assess whether MTHFR rs1801131 and rs1801133 SNPs are associated with concomitant psoriatic arthritis (PsA) and investigate the efficacy and hepatotoxicity of MTX in patients with psoriasis in the Han Chinese population. Methods This prospective, single-arm, interventional study recruited a total of 309 patients with psoriasis, 163 with psoriatic arthritis and 146 without psoriatic arthritis, who completed a 12-week MTX treatment and 1,031 healthy controls. Patients' characteristics including age, gender, disease duration, height, weight, smoking status, alcohol consumption, medical history, disease severity and liver function test results were accessed and recorded. Single nucleotide polymorphism (SNP) genotyping of rs1801131 and rs1801133 in the MTHFR gene was performed. Results The rs1801133 CC genotype was more frequent in patients with PsA than those with PsO and healthy controls (42.3% vs. 28.8% vs. 33.1%, p < 0.05). The 90% reduction from baseline PASI score (PASI 90) response rates to MTX were significantly higher in patients with the rs1801133 TT genotype than those with the CT and CC genotype (33.96% vs. 19.31% vs. 14.41%, OR = 2.76, p = 0.006). The rs1801133 CT+TT genotype was more frequent in PsA patients with abnormal liver function than in those with normal liver function (p < 0.05). In addition, patients with the rs1801131 CT genotype had lower PASI 75 response rates to MTX (OR = 0.49, p = 0.01), and lower risk of ALT elevation (OR = 0.46, p = 0.04). Conclusions This study provided some evidence for MTHFR polymorphism association with the risk of PsA and the efficacy and hepatotoxicity of the low-dose MTX in the Chinese population. Given the relatively small sample size and potentially missed diagnosis of PsA, the results from this study warrant further investigation.
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Affiliation(s)
- Jie Zhu
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhicheng Wang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Lu Tao
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Han
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiong Huang
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Fang
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ke Yang
- Department of Information, Huashan Hospital, Fudan University, Shanghai, China
| | - Guiqin Huang
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhizhong Zheng
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Nikhil Yawalkar
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Zhenghua Zhang
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
- Zhenghua Zhang
| | - Kexiang Yan
- Shanghai Institute of Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Kexiang Yan
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12
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Hoelker S, Ninosu N, Buettner S, Peitsch WK, Schaarschmidt ML. Patient preferences for topical psoriasis treatments: a discrete choice experiment. J DERMATOL TREAT 2022; 33:2595-2604. [DOI: 10.1080/09546634.2022.2059052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Suna Hoelker
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Buettner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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13
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Kumsa SM, Tadesse TA, Woldu MA. Management practice, quality of life and associated factors in psoriasis patients attending a dermatological center in Ethiopia. PLoS One 2021; 16:e0260243. [PMID: 34797854 PMCID: PMC8604307 DOI: 10.1371/journal.pone.0260243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/07/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation and aberrant differentiation with great negative impact on patients' quality of life (QoL). This study aimed at assessing factors influencing management practice, and QoL and its associated factors among ambulatory psoriatic patients visiting All Africa Leprosy, Tuberculosis and Rehabilitation Training (ALERT) Center in Addis Ababa, Ethiopia. MATERIALS AND METHODS A cross sectional study was conducted in 207 patients with psoriasis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Data were collected using structured questionnaire and patients' chart review. Dermatology Life Quality Index (DLQI) was used to measure patients' QoL. Patients' characteristics were summarized using descriptive statistics and predictors of QoL were identified by binary logistic regression. RESULTS Among 207 study participants, 122 (58.9%) were females. The mean age of the study population was 37.92 (SD = 14.86) years (ranging from 16 to 68 years). The mean age at which diagnosis of psoriasis made was 32 (SD = 13.7) years ranging from 10 to 62 years. The duration of the disease in 112 (54.1%) patients were more than or equal to 5 years. Majority of study participants 145 (70.0%) had plaque psoriasis followed by sebopsoriasis, 24 (11.6%). The majority of plaque psoriasis (80%) cases were managed by topical corticosteroids with or without salicylic acid or coal tar and only 21 (14.5%) treated by methotrexate alone. The mean DLQI was 6.25 corresponding to a moderate effect. Symptoms and feelings were the most affected domains of QoL. Factors associated with poor QoL were female [AOR = 0.17 (95%CI: 0.06, 0.48)], low, above average and high family income ([AOR = 0.12 (95% CI: 0.02, 0.56)], [AOR = 0.06 (95% CI:0.01, 0.32)], and [AOR = 0.03 (95% CI: 0.01, 0.22)]), respectively, and primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)] while being on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] was predictor of better QoL. Poor QoL was predominant in females [AOR = 0.17 (95%CI: 0.06, 0.48)], low income [AOR = 0.12 (95% CI: 0.02, 0.56] patients, and patients with primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)]. Patients on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] had good QoL. CONCLUSION Our study identified that topical corticosteroids were the mainstay of psoriasis treatment in the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Moderate effect QoL was achieved by study participants based on DLQL score.
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Affiliation(s)
- Seefu Megarsa Kumsa
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Assefa Tadesse
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Minyahil Alebachew Woldu
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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14
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Lademann J, Mansouri P, Nahavandi A, Ahlers A, Zibakalam-Mofrad F, Brower B, Nahavandi M, Feddern F, Darvin ME, Schanzer S, Richter H, Meinke MC, Rezaii SA, Rohaninasab M, Farshi S, Iacobelli M, Jung S. In vivo skin penetration, radical protection and structural changes after topical application of a herbal oil cream compared to topical calcipotriol in mild to moderate psoriasis. Skin Pharmacol Physiol 2021; 34:337-350. [PMID: 34404045 DOI: 10.1159/000518970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/09/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Juergen Lademann
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Parvin Mansouri
- Tehran University of Medical Science, TUMS, Skin and Stem Cell Research Center, Tehran, Iran
| | | | | | | | | | | | | | - Maxim E Darvin
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sabine Schanzer
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Heike Richter
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Martina C Meinke
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Seyed Ahmad Rezaii
- Tehran University of Medical Science, TUMS, Research Management Office, Tehran, Iran
| | - Masoumeh Rohaninasab
- Tehran University of Medical Science, TUMS, Skin and Stem Cell Research Center, Tehran, Iran
| | - Susan Farshi
- Tehran University of Medical Science, TUMS, Skin and Stem Cell Research Center, Tehran, Iran
| | | | - Sora Jung
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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15
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Rigopoulos D, Lazaridou E, Papadavid E, Georgiou S, Chasapi V, Sfaelos K, Cheliotis G, Ioannides D. Patient-reported outcomes with calcipotriol/betamethasone aerosol foam in patients with plaque psoriasis in Greece. Results from the CELSUS study. J Eur Acad Dermatol Venereol 2021; 35:e931-e934. [PMID: 34374131 DOI: 10.1111/jdv.17593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/30/2021] [Indexed: 11/27/2022]
Affiliation(s)
- D Rigopoulos
- 1st Department of Dermatology-Venereology, University of Athens, Athens, Greece
| | - E Lazaridou
- 2nd Department of Dermatology-Venereology, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - E Papadavid
- 2nd Department of Dermatology and Venereology, ATTIKON University Hospital, Athens, Greece
| | - S Georgiou
- Department of Dermatology, Medical School, General University Hospital, University of Patras, Patras, Greece
| | - V Chasapi
- Department of Dermatology and Venereology NHS, Andreas Syggros Hospital, Athens, Greece
| | - K Sfaelos
- Dermatology, LEO Pharma Hellas, Athens, Greece
| | | | - D Ioannides
- First Department of Dermatology-Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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16
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Lebwohl M, Thaçi D, Warren RB. Addressing challenges associated with long-term topical treatment and benefits of proactive management in patients with psoriasis. J Eur Acad Dermatol Venereol 2021; 35 Suppl 1:35-41. [PMID: 33619776 PMCID: PMC7985873 DOI: 10.1111/jdv.17053] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/24/2020] [Indexed: 12/26/2022]
Abstract
The majority of patients with psoriasis vulgaris (chronic plaque psoriasis) can be treated successfully with short‐term topical therapies. However, long‐term management of psoriasis with topicals is challenging and tends to take a reactive approach to disease relapse, rather than a proactive approach aimed at maintaining disease remission. Patients are often dissatisfied with the delay in treatment response and inconvenience of applying topical treatments, and therefore frequently discontinue treatment leading to poor outcomes. Relapse is common, particularly with reactive management, as underlying residual disease can remain following initial skin clearance; some patients find that their disease at relapse may be worse than their initial symptoms. This can have a detrimental effect on patient quality of life (QoL) and increase the risk of psoriasis‐associated depression. A long‐term proactive management approach, with maintenance treatment following initial treatment success, could help sustain disease remission and improve clinical and QoL outcomes for patients. Treatment with fixed‐dose calcipotriol 50 µg/g betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) is effective in the short term, providing a fast onset of action and improvements in disease at 4 weeks. Results from the Phase III PSO‐LONG study demonstrated that long‐term proactive management was superior to reactive management in prolonging time to first relapse, reducing number of relapses and increasing days in remission in adults with psoriasis vulgaris. Furthermore, Cal/BD foam was well tolerated in PSO‐LONG. No new safety concerns were identified over 52 weeks; the safety profile was consistent with that described previously. Given this, Cal/BD foam should be considered when prescribing topicals for the long‐term proactive management for patients with psoriasis. Video abstract
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Affiliation(s)
- M Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - D Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, University of Manchester, Manchester, UK
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17
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Chen L, Li J, Yao Y, Wang S, Zheng S, Ju X, Zhang B. Circulating microRNA profile unveils mechanisms of action of acitretin for psoriasis vulgaris. Bioengineered 2021; 12:1838-1850. [PMID: 33975513 PMCID: PMC8806620 DOI: 10.1080/21655979.2021.1925205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Psoriasis vulgaris is a common chronic and recurrent inflammatory skin disease. In clinical practice, acitretin is the first-line treatment drug for psoriasis vulgaris. MicroRNAs (miRNAs) play a vital role in the initiation and development of psoriasis vulgaris. However few studies focused on the mechanisms of acitretin in the treatment of psoriasis vulgaris from the perspective of miRNAs. Here, the expression profiles of circulating miRNAs in the plasma of 12 patients with psoriasis vulgaris before and after acitretin treatment were sequenced. Three miRNAs (miR-146a-5p, miR-122-5p and miR-21-5p) were identified using expression pattern analysis, and the levels were significantly decreased after acitretin treatment (P< 0.001). Receiver operating characteristic (ROC) analyses indicated that the three miRNAs have the potential to be utilized as molecular markers to evaluate the therapeutic effect of acitretin, and the values of the area under the curve (AUC) were 0.825, 0.831, and 0.796, respectively. In addition, we predicted target genes of the three miRNAs and performed signaling pathway enrichment analyses. The results demonstrated that the target genes were mainly involved in the MAPK, JAK-STAT, and NF-κB signaling pathways, which were further validated through in vitro experiments. In conclusion, acitretin can suppress miRNA-mediated MAPK, JAK-STAT, and NF-κB signaling pathways by decreasing miRNAs expression, thereby inhibiting the proliferation and inflammatory response of keratinocytes.
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Affiliation(s)
- Lin Chen
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
| | - Jie Li
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
| | - Ying Yao
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
| | - Shanlong Wang
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
| | - Shuangjin Zheng
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
| | - Xinggang Ju
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
| | - Bin Zhang
- Department of Dermatology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, China
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18
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Xie X, Wang Y, Yao S, Xia Y, Luo H, Li L, Lu C. Biologics recommendations for patients with psoriasis: a critical appraisal of clinical practice guidelines for psoriasis. J DERMATOL TREAT 2021; 33:2038-2050. [PMID: 33849360 DOI: 10.1080/09546634.2021.1914306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE This review article serves to assess the consistency of recommendations from guidelines on biologic agents for psoriasis, based on the quality evaluation of psoriasis Clinical Practice Guidelines (CPGs). METHODS We conducted a systematic literature search to identify CPGs that provide recommendations on diagnosis and treatment for psoriasis. Four reviewers performed a quality assessment of the included CPGs with the Appraisal of Guidelines Research and Evaluation II (AGREE II) Instrument. RESULTS A total of 51 sets of CPGs from 22 medical societies or separate working groups fulfilled the inclusion criteria. The overall quality of the eligible sets of guidelines was moderate to high, with an overall average score of 55%The highest domain scores were Score and Purpose (70%) and Clarity of Presentation (68%). A total of 95 biologic agent recommendations were extracted from the 18 recommended CPGs.Three biologic agents (Etanercept, Adalimumab, Ustekinumab) were recommended for pediatric patients. Three biologic agents (Adalimumab, Ustekinumab, Secukinumab) were recommended as first-line biologic agents for adults with psoriasis. CONCLUSION The overall methodological quality of CPGs for psoriasis is medium to high. More attention should be paid to applicability in guideline development. The recommendations and the basis for them among various sets guidelines were almost consistent.
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Affiliation(s)
- Xiuli Xie
- Department of Standardization of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Department of Standardization of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.,Engineering and Technology Research Center of Standardization of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Yangyang Wang
- Department of Standardization of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Department of Standardization of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.,Engineering and Technology Research Center of Standardization of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Sha Yao
- Department of Standardization of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yun Xia
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hao Luo
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lui Li
- Department of Standardization of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Department of Standardization of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.,Engineering and Technology Research Center of Standardization of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuanjian Lu
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
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19
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Rigopoulos D, Lazaridou E, Papadavid E, Georgiou S, Chasapi V, Sfaelos K, Cheliotis G, Ioannides D. A real‐world, observational study on the effectiveness with calcipotriol/betamethasone aerosol foam in patients with plaque psoriasis in Greece: the CELSUS study. J Eur Acad Dermatol Venereol 2021; 35:e454-e457. [DOI: 10.1111/jdv.17211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 02/24/2021] [Indexed: 11/29/2022]
Affiliation(s)
- D. Rigopoulos
- 1st Department of Dermatology‐Venereology University of Athens Athens Greece
| | - E. Lazaridou
- 2nd Department of Dermatology‐Venereology Aristotle University Medical School Thessaloniki Greece
| | - E. Papadavid
- 2nd Department of Dermatology and Venereology ATTIKON University Hospital Athens Greece
| | - S. Georgiou
- Department of Dermatology Medical School General University HospitalUniversity of Patras Patras Greece
| | - V. Chasapi
- Department of Dermatology and Venereology NHS Andreas Syggros Hospital Athina Greece
| | - K. Sfaelos
- LEO Pharma Hellas; Dermatology Kifisia Greece
| | | | - D. Ioannides
- First Department of Dermatology‐Venereology Aristotle University of Thessaloniki Thessaloniki Greece
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20
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Lu Y, Xiao Y, Yin MZ, Zhou XC, Wu LS, Chen WQ, Luo Y, Kuang YH, Zhu W. Polyethylene Glycol Ointment Alleviates Psoriasis-Like Inflammation Through Down-Regulating the Function of Th17 Cells and MDSCs. Front Med (Lausanne) 2021; 7:560579. [PMID: 33834028 PMCID: PMC8022287 DOI: 10.3389/fmed.2020.560579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 12/30/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: To explore the possible mechanism of improving the imiquimod (IMQ)-induced psoriasis-like inflammation by using polyethylene glycol (PEG) ointment. Methods: We evaluated the appearance of psoriasis lesions by Psoriasis Area and Severity Index (PASI), observed the epidermal proliferation by histopathological staining and immunohistochemical staining, and explored the key molecules and signaling pathways of improving psoriasis-like inflammation treated with PEG ointment by RNA sequencing. Finally, we verified the expression of inflammatory cells and inflammatory factors by flow cytometry, immunohistochemical staining, and Q-PCR. Results: PEG ointment could improve the appearance of psoriasis lesions and the epidermis thickness of psoriasis mouse, inhibit the proliferation of keratinocytes, and down-regulate the relative mRNA levels of IL-23, IL-22, IL-6, IL-17C, IL-17F, S100A7, S100A8, S100A9, CXCL1, CXCL2, and IL-1β in the skin lesions of psoriasis mouse by down-regulating the numbers of myeloid-derived suppressor cells (MDSCs) and T helper 17 (Th17) cells. Conclusion: PEG ointment could improve the IMQ-induced psoriasis-like inflammation by down-regulating the functions of Th17 cells and MDSCs.
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Affiliation(s)
- Yan Lu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Ming-Zhu Yin
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Xing-Chen Zhou
- Pharmacy, Xiangya Hospital, Central South University, Changsha, China
| | - Li-Sha Wu
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,Institute of Medical Science, Xiangya Hospital, Central South University, Changsha, China
| | - Wang-Qing Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Luo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Ye-Hong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
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21
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Langenbruch A, Mohr N, Kirsten N, Reich K, von Kiedrowski R, Strömer K, Mrowietz U, Augustin M. Quality of psoriasis care in Germany - results from the nationwide health care studies PsoHealth 2004-2017. J Eur Acad Dermatol Venereol 2021; 35:1536-1542. [PMID: 33714231 DOI: 10.1111/jdv.17220] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the study series PsoHealth first data from 2004/05 showed a poor quality of health care for psoriasis in Germany. Most patients lacked sufficient care and only a minor proportion received systemic drugs. Since 2007, a national psoriasis programme has been conducted. OBJECTIVES (1) To analyse the quality of health care for psoriasis in the most recent PsoHealth4 survey 2016/17, (2) to compare health care quality indicators with prior assessments since 2004/05. MATERIALS AND METHODS The recent cross-sectional PsoHealth4 survey was conducted 2016/17, and three preceding studies were performed in 2004/05, 2007 and 2013/14, each including at least 1500 patients. The common set of quality indicators included disease severity (PASI and proportion of patients with PASI > 20, indicating high severity), quality of life (DLQI and proportion of patients with DLQI > 10, indicating strong impairments in quality of life), systemic therapy and inpatient treatment of the last five years. RESULTS Between December 2015 and December 2017, n = 1827 patients from 93 dermatological centres were included in the most recent survey (mean age: 50.8 ± 14.6 years, 45.2% female). 7.3% showed a PASI > 20, compared to 17.8% in 2004/05. 21.4% reported a DLQI > 10, compared to 34.0% in 2004/05. 57.6% of all participants stated to have received a systemic therapy at least once within the last five years, compared to 32.9% in 2004/05. 18.0% received inpatient hospital treatment at least once within the last five years, compared to 26.9% in 2004/05. CONCLUSION A remarkable improvement in the health care quality for psoriasis patients in Germany within the past 12 years can be assumed. Major determinants could be the innovation shift which included programmes such as the S3 guideline, a consensus on treatment goals, national health care goals for psoriasis and higher utilisation of innovative drugs.
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Affiliation(s)
- A Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - K Strömer
- Gemeinschaftspraxis für Dermatologie und Allergologie, Mönchengladbach, Germany
| | - U Mrowietz
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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22
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Chen H, Liu H, Tang B, Chen Y, Han L, Yu J, Yan Y, Lu C. The Protective Effects of 18 β-Glycyrrhetinic Acid on Imiquimod-Induced Psoriasis in Mice via Suppression of mTOR/STAT3 Signaling. J Immunol Res 2020; 2020:1980456. [PMID: 32908937 PMCID: PMC7474397 DOI: 10.1155/2020/1980456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/09/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is recognized as an autoimmune and inflammatory dermatosis, which is estimated to affect 2-3% of the population worldwide. 18β-Glycyrrhetinic acid (GA), one of the main ingredients of Licorice (Glycyrrhiza glabra L.), has been shown to have numerous pharmacological effects such as antioxidative, antitumor, and anti-inflammatory activities. However, it remains to be explored whether GA has antipsoriatic effect on psoriasis. In this study, we evaluated the protective effect of GA on psoriasis and its mechanisms of action in imiquimod-induced psoriasis-like mouse model. Results indicated that GA dramatically improved psoriatic lesions and reduced psoriasis area and severity index scores. GA also suppressed the mRNA levels of IL-6, TNF-α, IL-17, IL-23, and IL-1β in the skin and increased the proportion of CD4+ Foxp3+ regulatory T cells (Tregs) in both lymph nodes and spleens. Its anti-inflammatory and immunomodulatory activities may be related to its suppression of the STAT3 and mTOR signaling. In conclusion, GA ameliorated the symptoms of psoriasis, at least in part, through inhibition of inflammatory cytokines and STAT3/mTOR signaling and activation of Tregs in both lymph nodes and spleens. These effects are expected to be beneficial in the treatment and prevention of psoriasis.
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Affiliation(s)
- Haiming Chen
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510115, China
| | - Huazhen Liu
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
| | - Bin Tang
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
| | - Yuchao Chen
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
| | - Ling Han
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510115, China
| | - Jingjie Yu
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510115, China
| | - Yuhong Yan
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510115, China
| | - Chuanjian Lu
- State Key laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510115, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510115, China
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23
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Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients. Mediators Inflamm 2020; 2020:8065147. [PMID: 32801996 PMCID: PMC7415124 DOI: 10.1155/2020/8065147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/03/2020] [Indexed: 12/22/2022] Open
Abstract
Psoriasis is an inflammatory autoimmune disease characterized by cutaneous lesions in plaques. It has been proposed that the immune response has a key role in the disease progression. Particularly, the Th17 cells through IL-17 can contribute to maintain the inflammatory process. The pathogenic Th17 phenotype has been described in human diseases and associated with high severity in inflammatory experimental models. However, it is not clear if the pathogenic phenotype could be present in the skin and peripheral blood as well as its possible association to severity in psoriasis. In the lesional skin, we found high infiltration of Th17 cells and the pathogenic phenotype, finding a correlation between the frequency of Th17 cells and the Psoriasis Area and Severity Index (PASI) score. In peripheral blood, we observed a pool of Th17 lymphocytes with potential to acquire pathogenic features. Interestingly, the percentage of pathogenic Th17 cells (CD4+ RORγt+ IFN-γ+) correlates with disease severity. Moreover, we distinguished three groups of patients based on their IL-17/IFN-γ production by Th17 lymphocytes, which seems to be related with a dynamic or stable potential to express these cytokines. Remarkably, we evaluated the cytokine production by Th17 cells as an immunological marker for the adequate selection of biologic therapy. We found that patients analyzed by this immunological approach and treated with antibodies against IL-17 and TNFα showed great improvement depicted by reduction in PASI and Dermatology Life Quality Index (DLQI) score as well as the percentage of Body Surface Area (BSA). Altogether, our results highlight the importance of the assessment of the pathogenic phenotype in Th17 cells as an immune personalized analysis with the potential to support the therapy choice in the clinical practice.
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24
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Yu Y, Yi X, Zhang Y, Yu N, Yu Q, Le Q, Chen Z, Ding Y, Shi Y. Comparison of different incremental dose regimens of narrow-band ultraviolet B in skin types III to V: A prospective, randomized, single-blind, parallel study in patients with psoriasis. J Am Acad Dermatol 2020; 84:1136-1138. [PMID: 32619612 DOI: 10.1016/j.jaad.2020.06.993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Yingyuan Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Xuemei Yi
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Ning Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Qian Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Qianlian Le
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Zeyu Chen
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China.
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, and the Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China.
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25
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Bakshi H, Nagpal M, Singh M, Dhingra GA, Aggarwal G. Treatment of Psoriasis: A Comprehensive Review of Entire Therapies. Curr Drug Saf 2020; 15:82-104. [DOI: 10.2174/1574886315666200128095958] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 12/19/2022]
Abstract
Background:
Psoriasis is an autoimmune disease that ingeminates itself with the repeated
proliferation of keratinocytes. It globally strikes a 2-5 % population on an average. Management
of psoriasis remains a daunting task with various challenges influencing treatment, such as patient
conformity and adherence to therapy, delicate patient profiles, psychological aspects, and skin as a
barrier to topical delivery. The first part reviewed pathophysiology, triggering factors, and clinical
classification. The second part reviewed all the therapies, such as topical, oral, biological, parenteral
therapy, phototherapy, and the phyto-pharmaceuticals.
Methods:
The research data related to the existing and upcoming therapies for psoriasis treatment,
several nanocarriers, existing marketed formulations, and detailed description of phytopharmaceuticals
with their mechanism.
Results:
Topical therapy is the mainstay treatment option with limited adverse effects. Biological therapy
has reformed conventional psoriasis treatment by being more efficacious and has increased patient
acceptance due to decreased adverse events. Nanoformulations present an edge over conventional
therapy due to improved anti-psoriatic effect and decreased side effects. Phyto-pharmaceuticals act as
a complementary and alternative therapy for diminishing psoriasis symptoms.
Conclusion:
A rationalized cost-effective patient compliant therapy is required for effective management
and complete cure of psoriasis.
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Affiliation(s)
- Harman Bakshi
- Chitkara College of Pharmacy, Chitkara University, Chandigarh-Patiala, NH 7, 64, Tehsil, Rajpura, Punjab, India
| | - Manju Nagpal
- Chitkara College of Pharmacy, Chitkara University, Chandigarh-Patiala, NH 7, 64, Tehsil, Rajpura, Punjab, India
| | - Manjinder Singh
- Chitkara College of Pharmacy, Chitkara University, Chandigarh-Patiala, NH 7, 64, Tehsil, Rajpura, Punjab, India
| | | | - Geeta Aggarwal
- Delhi Pharmaceutical Sciences and Research University, New Delhi-110017, India
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26
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Benezeder T, Painsi C, Patra V, Dey S, Holcmann M, Lange-Asschenfeldt B, Sibilia M, Wolf P. Dithranol targets keratinocytes, their crosstalk with neutrophils and inhibits the IL-36 inflammatory loop in psoriasis. eLife 2020; 9:e56991. [PMID: 32484435 PMCID: PMC7266641 DOI: 10.7554/elife.56991] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/18/2020] [Indexed: 12/18/2022] Open
Abstract
Despite the introduction of biologics, topical dithranol (anthralin) has remained one of the most effective anti-psoriatic agents. Serial biopsies from human psoriatic lesions and both the c-Jun/JunB and imiquimod psoriasis mouse model allowed us to study the therapeutic mechanism of this drug. Top differentially expressed genes in the early response to dithranol belonged to keratinocyte and epidermal differentiation pathways and IL-1 family members (i.e. IL36RN) but not elements of the IL-17/IL-23 axis. In human psoriatic response to dithranol, rapid decrease in expression of keratinocyte differentiation regulators (e.g. involucrin, SERPINB7 and SERPINB13), antimicrobial peptides (e.g. ß-defensins like DEFB4A, DEFB4B, DEFB103A, S100 proteins like S100A7, S100A12), chemotactic factors for neutrophils (e.g. CXCL5, CXCL8) and neutrophilic infiltration was followed with much delay by reduction in T cell infiltration. Targeting keratinocytes rather than immune cells may be an alternative approach in particular for topical anti-psoriatic treatment, an area with high need for new drugs.
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Affiliation(s)
| | - Clemens Painsi
- State Hospital KlagenfurtKlagenfurt am WörtherseeAustria
| | - VijayKumar Patra
- Department of Dermatology, Medical University of GrazGrazAustria
| | - Saptaswa Dey
- Department of Dermatology, Medical University of GrazGrazAustria
| | - Martin Holcmann
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of ViennaViennaAustria
| | | | - Maria Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of ViennaViennaAustria
| | - Peter Wolf
- Department of Dermatology, Medical University of GrazGrazAustria
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27
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Nanostructured lipidic carriers for dual drug delivery in the management of psoriasis: Systematic optimization, dermatokinetic and preclinical evaluation. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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28
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Chen M, Chen W, Liu P, Yan K, Lv C, Zhang M, Lu Y, Qin Q, Kuang Y, Zhu W, Chen X. The impacts of gene polymorphisms on methotrexate in Chinese psoriatic patients. J Eur Acad Dermatol Venereol 2020; 34:2059-2065. [PMID: 32271961 DOI: 10.1111/jdv.16440] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/24/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Methotrexate (MTX) is the first-line treatment for psoriasis in China. The metabolic processes of MTX include various proteins and genes. Previous studies have shown that gene polymorphisms had significant impacts on the efficacy of MTX. However, the influence of gene polymorphisms has not been reported in the Chinese psoriatic patients. OBJECTIVE The aim of this study was to verify the impacts of candidate genes polymorphisms on the effectiveness of MTX in a Chinese psoriatic population. METHODS In this study, we enrolled 259 psoriasis patients from two clinical centres. Each of them received MTX treatment at 7.5-15 mg/week for at least 8 weeks. Patients were stratified as responders and non-responders according to whether the Psoriasis Area and Severity Index score declined more than 75% (PASI75). According to previous reports, 16 single nucleotide polymorphisms (SNPs) were selected and genotyped for each patient using the Sequenom platform. Fisher's exact test, the chi-square test, Mann-Whitney tests and ANOVA analyses were used for statistical analysis. RESULTS Among 259 patients, there were 182 males and 77 females, 63 patients with psoriatic arthritis and 196 patients without arthritis phenotype, and the age of all patients ranged from 19 to 70 years (49.7 ± 13.6). The baseline PASI value of patients was 13.8 ± 8.5, and 33.2% of patients achieved a PASI75 response after MTX treatment. Patients carrying the ATP-binding cassette subfamily B member 1 gene (ABCB1) rs1045642 TT genotype were associated with more severe psoriasis skin lesion (P = 0.032). Furthermore, the ABCB1 rs1045642 TT genotype was found to be more frequent in non-responders (P = 0.017), especially in moderate-to-severe patients (P = 0.002) and patients without psoriatic arthritis (P = 0.026) after MTX treatment. CONCLUSION We have demonstrated for the first time that polymorphism of the ABCB1 rs1045642 TT genotype is predictive of a worse clinical response of skin lesions to MTX therapy in a Chinese psoriatic population.
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Affiliation(s)
- M Chen
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - W Chen
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - P Liu
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - K Yan
- Department of Dermatology, Dalian Dermatosis Hospital, Dalian, Liaoning, China
| | - C Lv
- Gerontology Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - M Zhang
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - Y Lu
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - Q Qin
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - Y Kuang
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - W Zhu
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
| | - X Chen
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China.,Department of Dermatology, Hua Shan Hospital, Fu dan University, Shanghai, China
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29
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Zorlu O, Bülbül Başkan E, Yazici S, Sığırlı D, Budak F, Sarıcaoğlu H, Aydoğan K, Cevhertas L. Predictors of drug survival of biologic therapies in psoriasis patients. J DERMATOL TREAT 2020; 33:437-442. [PMID: 32351141 DOI: 10.1080/09546634.2020.1763240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION We aimed to investigate the clinical, immunological, and genetic factors affecting the response to anti-TNFα (tumor necrosis factor-α) and interleukin-12/23 therapies and drug survivals. METHODS A total of 180 patients were divided into two groups: 89 patients who used at least two biologic agents, with the initial biologic agent used less than 12 months (group A), and 91 biologic-naive patients who have been receiving a single biologic agent for more than 12 months (group B). ELISA (enzyme-linked immunosorbent assay) was used to analyze anti-drug antibodies (ADAs) in blood samples. Clinical data of the patients were retrospectively analyzed. HLA-SSO (sequence-specific oligonucleotide) Typing Kits were used for HLA-C typing. IBM SPSS v.21 was used for statistical analysis.Results: Infliximab had the longest drug survival as the first biologic agent in group A (p = .015). Etanercept had the lowest ADA count compared to the other anti-TNF agents (p = .001). HLA-Cw6 negativity, late-onset psoriasis, smoking and alcohol use were determined to be risk factors for treatment failure in group A. HLA-Cw6 was found to be associated with type I psoriasis (p = .000). CONCLUSIONS Although our study is retrospective of a relatively low number of patients, this is a preliminary study focusing on two different patient populations based on therapy response.
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Affiliation(s)
- Ozge Zorlu
- Department of Dermatology and Venereology, Uludag University School of Medicine, Bursa, Turkey
| | - Emel Bülbül Başkan
- Department of Dermatology and Venereology, Uludag University School of Medicine, Bursa, Turkey
| | - Serkan Yazici
- Department of Dermatology and Venereology, Uludag University School of Medicine, Bursa, Turkey
| | - Deniz Sığırlı
- Department of Statistics, Uludag University School of Medicine, Bursa, Turkey
| | - Ferah Budak
- Department of Immunology, Uludag University School of Medicine, Bursa, Turkey
| | - Hayriye Sarıcaoğlu
- Department of Dermatology and Venereology, Uludag University School of Medicine, Bursa, Turkey
| | - Kenan Aydoğan
- Department of Dermatology and Venereology, Uludag University School of Medicine, Bursa, Turkey
| | - Lacin Cevhertas
- Department of Medical Immunology, Institute of Health Sciences, Bursa Uludag University, Bursa, Turkey
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30
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Conti A, Giovannini L, Mandel VD, Odorici G, Lasagni C, Bigi L, Pellacani G, Cappelli G. Chronische Nierenerkrankung bei Psoriasis: eine Kohortenstudie. J Dtsch Dermatol Ges 2020; 18:438-446. [DOI: 10.1111/ddg.14087_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 09/20/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Andrea Conti
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Lisa Giovannini
- Nephrology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Victor Desmond Mandel
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
- Dermatology Unit Department of Clinical and Experimental Medicine University of Parma Parma Italy
| | - Giulia Odorici
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Claudia Lasagni
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Laura Bigi
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Giovanni Pellacani
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Gianni Cappelli
- Nephrology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
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31
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Zhang J, Yu Q, Peng L, Zhang F, Lin W, Guo J, Xiao M, Chen M. Cupping for psoriasis vulgaris: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20348. [PMID: 32443388 PMCID: PMC7253533 DOI: 10.1097/md.0000000000020348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psoriasis vulgaris (PV) is a chronic, immune-mediated dermatological disease that significantly affects the patient's health and quality of life. At present, cupping has been widely used in the treatment of psoriasis. However, the effectiveness and safety of cupping in patients with PV are still controversial. Therefore, this review aims to evaluate the efficacy and safety of cupping therapy on PV. METHODS The following databases will be searched from their inceptions to April 2020 with a language limitation of English and Chinese: Pubmed, Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Databas, China National Knowledge Infrastructure Database, Wanfang database and Chinese Scientific Journal Database. The reference lists of eligible studies and other resources will also be searched. Two researchers will independently perform the selection of studies, data extraction, and data analysis. A fixed or random-effect model will be applied to synthesize data depend on the heterogeneity test. The primary outcome is the proportion of patients achieving at least a 60% improvement in psoriasis area and severity index (PASI) score from baseline (PASI 60). Secondary outcomes include the proportion of patients achieving at least a 90% improvement in PASI score from baseline (PASI 90), the mean change of PASI and dermatology life quality index score, the itching index, adverse events, and recurrence rate. RevMan V.5.3 software will be used for meta-analysis. RESULTS The study will provide a high-quality evidence-based review of cupping for PV. CONCLUSIONS The study will be conducted to evaluate the efficacy and safety of cupping in the treatment of PV and supposed to provide clear evidence for the clinical application of cupping therapy. ETHICS AND DISSEMINATION As the study is a protocol of systematic review and meta-analysis that does not involve individual data, ethical approval will not be required. The results will be published in a peer-reviewed journal. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/KV4CJ.
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32
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Wu X, Deng X, Wang J, Li Q. Baicalin Inhibits Cell Proliferation and Inflammatory Cytokines Induced by Tumor Necrosis Factor α (TNF-α) in Human Immortalized Keratinocytes (HaCaT) Human Keratinocytes by Inhibiting the STAT3/Nuclear Factor kappa B (NF-κB) Signaling Pathway. Med Sci Monit 2020; 26:e919392. [PMID: 32321906 PMCID: PMC7193247 DOI: 10.12659/msm.919392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Baicalin is a flavone isolated from the root of Scutellaria baicalensis and is used in traditional Chinese medicine. Psoriasis is a persistent and recurrent chronic inflammatory skin disease that is characterized by inflammation and increased proliferation of keratinocytes. This study aimed to investigate the effects of baicalin on HaCaT immortalized human keratinocytes in vitro and the molecular mechanisms involved. Material/Methods HaCaT keratinocytes were cultured in increasing concentrations of baicalin at 6.25 μM, 12.5 μM, and 25 μM. The in vitro model of psoriasis was established using HaCaT cells treated with tumor necrosis factor-α (TNF-α). The MTT assay was used to asses cell viability and apoptosis. Western blot was used to measure the expression of Bcl-2, Bax, pro-caspase-3, and cleaved caspase-3, and enzyme-linked immunosorbent assay (ELISA) was performed to detect inflammatory cytokines. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to detect the levels of STAT3 and p65 mRNA. Results Baicalin reduced cell viability and induced apoptosis of HaCaT human keratinocytes in a dose-dependent manner. Increased cell viability and the expression of inflammatory cytokines by HaCaT cells induced by TNF-α were significantly inhibited by baicalin. Baicalin significantly inhibited the activation of the STAT3/NF-κB pathway in HaCaT cells stimulated by TNF-α. Conclusions Baicalin inhibited the proliferation and expression of inflammatory cytokines in HaCaT immortalized human keratinocytes in vitro through the inhibition of the STAT3/NF-κB signaling pathway.
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Affiliation(s)
- Xianwei Wu
- Department of Dermatology, Gansu Provincial Hospital, Lanzhou, Gansu, China (mainland)
| | - Xiue Deng
- Department of Dermatology, Gansu Provincial Hospital, Lanzhou, Gansu, China (mainland)
| | - Jiandi Wang
- Department of Dermatology, Gansu Provincial Hospital, Lanzhou, Gansu, China (mainland)
| | - Qin Li
- Department of Dermatology, Gansu Provincial Hospital, Lanzhou, Gansu, China (mainland)
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Conti A, Giovannini L, Mandel VD, Odorici G, Lasagni C, Bigi L, Pellacani G, Cappelli G. Chronic kidney disease in psoriasis: a cohort study. J Dtsch Dermatol Ges 2020; 18:438-445. [DOI: 10.1111/ddg.14087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 09/20/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea Conti
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Lisa Giovannini
- Nephrology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Victor Desmond Mandel
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
- Dermatology Unit Department of Clinical and Experimental Medicine University of Parma Parma Italy
| | - Giulia Odorici
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Claudia Lasagni
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Laura Bigi
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Giovanni Pellacani
- Dermatology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - Gianni Cappelli
- Nephrology Unit Surgical Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
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Yue L, Ailin W, Jinwei Z, Leng L, Jianan W, Li L, Haiming C, Ling H, Chuanjian L. PSORI-CM02 ameliorates psoriasis in vivo and in vitro by inducing autophagy via inhibition of the PI3K/Akt/mTOR pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 64:153054. [PMID: 31401494 DOI: 10.1016/j.phymed.2019.153054] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/20/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Psoriasis is an inflammatory skin disease that affects an estimated 3% of the world's population. PSORI-CM02 is an empirically developed Chinese medicine formula optimised from Yin Xie Ling, summarised by national medical master Guo-Wei Xuan, that has been used for decades to treat psoriasis in the Guangdong Provincial Hospital of Chinese Medicine. However, its anti-psoriatic mechanisms are still poorly understood. In this study, we explored the effects of PSORI-CM02 on autophagy and the underlying mechanisms in TNF-α-stimulated HaCaT cells and in a mouse model of imiquimod-induced psoriasis. METHODS Cell viability was assessed by MTT assay. Apoptosis was detected by annexin V-FITC/PI double-staining and caspase-3 assays. Autophagy was detected by electron microscopy, RT-PCR and western blotting. The PI3K/Akt/mTOR pathway was analysed by western blotting and immunochemical analysis. RESULTS PSORI-CM02 induced autophagy and thus inhibited the proliferation of HaCaT cells via suppression of the PI3K/Akt/mTOR pathway. In mice with IMQ-induced psoriasis, PSORI-CM02 relieved psoriasis symptoms, induced autophagy and inhibited the phosphorylation of the PI3K/AKT/mTOR pathway in the skin. CONCLUSION These results suggest that PSORI-CM02 treats psoriasis by inducing autophagy via inhibition of the PI3K/Akt/mTOR pathway.
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Affiliation(s)
- Lu Yue
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China; Dermatology Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Wang Ailin
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China; Dermatology Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Zhang Jinwei
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China
| | - Li Leng
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China
| | - Wei Jianan
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China
| | - Li Li
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China
| | - Chen Haiming
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China
| | - Han Ling
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510120, Guangdong, China.
| | - Lu Chuanjian
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong, China; Dermatology Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou 510120, Guangdong, China.
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Nast A, Amelunxen L, Augustin M, Boehncke WH, Dressler C, Gaskins M, Härle P, Hoffstadt B, Klaus J, Koza J, Mrowietz U, Ockenfels HM, Philipp S, Reich K, Rosenbach T, Rzany B, Schlaeger M, Schmid-Ott G, Sebastian M, von Kiedrowski R, Weberschock T. S3 Guideline for the treatment of psoriasis vulgaris, update - Short version part 1 - Systemic treatment. J Dtsch Dermatol Ges 2019; 16:645-669. [PMID: 29750443 DOI: 10.1111/ddg.13516] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The German guideline for the treatment of psoriasis vulgaris was updated using GRADE methodology. The guideline is based on a systematic literature review completed on December 1, 2016, and on a formal consensus and approval process. The first section of this short version of the guideline covers systemic treatment options considered relevant by the expert panel and approved in Germany at the time of the consensus conference (acitretin, adalimumab, apremilast, cyclosporine, etanercept, fumaric acid esters, infliximab, methotrexate, secukinumab and ustekinumab). Detailed information is provided on the management and monitoring of the included treatment options.
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Affiliation(s)
- Alexander Nast
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence-Based Medicine (dEBM)
| | | | - Matthias Augustin
- Universitätsklinikum Hamburg-Eppendorf, Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen [University Hospital Hamburg-Eppendorf, Institute for Health Care Research in Dermatology and Nursing]
| | - Wolf-Henning Boehncke
- Service de Dermatologie et Vénéréologie, Hôpitaux Universitaires de Genève [Dermatology and Venereology Service, Geneva University Hospitals]
| | - Corinna Dressler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence-Based Medicine (dEBM)
| | - Matthew Gaskins
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence-Based Medicine (dEBM)
| | - Peter Härle
- Katholisches Klinikum Mainz, Zentrum für Rheumatologische Akutdiagnostik, Klinik für Rheumatologie, Klinische Immunologie und Physikalische Therapie [Catholic Medical Center Mainz, Center for Rheumatological Diagnostics, Department of Rheumatology, ClinicaI Immunology and Physical Therapy]
| | - Bernd Hoffstadt
- Selbsthilfegemeinschaft Haut e. V. [Skin self-help association]
| | - Joachim Klaus
- Deutscher Psoriasis Bund e. V. [German Psoriasis Society]
| | - Joachim Koza
- Deutscher Psoriasis Bund e. V. [German Psoriasis Society]
| | - Ulrich Mrowietz
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie, Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel [Psoriasis Center, Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein Kiel campus]
| | - Hans-Michael Ockenfels
- Haut- und Allergieklinik, Klinikum Hanau [Department of Dermatology and Allergology, Hanau Medical Center]
| | - Sandra Philipp
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Psoriasisstudienzentrum [Psoriasis Study Center]
| | | | - Thomas Rosenbach
- Niedergelassener Dermatologe, Osnabrück [Office-based Dermatologist, Osnabrück]
| | - Berthold Rzany
- Privatpraxis Rzany & Hund, Berlin [Office-based Dermatologists Rzany & Hund, Berlin]
| | - Martin Schlaeger
- Niedergelassener Dermatologe, Oldenburg [Office-based Dermatologist, Osnabrück]
| | | | - Michael Sebastian
- Niedergelassener Dermatologe, Mahlow [Office-based Dermatologist, Mahlow]
| | | | - Tobias Weberschock
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt/Main und Arbeitsgruppe EbM Frankfurt, Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt/Main [Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt/Main and EbM Frankfurt working group, Institute for General Medicine, Goethe University Frankfurt, Frankfurt/Main]
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Shikonin induces apoptosis and suppresses growth in keratinocytes via CEBP-δ upregulation. Int Immunopharmacol 2019; 72:511-521. [DOI: 10.1016/j.intimp.2019.04.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/19/2019] [Accepted: 04/23/2019] [Indexed: 12/25/2022]
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Mazaud C, Fardet L. Daily practices regarding safety monitoring of low-dose methotrexate and comparison to guidelines: A population-based cohort study. Therapie 2019; 76:425-433. [PMID: 32354461 DOI: 10.1016/j.therap.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/28/2019] [Accepted: 05/28/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To describe daily practices regarding safety monitoring of methotrexate prescribed at low-(i.e.≤30mg/week). To identify determinants of these practices. To assess association between monitoring and early methotrexate discontinuation. METHODS Population-based cohort study using the French claims database échantillongénéralistedebénéficiaires (EGB) over the period 2009-2015. Incident methotrexate users were included. The pre-treatment and post-treatment monitoring prescribed to these patients was analyzed. Determinants of monitoring were identified using a logistic regression model. Association between monitoring and early methotrexate discontinuation was assessed using Cox proportional-hazards model. RESULTS During the study period, 615924 individuals had data in the EGB and 2472 (0.40%) were incident methotrexate users (63.3% women; mean age: 54.7±17.8 years; mean weekly dosage: 13.0±5.3mg). Among these incident users, only 50-70% had an albumin testing (67.0%); HIV (49.7%), hepatitis B (54.8%) or C (55.0%) serology; or chest X-ray (57.4%) within the year before initiating methotrexate. Only 65.7% had a least one CBC, transaminase and urea-creatinine testing combined within the three months before initiation. During the first three months of exposure, the median number of CBC, transaminase and urea-creatinine testing was 2 [1-4], 2 [1-4], and 2 [1-3], respectively. The monitoring modalities depend more on prescriber characteristics than on patient or treatment characteristics. There was a significant positive association between frequency of monitoring during exposure and early methotrexate discontinuation. CONCLUSION Monitoring of patients prescribed low-dose methotrexate is much less frequent than recommended. Frequent monitoring is associated with early methotrexate discontinuation.
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Affiliation(s)
- Canelle Mazaud
- Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Laurence Fardet
- Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France; EA 7379, EpiDermE, université Paris Est Créteil (UPEC), 94010 Créteil, France.
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Buhl AL, Wenzel J. Interleukin-36 in Infectious and Inflammatory Skin Diseases. Front Immunol 2019; 10:1162. [PMID: 31191535 PMCID: PMC6545975 DOI: 10.3389/fimmu.2019.01162] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/08/2019] [Indexed: 12/20/2022] Open
Abstract
Interleukin-36 (IL-36) comprises to a cytokine family consisting of four isoforms IL-36α, IL-36β, IL-36γ, and IL-36 receptor antagonist (IL-36 Ra). These IL-36 cytokines, in turn, belong to the IL-1 superfamily. The IL-36 receptor (IL-1R6) is functional as a heterodimer formed of IL-1R6 and IL-1 receptor accessory protein (IL-1RAcP). IL-36α, IL-36β, and IL-36γ are regarded as pro-inflammatory ligands and IL-36 Ra as well as IL-38 as anti-inflammatory ligands of IL-1R6. IL-36 cytokines are mainly expressed on the barrier sites of the body e.g., bronchial, intestinal, and dermal epithelium. One of their most important biological functions is the bridging of innate and adaptive immune responses. A disturbed balance between pro-inflammatory and anti-inflammatory branches easily leads to inflammation of the corresponding tissue. The most prominent example for an altered IL-36 expression is the spectrum of psoriasis. In addition to inflammatory dermatoses, IL-36 also seems to play a role in infectious dermatoses. Microbial triggers, especially Staphylococcus aureus infection, increase the production of pro-inflammatory IL-36 cytokines and initiate/promote the inflammation of skin lesions. Due to the discovery of IL-36 as an important immune mediator, it has already been possible to develop important diagnostic tools for dermatitis. Not only in the field of inflammatory skin diseases, but also in pulmonary and intestinal inflammation, there is evidence that IL-36 cytokines might have diagnostic and/or therapeutic relevance.
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Affiliation(s)
- Anna-Lena Buhl
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
| | - Joerg Wenzel
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
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Esen Salman K, Kıvanç Altunay İ, Salman A. The efficacy and safety of targeted narrowband UVB therapy: a retrospective cohort study. Turk J Med Sci 2019; 49:595-603. [PMID: 30997975 PMCID: PMC7018302 DOI: 10.3906/sag-1810-110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background/aim Phototherapy is a safe and effective treatment modality for numerous dermatological conditions. Recently, targeted phototherapy modalities have gained importance due to their advantages over conventional phototherapy. This retrospective study aimed to evaluate the safety and efficacy of targeted narrowband UVB phototherapy in patients with dermatological disorders. Materials and methods This single-center study included 173 patients who were treated with targeted narrowband UVB phototherapy. Demographic features, phototherapy parameters, and adverse effects were evaluated in all patients, and the treatment response was assessed in patients who attended at least one follow-up visit. Results A total of 173 patients (102 females; 71 males) with vitiligo, alopecia areata, lichen simplex chronicus, palmoplantar psoriasis, and psoriasis vulgaris were included in the study. Among 73 patients, with whom the treatment was finalized by physician, an excellent response was obtained in 10%, 52.9%, 53.8%, 28.6%, and 40% of patients with vitiligo, alopecia areata, lichen simplex chronicus, palmoplantar psoriasis, and psoriasis, respectively. The treatment was generally well tolerated and was discontinued in only two patients due to adverse effects. Conclusion This study demonstrates that targeted narrowband UVB therapy is a safe and effective treatment alternative, particularly for alopecia areata, lichen simplex chronicus, and palmoplantar and plaque-type psoriasis.
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Xiao S, Li B, Feng S, Liu C, Zhang G. Acupuncture combined with herbal medicine versus herbal medicine alone for plaque psoriasis: a systematic review protocol. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:115. [PMID: 31032270 DOI: 10.21037/atm.2018.09.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Psoriasis is a condition with a multifactorial etiopathogenesis worldwide, and plaque psoriasis, which is characterized by redness, thickness, and scaling, is the most common kind. Individuals living with psoriasis show low levels of life quality, and having fewer or less extensive lesions may improve spiritual and mental health. Therefore, our objective is to explore the effectiveness of acupuncture combined with herbal medicine for plaque psoriasis and to compare acupuncture combined with herbal medicine with herbal medicine alone. Methods Databases including PubMed, MEDLINE, the Cochrane Library, Excerpta Medica (EMBASE), the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure Database (CNKI), the Wanfang database and the Chinese Scientific Journal Database (VIP database) will be searched from inception to March 2018. We will employ hand searches, and grey literature will also be obtained. Only randomized controlled trials evaluating acupuncture combined with herbal medicine to treat plaque psoriasis in adults will be assessed. The Psoriasis Area and Severity Index score (PASI score), the itching index, the life quality scores, and the anxiety index will be the outcome measures. Two independent reviewers will select the articles included, assess the risk of bias and extract data according to the inclusion criteria. A third reviewer will resolve disagreements. The purpose of this study will be to identify the effect of acupuncture combined with herbal medicine on the lesions (PASI score), symptoms (itching index, life quality scores) and mental status (anxiety index) of the patients. Discussion The meta-analysis will retrospectively examine current evidence regarding the effectiveness of the practice of acupuncture combined with herbal medicine to treat plaque psoriasis. This study may reveal, for the first time, an adjuvant therapy for psoriasis. Trial registration As the study is a systematic review protocol, trial registration will not be necessary. An article containing the results will be published in a peer-reviewed journal and disseminated through scientific conferences.
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Affiliation(s)
- Shiju Xiao
- Dermatology Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, China.,Graduate School, Capital Medical University, Beijing 100069, China
| | - Bo Li
- Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China
| | - Shuo Feng
- Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China
| | - Cunzhi Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated with Capital Medical University, Beijing 100010, China
| | - Guangzhong Zhang
- Dermatology Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, China
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Tripathi PK, Gorain B, Choudhury H, Srivastava A, Kesharwani P. Dendrimer entrapped microsponge gel of dithranol for effective topical treatment. Heliyon 2019; 5:e01343. [PMID: 30957038 PMCID: PMC6431737 DOI: 10.1016/j.heliyon.2019.e01343] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/31/2018] [Accepted: 03/11/2019] [Indexed: 01/09/2023] Open
Abstract
Dithranol is one of the important topical agents for the treatment of psoriasis, a chronic inflammatory skin disease with aberrant differentiation of keratinocytes. However, its application is troublesome and inconvenient because of its associated side effects, including staining, burning sensation, irritation, and necrotizing effect on the diseased cells as well as on the normal cells. The purpose of the current investigation was to explore the potential of poly(amido) amine (PAMAM) dendrimers in the topical delivery of dithranol through a novel microsponge based gel. Generation-4 (G4) dendrimers were incorporated into the microsponge based gel formulation by quasi-emulsion solvent diffusion method with varying concentration of polymers, and evaluated for the morphology of the formulation, encapsulation efficiency and skin irritation potential. Percentage yield of the formulation was found to be 66.28%, whereas encapsulation efficiency was ranged between 71.33% to 49.21%, and an average particle size was ranged between 28 ± 1.12 μm to 130 ± 1.01 μm. Surface morphology of developed microsponge was confirmed by scanning electron microscopy, revealed micro-porous nature. The optimized microsponge formulation was found to be stable and recorded non-irritant during cutaneous application of the experimental animals. Further, the pharmacokinetic outcomes of study were showed prolong penetration of the drug through the skin, equivalent to the marketed formulation of dithranol. Therefore, it could be conferred that the microsponge formulation of the PAMAM entrapped dithranol can produce prolonged efficacy without producing toxicities to the skin, and thus can effectively be projected in the treatment of diseases like psoriasis.
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Affiliation(s)
- Pushpendra Kumar Tripathi
- Department of Pharmaceutics, Rameshwaram Institute of Technology and Management, Sitapur Road, Lucknow, Uttar Pradesh, India
| | - Bapi Gorain
- School of Pharmacy, Faculty of Health and Medical Science, Taylor's University, Subang Jaya, 47500, Selengor, Malaysia
| | - Hira Choudhury
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Bukit Jalil 57000 Kuala Lumpur, Malaysia
| | - Ayushi Srivastava
- Department of Pharmaceutics, Rameshwaram Institute of Technology and Management, Sitapur Road, Lucknow, Uttar Pradesh, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
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Abstract
Psoriasis is a prevalent systemic immune-mediated disease with cutaneous manifestations. In HIV-infected patients, psoriasis may have a higher incidence, present atypical and more exuberant clinical features, and is frequently recalcitrant to treatment. Despite this aggravated severity, treatment options for psoriasis in HIV-infected individuals remain limited due to the risk of fatal immunosuppression associated with both classical immunosuppressants and new biological drugs. Notwithstanding, drug therapy in psoriasis has been undergoing major advances for the last few years, with novel drugs approved, which could significantly add to the management of HIV-infected patients. It is therefore our aim to present a review of the available literature to highlight the updated evidence on psoriasis in HIV-infected individuals, particularly in regards to its epidemiology, proposed pathophysiology, clinical presentation, currently available therapeutic options, and future perspectives.
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Affiliation(s)
- Miguel Alpalhão
- 1 Dermatology and Venereology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.,2 Dermatology Investigation Unit, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal
| | - J Borges-Costa
- 1 Dermatology and Venereology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.,2 Dermatology Investigation Unit, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal.,3 Clínica Universitária de Dermatologia, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Paulo Filipe
- 1 Dermatology and Venereology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.,2 Dermatology Investigation Unit, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal.,3 Clínica Universitária de Dermatologia, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
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Ighani A, Yu AM, Sandhu VK, Barankin B, Manolson MF. Satisfaction and Awareness of Systemic Psoriasis Treatments: A National Survey Comparing Biologic and Nonbiologic Users. J Cutan Med Surg 2019; 23:148-156. [PMID: 30801221 DOI: 10.1177/1203475418808764] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: There is ongoing development of new therapies for psoriasis, including biologic and systemic agents such as interleukin-17, interleukin-23, and phosphodiesterase-4 inhibitors. The development of these agents has changed the landscape of psoriasis treatment options. OBJECTIVE: The objective of this study was to characterize the impact of newer biologic and systemic agents approved by June 2016 on patient outcomes. We sought to evaluate and compare biologic users and nonbiologic systemic users with respect to their treatment awareness and satisfaction. METHODS: We conducted a national Canadian survey from July to September 2016 on adult patients with moderate-to-severe psoriasis using biologic agents or nonbiologic systemic agents as their current primary treatment modality. Patients were asked to evaluate their overall satisfaction with their treatment agent and their awareness of other treatment options. Responses from biologic and nonbiologic systemic users were compared. RESULTS: Overall, 343 participants were included (biologic users: n = 218; nonbiologic users: n = 125). Treatment satisfaction: Biologic users had a higher overall satisfaction score than nonbiologic users ( P < .001). Among nonbiologic agents, apremilast (62%) was associated with the highest satisfaction proportion. Among biologic agents, ustekinumab (77%) and adalimumab (72%) were associated with the highest proportions of satisfaction. With respect to treatment awareness, 30% of nonbiologic patients did not have enough information to form an opinion about biologics. CONCLUSIONS: This study demonstrates the greater treatment satisfaction of biologic users compared with nonbiologic users for moderate-to-severe psoriasis. Given that nearly one-third of nonbiologic users did not have enough information to form an opinion about biologic agents, physicians may consider counselling these patients on the use of biologic agents for psoriasis management.
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Affiliation(s)
- Arvin Ighani
- 1 Faculty of Medicine, University of Toronto, ON, Canada
| | - Ashley M Yu
- 2 School of Medicine, University of Ottawa, ON, Canada
| | - Vijay K Sandhu
- 1 Faculty of Medicine, University of Toronto, ON, Canada
| | | | - Morris F Manolson
- 4 Department of Biochemistry, University of Toronto, ON, Canada.,5 Canadian Association of Psoriasis Patients, Ottawa, ON
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Fink C, Fuchs T, Enk A, Haenssle HA. Design of an Algorithm for Automated, Computer-Guided PASI Measurements by Digital Image Analysis. J Med Syst 2018; 42:248. [DOI: 10.1007/s10916-018-1110-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 10/24/2018] [Indexed: 11/28/2022]
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Fujita H, Terui T, Hayama K, Akiyama M, Ikeda S, Mabuchi T, Ozawa A, Kanekura T, Kurosawa M, Komine M, Nakajima K, Sano S, Nemoto O, Muto M, Imai Y, Yamanishi K, Aoyama Y, Iwatsuki K. Japanese guidelines for the management and treatment of generalized pustular psoriasis: The new pathogenesis and treatment of GPP. J Dermatol 2018; 45:1235-1270. [PMID: 30230572 DOI: 10.1111/1346-8138.14523] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 05/01/2024]
Abstract
Generalized pustular psoriasis (GPP) is a rare disease characterized by recurrent fever and systemic flushing accompanied by extensive sterile pustules. The committee of the guidelines was founded as a collaborative project between the Japanese Dermatological Association and the Study Group for Rare Intractable Skin Diseases under the Ministry of Health, Labour, and Welfare Research Project on Overcoming Intractable Diseases. The aim of the guidelines was to provide current information to aid in the treatment of patients with GPP in Japan. Its contents include the diagnostic and severity classification criteria for GPP, its pathogenesis, and recommendations for the treatment of GPP. Since there are few clinical trial data with high levels of evidence for this rare disease, recommendations by the committee are described in the present guidelines.
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Affiliation(s)
- Hideki Fujita
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigaku Ikeda
- Department of Dermatology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Tomotaka Mabuchi
- Department of Dermatology, Tokai University School of Medicine, Isehara, Japan
| | - Akira Ozawa
- Department of Dermatology, Tokai University School of Medicine, Isehara, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Michiko Kurosawa
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | | | - Masahiko Muto
- Department of Dermatology, Yamaguchi University School of Medicine, Ube, Japan
| | - Yasutomo Imai
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kiyofumi Yamanishi
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yumi Aoyama
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Keiji Iwatsuki
- Department of Dermatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
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Fink C, Alt C, Uhlmann L, Klose C, Enk A, Haenssle H. Precision and reproducibility of automated computer‐guided Psoriasis Area and Severity Index measurements in comparison with trained physicians. Br J Dermatol 2018; 180:390-396. [DOI: 10.1111/bjd.17200] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2018] [Indexed: 01/05/2023]
Affiliation(s)
- C. Fink
- Department of Dermatology University of Heidelberg Im Neuenheimer Feld 440 69120 Heidelberg Germany
| | - C. Alt
- Department of Dermatology University of Heidelberg Im Neuenheimer Feld 440 69120 Heidelberg Germany
| | - L. Uhlmann
- Institute of Medical Biometry and Informatics University of Heidelberg Im Neuenheimer Feld 440 69120 Heidelberg Germany
| | - C. Klose
- Institute of Medical Biometry and Informatics University of Heidelberg Im Neuenheimer Feld 440 69120 Heidelberg Germany
| | - A. Enk
- Department of Dermatology University of Heidelberg Im Neuenheimer Feld 440 69120 Heidelberg Germany
| | - H.A. Haenssle
- Department of Dermatology University of Heidelberg Im Neuenheimer Feld 440 69120 Heidelberg Germany
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Dickel H, Bruckner T, Altmeyer P. Long-term real-life safety profile and effectiveness of fumaric acid esters in psoriasis patients: a single-centre, retrospective, observational study. J Eur Acad Dermatol Venereol 2018; 32:1710-1727. [PMID: 29705996 PMCID: PMC6221124 DOI: 10.1111/jdv.15019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/04/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fumaric acid esters (FAEs) are an established systemic treatment for moderate-to-severe psoriasis. However, the long-term clinical safety and effectiveness of continuous FAE monotherapy and combination therapy have not been established. OBJECTIVE To examine the long-term safety and effectiveness of FAEs as monotherapy and in combination with phototherapy or methotrexate in patients with psoriasis treated at a single centre in Germany. METHODS This monocentric, retrospective observational study, with a follow-up period of up to 32.5 years, included 859 patients: 626 received FAE monotherapy, 123 received FAEs with concomitant phototherapy and 110 received FAEs with methotrexate. RESULTS Approximately half of patients (49.0%) reported adverse events (566 total events), most of which involved the gastrointestinal tract. Serious adverse events were reported in 2.3% of patients, but none were deemed to have a causal relationship with any of the treatment regimens. Adverse events leading to treatment discontinuation were observed in 12.9% of patients. A median duration of 1 year was observed in all three treatment subcohorts (P = 0.70) from initiation of FAE treatment to a 50% response rate, where response was defined as achieving a cumulative static Physician's Global Assessment (PGA) score of 'light' and at least a 2-point reduction in baseline PGA. A 50% response rate for the cumulative Psoriasis Area and Severity Index 75 was achieved in the FAE monotherapy subcohort after a median of 3 years of treatment, in the FAEs + phototherapy subcohort after 6.7 years and in the FAEs + methotrexate subcohort after 8.1 years (P = 0.001). CONCLUSION According to our data, FAEs as monotherapy or in combination with phototherapy or methotrexate are safe and beneficial for long-term clinical use. However, multicentre, randomized controlled trials are required to establish the clinical value of monotherapy versus combination therapy and the optimal treatment duration.
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Affiliation(s)
- H. Dickel
- Department of Dermatology, Venereology and AllergologyRuhr University BochumBochumGermany
| | - T. Bruckner
- Institute of Medical Biometry and Informatics (IMBI)University Hospital HeidelbergHeidelbergGermany
| | - P. Altmeyer
- Department of Dermatology, Venereology and AllergologyRuhr University BochumBochumGermany
- Dermatology Practice at City ParkBochumGermany
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Fink C, Kilian S, Bertlich I, Hoxha E, Bardehle F, Enk A, Haenssle HA. Evaluation of capillary pathologies by nailfold capillaroscopy in patients with psoriasis vulgaris: study protocol for a prospective, controlled exploratory study. BMJ Open 2018; 8:e021595. [PMID: 30099394 PMCID: PMC6089272 DOI: 10.1136/bmjopen-2018-021595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Psoriasis vulgaris was shown to be an independent factor increasing the risk of several comorbidities such as obesity, diabetes and dyslipidaemia with an increased risk of stroke and myocardial infarction. We hypothesise that early endothelial dysfunction, which plays a crucial role in the pathogenesis of atherosclerosis, may be detected by digital video nailfold capillaroscopy (DVNC) at the level of the dermal capillary microvasculature as a surrogate parameter. Nailfolds represent the only body site allowing for a non-invasive assessment of the capillary microvasculature at a horizontal plane. DVNC is a well-established diagnostic tool for in vivo assessment of the peripheral microcirculation by evaluating the morphology of dermal papillary capillaries. To date, reports on morphological changes of the non-lesional nailfold capillaries in patients with psoriasis vulgaris are scarce and the existing data are not conclusive. METHODS AND ANALYSIS This is a prospective, single-centre, non-randomised, controlled, exploratory study assessing the capillary patterns in 100 subjects affected by psoriasis vulgaris. Non-lesional nailfold capillaries will be imaged by means of DVNC (Optilia Digital Capillaroscopy System, Optilia Instruments AB, Sollentuna, Sweden) in 50 patients affected by psoriasis vulgaris and 50 healthy controls. Assessments will include a qualitative, descriptive analysis of the nailfold capillaries' morphology, as well as a quantitative investigation (frequency, extent) of changes in capillary patterns. Moreover, patients' characteristics associated with the manifestation of nailfold capillaries' pathologies including well-known cardiovascular risk markers will be studied. ETHICS AND DISSEMINATION Ethical approval was provided by the ethic committee of the medical faculty of the University of Heidelberg (Ethics approval number S-447/2017). The design and the final results of the study will be published and made available to the public. TRIAL REGISTRATION NUMBER DRKS00012856.
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Affiliation(s)
- Christine Fink
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Samuel Kilian
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Ines Bertlich
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Elti Hoxha
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Felicitas Bardehle
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Alexander Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Holger A Haenssle
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
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Hu Y, Chen Z, Gong Y, Shi Y. A Review of Switching Biologic Agents in the Treatment of Moderate-to-Severe Plaque Psoriasis. Clin Drug Investig 2018; 38:191-199. [PMID: 29249053 DOI: 10.1007/s40261-017-0603-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Psoriasis is an immune-mediated polygenic inherited skin disease. Many biologic agents have been approved for the treatment of moderate-to-severe plaque psoriasis. The most commonly utilized biologics include TNF-α antagonists (etanercept, infliximab, and adalimumab), IL-12/23P40 antagonist (ustekinumab), IL-23P19 antagonist (guselkumab), IL-17A antagonist (secukinumab and ixekizumab), and IL-17RA antagonist (brodalumab). However, some patients may fail to respond well to their first biologic agent. Reasons for failure include primary failure (lack of initial efficacy), secondary failure (loss of efficacy over time) or the development of adverse effects. For patients desiring maximum skin clearance and better quality of life, switching to a second biologic agent might be a worthwhile option. This review discusses recent clinical studies on switching therapies in treating psoriasis, and found that switching biologic agents can significantly improve outcomes for patients. Some clinical guidelines are also discussed. This research provides some advice on establishing individualized treatment regimens based on clinical needs and pharmacologic characteristics.
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Affiliation(s)
- Yifan Hu
- 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
| | - Yu Gong
- 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.
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Thibodaux RJ, Triche MW, Espinoza LR. Ustekinumab for the treatment of psoriasis and psoriatic arthritis: a drug evaluation and literature review. Expert Opin Biol Ther 2018; 18:821-827. [PMID: 29949399 DOI: 10.1080/14712598.2018.1492545] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Psoriasis (PsO) is an inflammatory disorder characterized by proliferation of keratinocytes, and it may be associated with a systemic inflammatory articular disorder, psoriatic arthritis (PsA). The presentations of PsO and PsA are heterogeneous, and our understanding of pathogenesis has led to a better understanding of the role of the interleukin (IL)-23/T-helper 17 (Th17) axis. Areas covered: Ustekinumab is a monoclonal antibody against IL-12 and IL-23. The pathogenesis of PsO and PsA is a multifactorial process involving genetic, environmental, and lifestyle factors. IL-23 signaling and activation of Th17 cells leads to a self-perpetuating inflammatory loop resulting in continuous keratinocyte proliferation and synovitis. Treatment options are varied, ranging from topical therapy to injection of targeted biologic disease-modifying antirheumatic drugs (bDMARDs). Evidence on the use of ustekinumab in the management of PsO is strong, but it is not as impressive in management of PsA. Expert opinion: IL-12/23 inhibition appears to be a good first-line option for plaque PsO, but efficacy in PsA does not compare favorably to IL-17 inhibition. In general, poorer responses to therapy with any bDMARD in PsA cohorts highlight psoriatic disease heterogeneity. Until new knowledge can remedy the failure of monotherapy, synergistic methods may have to be explored, including combination biologic therapy.
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Affiliation(s)
- Ross J Thibodaux
- a Section of Rheumatology, Department of Internal Medicine , LSU Health Sciences Center at New Orleans , New Orleans , LA , USA
| | - Mallory W Triche
- b Clinical Pharmacy Department , Thibodaux Regional Medical Center , Thibodaux , LA , USA
| | - Luis R Espinoza
- a Section of Rheumatology, Department of Internal Medicine , LSU Health Sciences Center at New Orleans , New Orleans , LA , USA
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