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Ran M, Sha O, Tam KY. Exploring casual effects and shared molecular mechanism between psoriasis and liver cancer through Mendelian randomization and comprehensive bioinformatic analyses. Comput Biol Chem 2024; 110:108089. [PMID: 38703750 DOI: 10.1016/j.compbiolchem.2024.108089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/10/2024] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
Psoriasis (Ps), a chronic inflammatory disease affecting approximately 2 % of the global population, has been associated with an increased risk of liver cancer in observational studies. However, their causal relationships as well as underlying shared molecular mechanisms between Ps and liver cancer remain unclear. Using bidirectional Mendelian randomization analysis, we revealed that a genetic predisposition to liver cancer increased the risk of Ps in European and East Asian populations but not the other way around. Moreover, we analyzed three transcriptomic datasets of patients with Ps and liver cancer from open-source databases. Differentially expressed genes (DEGs) and disease-specific gene co-expression module analyses revealed that cell-cycle dysregulation was the shared mechanism of Ps and liver cancer. Moreover, we identified a rank-conservative gene signature shared between these two diseases, which demonstrated significance in diagnostic and prognostic predictions. These findings provided valuable insights into the interconnections between Ps and liver cancer, which may be helpful to guide therapeutic management.
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Affiliation(s)
- Maoxin Ran
- Faculty of Health Sciences, University of Macau, Taipa, Macau
| | - Ou Sha
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China.
| | - Kin Yip Tam
- Faculty of Health Sciences, University of Macau, Taipa, Macau.
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Bao X, Liang Y, Chang H, Cai T, Feng B, Gordon K, Zhu Y, Shi H, He Y, Xie L. Targeting proprotein convertase subtilisin/kexin type 9 (PCSK9): from bench to bedside. Signal Transduct Target Ther 2024; 9:13. [PMID: 38185721 PMCID: PMC10772138 DOI: 10.1038/s41392-023-01690-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/27/2023] [Accepted: 10/27/2023] [Indexed: 01/09/2024] Open
Abstract
Proprotein convertase subtilisin/kexin type 9 (PCSK9) has evolved as a pivotal enzyme in lipid metabolism and a revolutionary therapeutic target for hypercholesterolemia and its related cardiovascular diseases (CVD). This comprehensive review delineates the intricate roles and wide-ranging implications of PCSK9, extending beyond CVD to emphasize its significance in diverse physiological and pathological states, including liver diseases, infectious diseases, autoimmune disorders, and notably, cancer. Our exploration offers insights into the interaction between PCSK9 and low-density lipoprotein receptors (LDLRs), elucidating its substantial impact on cholesterol homeostasis and cardiovascular health. It also details the evolution of PCSK9-targeted therapies, translating foundational bench discoveries into bedside applications for optimized patient care. The advent and clinical approval of innovative PCSK9 inhibitory therapies (PCSK9-iTs), including three monoclonal antibodies (Evolocumab, Alirocumab, and Tafolecimab) and one small interfering RNA (siRNA, Inclisiran), have marked a significant breakthrough in cardiovascular medicine. These therapies have demonstrated unparalleled efficacy in mitigating hypercholesterolemia, reducing cardiovascular risks, and have showcased profound value in clinical applications, offering novel therapeutic avenues and a promising future in personalized medicine for cardiovascular disorders. Furthermore, emerging research, inclusive of our findings, unveils PCSK9's potential role as a pivotal indicator for cancer prognosis and its prospective application as a transformative target for cancer treatment. This review also highlights PCSK9's aberrant expression in various cancer forms, its association with cancer prognosis, and its crucial roles in carcinogenesis and cancer immunity. In conclusion, this synthesized review integrates existing knowledge and novel insights on PCSK9, providing a holistic perspective on its transformative impact in reshaping therapeutic paradigms across various disorders. It emphasizes the clinical value and effect of PCSK9-iT, underscoring its potential in advancing the landscape of biomedical research and its capabilities in heralding new eras in personalized medicine.
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Affiliation(s)
- Xuhui Bao
- Institute of Therapeutic Cancer Vaccines, Fudan University Pudong Medical Center, Shanghai, China.
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China.
- Department of Oncology, Fudan University Pudong Medical Center, Shanghai, China.
- Center for Clinical Research, Fudan University Pudong Medical Center, Shanghai, China.
- Clinical Research Center for Cell-based Immunotherapy, Fudan University, Shanghai, China.
- Department of Pathology, Duke University Medical Center, Durham, NC, USA.
| | - Yongjun Liang
- Center for Medical Research and Innovation, Fudan University Pudong Medical Center, Shanghai, China
| | - Hanman Chang
- Institute for Food Safety and Health, Illinois Institute of Technology, Chicago, IL, USA
| | - Tianji Cai
- Department of Sociology, University of Macau, Taipa, Macau, China
| | - Baijie Feng
- Department of Oncology, Fudan University Pudong Medical Center, Shanghai, China
| | - Konstantin Gordon
- Medical Institute, Peoples' Friendship University of Russia, Moscow, Russia
- A. Tsyb Medical Radiological Research Center, Obninsk, Russia
| | - Yuekun Zhu
- Department of Colorectal Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Hailian Shi
- Shanghai Key Laboratory of Compound Chinese Medicines, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Zhangjiang Hi-tech Park, Shanghai, China
| | - Yundong He
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China.
| | - Liyi Xie
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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Zhao Y, Yang XT, Bai YP, Li LF. Association of Complete Blood Cell Count-Derived Inflammatory Biomarkers with Psoriasis and Mortality. Clin Cosmet Investig Dermatol 2023; 16:3267-3278. [PMID: 38021430 PMCID: PMC10655728 DOI: 10.2147/ccid.s437936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
Background and Aim Psoriasis is a persistent inflammatory disorder that affects 3% of the population and is associated with cardiovascular diseases. Therefore, this study aimed to investigate the correlations between complete blood cell count (CBC)-derived inflammatory biomarkers, psoriasis prevalence, and all-cause mortality. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES) spanning 2003-2006 and 2009-2014. Mortality data up to December 31, 2019 were obtained using the National Death Index. The following CBC-derived inflammatory biomarkers were examined: neutrophil/lymphocyte ratio (NLR), neutrophil/(white blood cells - neutrophils) ratio (dNLR), monocyte count/lymphocyte ratio (MLR), (neutrophil + monocyte)/lymphocyte ratio (NMLR), platelet/lymphocyte ratio (PLR), and systemic inflammatory response index (SIRI). Weighted logistic and Cox regression analyses were used to calculate odds ratios, hazard ratios, and the corresponding 95% confidence intervals. Additionally, the prognostic value of the inflammatory indicators was assessed and ranked using the random survival forest approach. Results In total, data from 21,431 participants with average age of 45.02 ± 0.27 years (49.51% male) were included in the study, among which 600 participants were positive for psoriasis (prevalence rate, 2.80%). Additionally, 79 all-cause deaths were recorded during a median follow-up period of 8.83 (6.67-11.00) years. Moreover, NLR, dNLR, NMLR, PLR, and SIRI were positively associated with the prevalence of psoriasis. Furthermore, MLR, NMLR, and SIRI were positively correlated with all-cause mortality in patients with psoriasis, with NMLR being the most valuable predictor of all-cause mortality. Conclusion CBC-derived inflammatory biomarkers were associated with psoriasis prevalence, NMLR, SIRI, and MLR values were associated with all-cause mortality in patients with psoriasis. Overall, assessment of these CBC-derived indicators may serve as a simple method for screening high-risk individuals among patients with psoriasis.
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Affiliation(s)
- Yang Zhao
- Department of Dermatology, Daxing Teaching Hospital, Capital Medical University, Beijing, 102600, People’s Republic of China
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China
| | - Xu Tong Yang
- Department of Dermatology, Daxing Teaching Hospital, Capital Medical University, Beijing, 102600, People’s Republic of China
| | - Yan Ping Bai
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China
| | - Lin Feng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China
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Damiani G, Pacifico A, Scoditti E, di Gregorio S, Del Fabbro M, Cozzolino C, Buja A, Mercuri SR, Bianchi VG, Grada A, Garbarino S, Bunick CG. Circadian Oscillations of Minimal Erythema Dose (MED) are Also Influenced by Diet in Patients with Psoriasis: A Chronomedical Study. Dermatol Ther (Heidelb) 2023; 13:2229-2246. [PMID: 37573289 PMCID: PMC10539244 DOI: 10.1007/s13555-023-00987-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/17/2023] [Indexed: 08/14/2023] Open
Abstract
INTRODUCTION Minimal erythema dose (MED) remains a parameter of paramount importance to orient narrow-band (NB)-UVB phototherapy in psoriatic (PsO) patients. Recently, circadian rhythm and diet were recognized as potential MED modulators, but their mutual interaction remains understudied. Thus, we aimed to evaluate the potential diet modulation of MED circadian oscillations. METHODS In the first phase, a cohort study was performed comparing potential MED oscillations (morning, afternoon, and evening) among omnivorous psoriatic patients before and after a phototherapy cycle and omnivorous healthy controls. The two groups were age-, gender-, skin-type-, MED-, and diet-matched. Then, in the second phase, another cohort study was carried out comparing MED oscillations 24 h after the last phototherapeutic session only in psoriatic patients cleared with NB-UVB and undergoing different diets (vegan, vegetarian, paleo , ketogenic, intermittent circadian fasting, and omnivore). Patients with different diets were age-, gender-, and skin-type matched. RESULTS In the first phase, we enrolled only omnivores, specifically 54 PsO patients and 54 healthy individuals. Their MED before and after NB-UVB therapy changed significantly among the three different time-points (morning, afternoon, and evening) (p < 0.001). The time effect was statistically significant in both groups before and after phototherapy. In the second phase, we enrolled 144 PsO patients (vegan, vegetarian, paleo, ketogenic, intermittent circadian fasting, and omnivore). MED circadian oscillations preserved a significant difference also after clearance and were influenced by diet type and time of day (p < 0.001). In particular, vegans displayed the lowest MED values, whilst Ramadan fasting showed the highest values in morning, afternoon, and evening. CONCLUSIONS Diet, like other ongoing therapies, should be reported in the medical records of patients with psoriasis undergoing NB-UVB and patients with lower MEDs should be preferentially treated in the morning when the MED is higher.
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Affiliation(s)
- Giovanni Damiani
- Italian Center for Precision Medicine in Chronic Inflammation, University of Milan, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- PhD Degree Program in Pharmacological Sciences, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Alessia Pacifico
- Clinical Dermatology Department, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Egeria Scoditti
- Institute of Clinical Physiology, National Research Council (CNR), 73100 Lecce, Italy
| | - Sara di Gregorio
- Italian Center for Precision Medicine in Chronic Inflammation, University of Milan, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Claudia Cozzolino
- Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, University of Padova, 35128 Padua, Italy
| | - Alessandra Buja
- Italian Center for Precision Medicine in Chronic Inflammation, University of Milan, 20122 Milan, Italy
- Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, University of Padova, 35128 Padua, Italy
| | - Santo R. Mercuri
- Unit of Dermatology, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | | | - Ayman Grada
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH USA
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy
| | - Christopher G. Bunick
- Department of Dermatology, Yale University School of Medicine, New Haven, CT USA
- Program in Translational Biomedicine, Yale University School of Medicine, New Haven, CT USA
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Queiro R, Loredo M, Braña I, Pardo E, Alonso S, Alperi M. Managing psoriatic arthritis in different clinical scenarios. Expert Rev Clin Immunol 2023; 19:1469-1484. [PMID: 37589128 DOI: 10.1080/1744666x.2023.2249235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic, immune-mediated disease characterized by synovio-entheseal inflammation. It is estimated to affect around 30% of patients with psoriasis and significantly reduces patients' physical function and quality of life. There is a growing number of treatment options for PsA, but due to the heterogeneous clinical features of the disease and prevalence of comorbidities, managing PsA can be challenging. AREAS COVERED In this article, we review current understanding of the disease and available pharmacological options. Based on published treatment guidelines, emerging evidence and clinical experience, we provide our expert opinion on treatment strategies, taking into consideration the predominant disease domain and the presence of comorbidities, which can impact treatment decisions and clinical outcomes. EXPERT OPINION Biological and targeted synthetic disease-modifying agents are dramatically improving the lives of patients with PsA. Biosimilar TNF inhibitors offer a particularly versatile and cost-effective option, whilst newer biologics and targeted synthetic molecules that can be used to treat most domains of psoriatic disease are an attractive alternative to TNF inhibitors. Despite a lack of consensus on treatment sequencing and tapering, it is important that PsA patients, especially those with comorbidities, are looked after by a multidisciplinary team to optimize their care.
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Affiliation(s)
- Rubén Queiro
- Rheumatology & ISPA Translational Immunology Division, Central University Hospital of Asturias, Oviedo, Spain
- Department of Medicine, Oviedo University School of Medicine, Oviedo, Spain
| | - Marta Loredo
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Ignacio Braña
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Estefanía Pardo
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Sara Alonso
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Mercedes Alperi
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
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Carrascosa JM, Vilarrasa E, Belinchón I, Herranz P, Crespo J, Guimerá F, Olveira A. Common Approach to Metabolic-Associated Fatty Liver Disease in Patients With Psoriasis: Consensus-Based Recommendations From a Multidisciplinary Group of Experts. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:392-401. [PMID: 36720362 DOI: 10.1016/j.ad.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/31/2023] Open
Abstract
Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitario Germans Trias i Pujol, Universitat Autònoma de Barcelona. IGTP Badalona, Barcelona, España.
| | - E Vilarrasa
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL), Universidad Miguel Hernández de Elche, Alicante, España
| | - P Herranz
- Departamento de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - J Crespo
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Marqués de Valdecilla. IDIVAL. Escuela de Medicina. Universidad de Cantabria, Santander, España
| | - F Guimerá
- Servicio de Dermatología y Patología, Hospital Universitario de Canarias, La Laguna, España
| | - A Olveira
- Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, España
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The role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in the pathophysiology of psoriasis and systemic lupus erythematosus. Postepy Dermatol Alergol 2022; 39:645-650. [PMID: 36090718 PMCID: PMC9454343 DOI: 10.5114/ada.2022.118919] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022] Open
Abstract
Inflammation and atherogenic dyslipidaemia are often observed in skin diseases and represent an increased risk of cardiovascular disorders. Proprotein convertase subtilisin/kexin type 9 plays an important role in the regulation of serum low-density lipoprotein cholesterol levels. Its biological role, however, seems to go much beyond the regulation of cholesterol metabolism. The article presents potential pathophysiological links between inflammatory process and lipid disorders based on the example of psoriasis and systemic lupus erythematosus.
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Cognition/Psychological Burden and Resilience in Cutaneous T-Cell Lymphoma and Psoriasis Patients: Real-Life Data and Implications for the Treatment. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8802469. [PMID: 35937394 PMCID: PMC9348939 DOI: 10.1155/2022/8802469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/14/2022] [Accepted: 06/28/2022] [Indexed: 01/09/2023]
Abstract
Background. Psoriasis and cutaneous T-cell lymphoma (CTCL) expose patients to chronic inflammation as well as physical and psychological disabilities, but the impact of such alterations on cognitive function is unknown. Objective. This study is aimed at determining if CTCL and psoriasis impact cognitive functioning in relation to psychological and health-related quality of life (HR-QOL) status. Methods. A cross-sectional study was performed in an outpatient dermatology clinic of a university teaching hospital. Thirty-nine subjects with CTCL (
) or psoriasis (
) who met eligibility criteria were included. The cognitive domains of memory, attention and processing speed, and executive function were assessed with standard neuropsychological tests. Subjects were assessed for depression, anxiety, and HR-QOL (using the SKINDEX-29 questionnaire). Results. Study participants were CTCL and psoriasis subjects; cognitive impairment was found in the domain of memory in 17.9% subjects with CTCL or psoriasis. Lower scores on executive function tests were predicted by higher (worse HR-QOL) SKINDEX-29 functioning scores (
). A higher estimated baseline intellectual functioning predicted lower scores (better HR-QOL) on the symptoms and functioning domains of SKINDEX-29 (
and 0.02, respectively) and a statistical trend (
) for the emotion domain. Memory and acute anxiety were adversely impacted by shorter disease duration (
for both). Conclusions. Memory impairment may be associated comorbidity in CTCL and psoriasis. Subjects with stronger cognitive resources appear to cope better with health-related quality of life (HR-QOL) challenges.
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Mahajan VK, Chauhan NS, Rana BS, Mehta KS, Hooda S, Chauhan PS, Kukreja A. The Association Between Chronic Plaque Psoriasis and Nonalcoholic Fatty Liver Disease in Indian Patients: Results of a Pilot Study. J Clin Exp Hepatol 2022; 12:785-792. [PMID: 35677516 PMCID: PMC9168695 DOI: 10.1016/j.jceh.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/26/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic dermatosis with potential to cause systemic disease by triggering dysmetabolism, such as metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). We studied the relationship and associations between NAFLD and clinical features, including age, gender, disease duration, and severity of psoriasis in our patients. METHODS This cross-sectional study comprised 61 (m:f, 43:19) patients without pre-existing comorbidities and matched 24 (m:f, 16:8) healthy controls aged between 20 and 68 years. Disease severity was graded as mild, moderate, and severe by psoriasis area and severity index score and body surface area (BSA) involvement. The grades of fatty liver and liver fibrosis were assessed using liver ultrasonography (USG) and transitional vibration-controlled elastography (Fibroscan). RESULTS Overall, 67.2% of patients were aged >40 years, and the duration of disease was <5years in 60.7% of patients. Mild and moderate to severe psoriasis occurred in 78.7% and 21.3% of patients, respectively. BSA was >10% in 57.5% patients. The proportion of NAFLD was 27.9% and 32.8% by USG and Fibroscan compared with 20.8% in controls. Statistically, there was no significant difference or association between the prevalence of NAFLD among patients and controls, and gender, age (mean ± standard deviation, 47.5 ± 13.8 vs. 45.2 ± 15.7), duration, severity of psoriasis, and arthritis between psoriatic patients with and without NAFLD. CONCLUSION This was a pilot study because of the numerosity of sample and highlights trends for possible link between psoriasis and NAFLD, but the results need cautious interpretation and clinical application. Whether NAFLD can be attributed to overall systemic inflammatory process of psoriasis or it occurs as an epiphenomenon of concurrent metabolic syndrome needs elucidation with well-designed studies. Cross-sectional study design, small number of patients, and controls remain major limitations. The study did not compare its findings with liver biopsy.
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Affiliation(s)
- Vikram K. Mahajan
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India,Address for correspondence: Vikram K Mahajan, Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India.
| | - Narvir S. Chauhan
- Department of Radio Diagnosis, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Baldev S. Rana
- Department of Gastroenterology & Hepatology, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Karaninder S. Mehta
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Sheenam Hooda
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Pushpinder S. Chauhan
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
| | - Amisha Kukreja
- Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India
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Hoffmann JHO, Enk AH. Evaluation of Psoriasis Area and Severity Index Thresholds as Proxies for Systemic Inflammation on an Individual Patient Level. Dermatology 2021; 238:609-614. [PMID: 34852349 DOI: 10.1159/000520163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/09/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic and systemic inflammatory disease with a loss of up to 5 life years, which is thought to be reduced by biologic treatment. Disease severity and eligibility for systemic treatment are often based on the cutaneous psoriasis area and severity index (PASI) with a cut-off of 10 in several European countries. However, it is unclear how well this cut-off reflects systemic inflammation and, consequently, the risk for the development of comorbidity. OBJECTIVES (1) To assess whether specific PASI thresholds, in particular PASI 10, predict elevated biomarkers of systemic inflammation and cardiovascular risk on an individual patient level. (2) To assess the association of PASI and psoriatic arthritis with biomarkers of systemic inflammation and cardiovascular risk. METHODS Retrospective cross-sectional study of 72 psoriasis patients without systemic treatment. RESULTS Overall, 68, 42, and 50% of patients had cardiovascular risk level neutrophil-to-lymphocyte ratio (NLR), C-reactive protein, and elevated platelet-to-lymphocyte ratio (PLR) values, respectively. The respective positive predictive values of PASI 10 were 70, 45, and 70. The performance of the optimal PASI cut-offs according to the Youden index was similarly weak. Subgrouping of patients with a PASI below 10 did not result in a considerably improved reflection of systemic inflammation. PLR was significantly higher in patients with moderate-to-severe compared to mild psoriasis and significantly correlated with PASI in patients with a PASI above 2 (rs = 0.266, n = 64). NLR was significantly higher in patients with psoriatic arthritis. CONCLUSION Specific PASI thresholds were not well suited to predict elevated biomarkers of systemic inflammation and cardiovascular risk on an individual patient level. Therefore, PASI, and possibly other purely cutaneous measures, may not be ideal as stand-alone parameters to define disease severity and eligibility for systemic treatment. Our results are relevant for the ongoing discussion on the definition of psoriasis severity and eligibility for systemic treatment. Further research addressing the added value of a set of biomarkers of systemic inflammation in the assessment of psoriasis severity would be desirable.
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Affiliation(s)
| | - Alexander H Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
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Zou Y, Meng Z. Literature Overview of the IL-17 Inhibition from Psoriasis to COVID-19. J Inflamm Res 2021; 14:5611-5618. [PMID: 34754211 PMCID: PMC8570377 DOI: 10.2147/jir.s329252] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/07/2021] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic has posed a serious problem for drug anti-viral efficacy in combatting the cytokine storm triggered by SARS-CoV-2. From dermato-epidemiological studies conducted on psoriatic and other rheumatological patients, IL-17 inhibitors seem to attenuate or even prevent the cytokine storm and thus ICU referral. Furthermore, both in-vivo and in-vitro experiments suggest that IL-17 plays a key role in SARS-CoV-2 infection progression. Due to this evidence, we decided to summarize the literature findings on IL-17 inhibitors and COVID-19, maintaining psoriasis as the referral disease to better understand the extent of drug effects on the immune system. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/sbxhPoQS7do
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Affiliation(s)
- Yulin Zou
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan City, People's Republic of China
| | - Zudong Meng
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan City, People's Republic of China
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Assessment of the Tissue Resident Memory Cells in Lesional Skin of Patients with Psoriasis and in Healthy Skin of Healthy Volunteers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111251. [PMID: 34769769 PMCID: PMC8582754 DOI: 10.3390/ijerph182111251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND In the course of plaque psoriasis, tissue resident memory cells (TRM) are responsible for the phenomenon of "immune memory" of lesions, i.e., the appearance of recurrences of lesions in the same location, as well as Koebner phenomenon. We present results determining the location and amount of TRM in psoriatic lesions in patients suffering from plaque psoriasis, as well as an analysis of the relationship between TRM markers expression and the duration and severity of the disease. METHODS TRM markers (CD4, CD8, CD103, CD69, CD49, CXCR6) and tissue expression of cytokines (IL-17, IL-22) in the lesional psoriatic skin of 32 patients compared with 10 healthy skin samples were evaluated by immunohistochemistry. RESULTS The presence of TRM markers in both the epidermis and skin with psoriatic eruptions was demonstrated in much higher amounts compared with the skin of healthy volunteers. A significant positive relationship was demonstrated between the expression of TRM markers in patients with plaque psoriasis and the duration of skin lesions. There was no relationship between the amount of TRM and the severity of plaque psoriasis. CONCLUSIONS A thorough understanding of the mechanisms responsible for the development and relapse of plaque psoriasis may contribute to the implementation of more effective therapies.
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Neagoe CD, Farmazon AS, Amzolini AM, Singer CE, Ianoşi SL, Tutunaru CV, Genunche-Dumitrescu AV, Ianoşi NG, Păun I, Leru PM, Tica OS, Popescu M. The role of non-invasive scores in determining the liver fibrosis in NAFLD and psoriatic patients. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:503-511. [PMID: 33544802 PMCID: PMC7864297 DOI: 10.47162/rjme.61.2.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
According to recent data, psoriatic patients have an increased prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome, compared with the general population. In some published studies, the severity and presence of psoriasis disease were correlated with the severity of NAFLD. In the current study, we aimed to compare the sensibility and specificity of the non-invasive scores and liver biopsy in determining fibrosis in patients with NAFLD and moderate to severe psoriasis. We performed the scientific research from June 2014–December 2017 and we included 71 patients: 40 patients with NAFLD and 31 patients with moderate to severe psoriasis according to Psoriasis Area and Severity Index (PASI) score and NAFLD, who received Etanercept treatment for at least one year. Based on the clinical and laboratory data, we calculated the following scores for fibrosis: body mass index (BMI), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, diabetes (BARD) score, Fibrosis-4 (FIB-4) score, and NAFLD fibrosis score (NFS). For liver biopsy, we used the Menghini technique. By calculating Kendall’s test, we also observed a strong direct correlation between the degree of fibrosis and FIB-4 (tau=0.558) and NFS (tau=0.490) scores, with a critical statistical impact, and the lack of a correlation with the BARD score (tau=0.095; p=0.332). The hepatic biopsy allowed the more accurate establishment of the role of the non-invasive tests in the diagnosis of the lesions of steatosis, steatohepatitis, and hepatic fibrosis. The non-invasive tests are most useful for the exclusion of the evolution lesions and for the confirmation of the advanced stages of the disease. Among these, the NFS score proved a high statistically significant correlation (p<0.0001) with the fibrosis histological lesions.
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Affiliation(s)
- Carmen Daniela Neagoe
- Department of Dermatology, Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; ,
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Magdaleno-Tapial J, López-Martí C, Ortiz-Salvador JM, Hernández-Bel P, Tamarit-García JJ, Diago-Madrid M, Sánchez-Carazo JL, Pérez-Ferriols A. Can secukinumab improve liver fibrosis? A pilot prospective study of 10 psoriatic patients. Dermatol Ther 2021; 34:e15065. [PMID: 34289229 DOI: 10.1111/dth.15065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/30/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - Cristina López-Martí
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Pablo Hernández-Bel
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Moisés Diago-Madrid
- Department of Gastroenterology and Hepatology, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Amparo Pérez-Ferriols
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
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Liu Y, Cui SN, Duan MY, Dou ZL, Li YZ, Liu YX, Xia Y, Zhang JW, Yan XN, Han DR. Is there a relationship between psoriasis and hepatitis C? A meta-analysis and bioinformatics investigation. Virol J 2021; 18:135. [PMID: 34215260 PMCID: PMC8252322 DOI: 10.1186/s12985-021-01606-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/23/2021] [Indexed: 02/08/2023] Open
Abstract
Background The relationship between psoriasis and hepatitis C was previously controversial, so our purpose is to investigate this connection.
Methods We conducted a systematic review of the case–control, cross-sectional and cohort studies examining the association between psoriasis and hepatitis C in PubMed, EMBASE and Cochrane library databases and investigated the overlapping genes between psoriasis targets and hepatitis C targets using bioinformatics analysis. Based on overlapping genes and hub nodes, we also constructed the protein–protein interaction (PPI) network and module respectively, followed by the pathway enrichment analysis.
Results We included 11 publications that reported a total of 11 studies (8 cross-sectional and 3 case–control). The case–control and cross-sectional studies included 25,047 psoriasis patients and 4,091,631 controls in total. Psoriasis was associated with a significant increase of prevalent hepatitis C (OR 1.72; 95% confidence interval [CI] (1.17–2.52)). A total of 389 significant genes were common to both hepatitis C and psoriasis, which mainly involved IL6, TNF, IL10, ALB, STAT3 and CXCL8. The module and pathway enrichment analyses showed that the common genes had the potential to influence varieties of biological pathways, including the inflammatory response, cytokine activity, cytokine–cytokine receptor interaction, Toll-like receptor signaling pathway, which play an important role in the pathogenesis of hepatitis C and psoriasis. Conclusion Patients with psoriasis display increased prevalence of hepatitis C and the basic related mechanisms between hepatitis C and psoriasis had been preliminarily clarified. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-021-01606-z.
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Affiliation(s)
- Yong Liu
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China.,Department of Dermatology, Shaanxi Hospital of Chinese Medicine, Xi'an, China
| | - Sheng Nan Cui
- Department of Dermatology, China Academy of Chinese Medical Science, Xiyuan Hospital, Beijing, China
| | - Meng Yao Duan
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi Li Dou
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Yi Zhen Li
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Yi Xing Liu
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Ye Xia
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Jia Wei Zhang
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao Ning Yan
- Department of Dermatology, Shaanxi Hospital of Chinese Medicine, Xi'an, China.
| | - Dong Ran Han
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China.
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Alantolactone Suppresses Proliferation and the Inflammatory Response in Human HaCaT Keratinocytes and Ameliorates Imiquimod-Induced Skin Lesions in a Psoriasis-Like Mouse Model. Life (Basel) 2021; 11:life11070616. [PMID: 34202301 PMCID: PMC8303865 DOI: 10.3390/life11070616] [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: 05/24/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/20/2022] Open
Abstract
Psoriasis is an immune-mediated inflammatory disease that affects 2% to 3% of the world population. Alantolactone, a sesquiterpene lactone, was isolated from Inula helenium and Radix inulae and has several biological effects, including antifungal, anthelmintic, antimicrobial, anti-inflammatory, antitrypanosomal, and anticancer properties. This study aimed to evaluate the antipsoriatic potential of alantolactone in vitro and in vivo and to explore its underlying mechanisms. These results showed that alantolactone significantly attenuated IL-17A, IL-22, oncostatin M, IL-1α, and TNF-α (M5) cytokine-induced hyperproliferation in HaCaT keratinocytes. Moreover, M5 cytokines significantly upregulated the mRNA levels of TNF-α, IL-6, IL-1β, and IL-8. However, alantolactone attenuated the upregulation of these inflammatory cytokines. In addition, alantolactone was found to inhibit STAT3 phosphorylation and NF-κB p65 nuclear translocation in HaCaT keratinocytes. Furthermore, alantolactone treatment in mice significantly alleviated the severity of skin lesions (erythema, scaling and epidermal thickness, and inflammatory cell infiltration) and decreased the mRNA expression of inflammatory cytokines (e.g., TNF-α, IL-6, IL-1β, IL-8, IL-17A, and IL-23) in an IMQ-induced-like mouse model. Therefore, our new findings revealed that alantolactone alleviates psoriatic skin lesions by inhibiting inflammation, making it an attractive candidate for future development as an antipsoriatic agent.
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Chang Z, Jian P, Zhang Q, Liang W, Zhou K, Hu Q, Liu Y, Liu R, Zhang L. Tannins in Terminalia bellirica inhibit hepatocellular carcinoma growth by regulating EGFR-signaling and tumor immunity. Food Funct 2021; 12:3720-3739. [PMID: 33900343 DOI: 10.1039/d1fo00203a] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The fruits of Terminalia bellirica (Gaertn.) Roxb. (TB) are used as a multi-use therapeutic herbal product in the Tibetan medicinal system and are prescribed as a general health tonic in the traditional Ayurvedic medicinal system. It has been demonstrated that these fruits have a variety of pharmacological activities, including anti-tumor, anti-oxidative, anti-inflammatory, hepatoprotective and immunoregulatory effects, etc. However, the therapeutic effects of tannins in TB on HCC and the underlying mechanisms remain uncharacterized. In the current study, we aimed to identify the anti-tumor effect of tannins in TB by employing a H22 xenograft mouse model and by performing cell-based in vitro studies with the assistance of the network pharmacology analysis. The crude extract of TB was purified to yield total tannin fraction (TB-TF), and our results found that TB-TF significantly inhibited the tumor growth of H22 xenografts in mice by inducing apoptosis and reducing angiogenesis. A total of 90 compounds were then identified in TB-TF by UPLC-MS/MS, and 27 were found in serum after oral administration of TB-TF in mice. The network pharmacology analysis based on these absorbed components was performed and, along with experimental evidence, it revealed that the ERBB, PI3K-Akt, and MAPK signaling pathways may be involved in the anti-tumor effect of TB-TF on HCC. Furthermore, we suggested that TB-TF effectively modulated the immunosuppressive tumor microenvironment in H22 xenograft mice. In summary, our study demonstrated that TB-TF could be developed as a functional food, which is not only a promising anti-cancer reagent but also a potential candidate with bright prospects for the emerging trends of immunotherapy for HCC.
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Affiliation(s)
- Zihao Chang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Ping Jian
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Qiunan Zhang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Wenyi Liang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Kun Zhou
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Qian Hu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Yuqi Liu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Runping Liu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
| | - Lanzhen Zhang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 102488, P. R. China.
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NAFLD and Infection, a Nuanced Relationship. Can J Gastroenterol Hepatol 2021; 2021:5556354. [PMID: 33977096 PMCID: PMC8087474 DOI: 10.1155/2021/5556354] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased significantly over the last few decades mirroring the increase in obesity and type II diabetes mellitus. NAFLD has become one of the most common indications for liver transplantation. The deleterious effects of NAFLD are not isolated to the liver only, for it has been recognized as a systemic disease affecting multiple organs through protracted low-grade inflammation mediated by the metabolic activity of excessive fat tissue. Extrahepatic manifestations of NAFLD such as cardiovascular disease, polycystic ovarian syndrome, chronic kidney disease, and hypothyroidism have been well described in the literature. In recent years, it has become evident that patients suffering from NAFLD might be at higher risk of developing various infections. The proposed mechanism for this association includes links through hyperglycemia, insulin resistance, alterations in innate immunity, obesity, and vitamin D deficiency. Additionally, a risk independent of these factors mediated by alterations in gut microbiota might contribute to a higher burden of infections in these individuals. In this narrative review, we synthetize current knowledge on several infections including urinary tract infection, pneumonia, Helicobacter pylori, coronavirus disease 2019, and Clostridioides difficile as they relate to NAFLD. Additionally, we explore NAFLD's association with hidradenitis suppurativa.
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Rapamycin Alleviates 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Induced Aggravated Dermatitis in Mice with Imiquimod-Induced Psoriasis-Like Dermatitis by Inducing Autophagy. Int J Mol Sci 2021; 22:ijms22083968. [PMID: 33921372 PMCID: PMC8069848 DOI: 10.3390/ijms22083968] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/05/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022] Open
Abstract
Recently, the mTOR signaling has emerged as an important player in the pathogenesis of psoriasis. We previously found that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced psoriatic skin inflammation was related to the inhibition of autophagy in keratinocytes. However, the effects and detailed molecular mechanisms of the mTOR inhibitor rapamycin and TCDD on psoriasis in vivo remain to be elucidated. In this study, we aimed to evaluate the effects of rapamycin and TCDD on skin lesions in imiquimod (IMQ)-induced psoriasis using a mouse model. TCDD aggravated skin inflammation in an IMQ-induced psoriatic mouse model. Furthermore, TCDD increased the expression of aryl hydrocarbon receptor (AHR), CYP1A1, proinflammatory cytokines, oxidative stress markers (NADPH oxidase (Nox) 2, Nox4), and phosphorylated P65NF-ĸB, whereas the expression of autophagy-related factors and the antioxidant marker nuclear factor-erythroid 2-related factor 2 (NRF2) decreased. Rapamycin reduced the aggravated skin inflammation induced by TCDD and restored TCDD-induced autophagy suppression and the increase of AHR expression, oxidative stress, and inflammatory response in the skin lesions of a psoriatic mouse model. In conclusion, we demonstrated that rapamycin alleviates TCDD-induced aggravated dermatitis in mice with imiquimod-induced psoriasis-like dermatitis through AHR and autophagy modulation.
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Guillot AJ, Jornet-Mollá E, Landsberg N, Milián-Guimerá C, Montesinos MC, Garrigues TM, Melero A. Cyanocobalamin Ultraflexible Lipid Vesicles: Characterization and In Vitro Evaluation of Drug-Skin Depth Profiles. Pharmaceutics 2021; 13:pharmaceutics13030418. [PMID: 33804652 PMCID: PMC8003749 DOI: 10.3390/pharmaceutics13030418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/17/2022] Open
Abstract
Atopic dermatitis (AD) and psoriasis are the most common chronic inflammatory skin disorders, which importantly affect the quality of life of patients who suffer them. Among other causes, nitric oxide has been reported as part of the triggering factors in the pathogenesis of both conditions. Cyanocobalamin (vitamin B12) has shown efficacy as a nitric oxide scavenger and some clinical trials have given positive outcomes in its use for treating skin pathologies. Passive skin diffusion is possible only for drugs with low molecular weights and intermediate lipophilicity. Unfortunately, the molecular weight and hydrophilicity of vitamin B12 do not predict its effective diffusion through the skin. The aim of this work was to design new lipid vesicles to encapsulate the vitamin B12 to enhance its skin penetration. Nine prototypes of vesicles were generated and characterized in terms of size, polydispersity, surface charge, drug encapsulation, flexibility, and stability with positive results. Additionally, their ability to release the drug content in a controlled manner was demonstrated. Finally, we found that these lipid vesicle formulations facilitated the penetration of cyanocobalamin to the deeper layers of the skin. The present work shows a promising system to effectively administer vitamin B12 topically, which could be of interest in the treatment of skin diseases such as AD and psoriasis.
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Affiliation(s)
- Antonio José Guillot
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - Enrique Jornet-Mollá
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - Natalia Landsberg
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - Carmen Milián-Guimerá
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - M. Carmen Montesinos
- Department of Pharmacology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
- Center of Molecular Recognition and Technological Development (IDM), Polytechnic University of Valencia and University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
- Correspondence: (M.C.M.); (T.M.G.)
| | - Teresa M. Garrigues
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
- Correspondence: (M.C.M.); (T.M.G.)
| | - Ana Melero
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
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Rivera R, Vilarrasa E, Ribera M, Roe E, Kueder-Pajares T, Zayas AI, Martínez-Molina L, Mataix Díaz J, Rodríguez-Nevado IM, Usero-Bárcena T, de la Mano D, García-Donoso C, Olveira A, Guinea G, Martín-Vázquez V, Ferran M. Unmet needs in patients with moderate-to-severe plaque psoriasis treated with methotrexate in real world practice: FirST study. J DERMATOL TREAT 2020; 33:1329-1338. [DOI: 10.1080/09546634.2020.1801977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Raquel Rivera
- Department of Dermatology, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - E. Vilarrasa
- Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - M. Ribera
- Department of Dermatology, Hospital Universitari Parc Taulí, Barcelona, Sabadell, Spain
| | - E. Roe
- Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - T. Kueder-Pajares
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - A. I. Zayas
- Department of Dermatology, Doctor Peset Universitary Hospital, Valencia, Spain
| | | | - J. Mataix Díaz
- Department of Dermatology, Marina Baixa Hospital, Alicante, Spain
| | - I. M. Rodríguez-Nevado
- Department of Dermatology, Hospital Infanta Cristina, Complejo Hospitalario Universitario de Badajoz, Spain
| | - T. Usero-Bárcena
- Department of Dermatology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - D. de la Mano
- Department of Dermatology, Hospital San Agustín, Avilés, Principado de Asturias, Spain
| | - C. García-Donoso
- Department of Dermatology, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - A. Olveira
- Department of Gastroenterology, Hospital Universitario La Paz, Madrid, Spain
| | - G. Guinea
- Medical Department, Novartis Farmacéutica, Barcelona, Spain
| | | | - M. Ferran
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
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Jindal S, Awasthi R, Singhare D, Kulkarni GT. Topical delivery of Tacrolimus using liposome containing gel: An emerging and synergistic approach in management of psoriasis. Med Hypotheses 2020; 142:109838. [DOI: 10.1016/j.mehy.2020.109838] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/12/2020] [Indexed: 12/18/2022]
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Jankowiak B, Kowalewska B, Krajewska-Kułak E, Kowalczuk K, Khvorik DF. The Sense of Stigmatization in Patients with Plaque Psoriasis. Dermatology 2020; 237:611-617. [PMID: 32841936 DOI: 10.1159/000510654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/30/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psoriasis is a systemic inflammatory disease capable of creating stigmatization in the form of social exclusion and decrement of psychological conditions. AIM The aim of the study was to determine the level of stigmatization in patients with plaque psoriasis. METHODS The study included 166 patients with plaque psoriasis (55.6% women and 44.3% men) with Psoriasis Area and Severity Index scores ≤10. The age of the study patients ranged between 18 and 72 years (arithmetic mean = 37.4; median = 38; standard deviation [SD] = 11.0). The mean age at the diagnosis of psoriasis was 21.5 years (median = 20; SD = 9.1) and disease duration varied from 2 to 59 years (arithmetic mean = 15.8; median = 15; SD = 11.3). The study patients completed the Polish version of the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire and a survey developed by the authors of this study, containing questions about the participants' sociodemographic characteristics (sex, age, place of residence, marital status, education, employment status) and information about their disease (location of psoriatic lesions, time elapsed since the diagnosis of psoriasis). RESULTS The mean score for the 6-item Stigmatization Scale for the whole study group was 7.6 out of 18 points (median = 7; SD = 3.8; minimum = 0; maximum = 17). The average score for the 33-item Stigma Feelings Questionnaire in our series was 84.5 out of 165 points (median = 88; SD = 20.9; minimum = 30; maximum = 136). A statistically significant sex-related difference was observed in the 6-item Stigmatization Scale scores, with higher stigmatization levels found in men than in women (p = 0.0082). Moreover, significantly higher levels of stigmatization were observed in countryside dwellers (p = 0.0311) and unmarried persons (p = 0.0321). Patients with a longer history of the disease (≥15 years) scored significantly higher on the 6-item Stigmatization Scale (p = 0.0217) than those in whom psoriasis lasted less long, and presented with higher, at the threshold of statistical significance, scores for the 33-item Feelings of Stigmatization Questionnaire. CONCLUSIONS Stigmatization awareness should be promoted among physicians and psoriatic patients to improve psoriasis management.
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Affiliation(s)
- Barbara Jankowiak
- Department of Integrated Medical Care, Medical University of Białystok, Białystok, Poland,
| | - Beata Kowalewska
- Department of Integrated Medical Care, Medical University of Białystok, Białystok, Poland
| | | | - Krystyna Kowalczuk
- Department of Integrated Medical Care, Medical University of Białystok, Białystok, Poland
| | - Dzmitry F Khvorik
- Department of Dermatovenereology, Medical University of Grodno, Grodno, Belarus
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Herrera-Acosta E, Garriga-Martina GG, Suárez-Pérez JA, Martínez-García E, Herrera-Ceballos E. Ixekizumab vs ustekinumab for skin clearance in patients with moderate to severe psoriasis after a year of treatment: Real-world practice. Dermatol Ther 2020; 33:e14202. [PMID: 32808703 DOI: 10.1111/dth.14202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
There is a lack of real practice studies comparing ustekinumab and ixekizumab effectiveness and safety. The main aim of this study was to compare the effectiveness and safety of both drugs used to treat moderate-to-severe psoriasis patients over 52 weeks. The secondary objective was to identify which clinical variables could have an impact on its effectiveness. A retrospective observational study was carried out, comparing the first 28 patients treated with ustekinumab after its commercialization was compared to the first 35 patients treated with ixekizumab. Although a higher level of skin clearance was achieved with ixekizumab with a PASI 90 and 100 response of 54.3% and 40% compared to 42.9% and 25% for ustekinumab, these differences were not statistically significant. Ixekizumab achieved a higher PASI 90 response in those patients with BMI > 27 (slightly overweight), which was statistically significant (P = .024). Ustekinumab had a greater survival at 52 weeks than ixekizumab, with a trend towards statistical significance (P = .052). Ixekizumab achieved higher skin clearance rates (PASI 90 and 100 response) than ustekinumab, with no statistically significant differences. However, ixekizumab should be specially considered in overweight patients.
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Wang SH, Wang J, Chi CC, Lin YS, Liao SC, Chen PE, Tung TH. Risk for Suicidal Behavior Among Psoriasis Patients: A Nationwide Cohort Study. Am J Clin Dermatol 2020; 21:431-439. [PMID: 31782075 DOI: 10.1007/s40257-019-00489-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The link between psoriasis and suicidality remains elusive and understudied. OBJECTIVE The aim was to assess the risk of suicidal behavior in psoriasis patients. METHODS We used Taiwan's National Health Insurance Research Database to conduct a nationwide retrospective cohort study to examine the risk for suicidal behavior among psoriasis patients. We performed subgroup analyses based on the severity of psoriasis and psoriatic arthritis. RESULTS We included 169,909 psoriasis patients (including 13,959 with concomitant psoriatic arthritis and 155,950 with psoriasis alone) and 169,909 matched nonpsoriasis controls. Suicidal behavior occurred in 104 and 89 subjects in the psoriasis group and nonpsoriasis controls, respectively; we found no significantly increased risk for suicidal behavior among psoriasis patients when compared to nonpsoriasis controls [adjusted hazard ratio (HR) 1.17, 95% confidence interval (CI) 0.88‒1.55]. The subgroup analysis showed no significantly increased risk for suicidal behavior in both the severe psoriasis group (adjusted HR 0.92, 95% CI 0.51-1.64) and the mild psoriasis group (adjusted HR 1.26, 95% CI 0.91‒1.75) when compared to nonpsoriasis controls. Also, we found no significant increased risk for suicidal behavior in the group of psoriasis patients who also had psoriatic arthritis (adjusted HR 2.00, 95% CI 0.68‒5.85) and in the group of patients with psoriasis alone (adjusted HR 1.12, 95% CI 0.83‒1.50) when compared to nonpsoriasis controls. CONCLUSION In a Taiwanese setting, no link between psoriasis or psoriatic arthritis and suicidal behavior was detected.
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Affiliation(s)
- Shu-Hui Wang
- Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu Jen Catholic University, New Taipei, Taiwan
| | - Jui Wang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St., Guishan Dist., Taoyuan, 33305, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yu-Sheng Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-En Chen
- Department of Medical Research and Education, Cheng Hsin General Hospital, 45, Cheng Hsin St., Pai-Tou, Taipei, 11220, Taiwan
| | - Tao-Hsin Tung
- Department of Medical Research and Education, Cheng Hsin General Hospital, 45, Cheng Hsin St., Pai-Tou, Taipei, 11220, Taiwan.
- Hechi Third People's Hospital, Hechi, Guangxi, China.
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26
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Damiani G, Bragazzi NL, McCormick TS, Pigatto PDM, Leone S, Pacifico A, Tiodorovic D, Di Franco S, Alfieri A, Fiore M. Gut microbiota and nutrient interactions with skin in psoriasis: A comprehensive review of animal and human studies. World J Clin Cases 2020; 8:1002-1012. [PMID: 32258071 PMCID: PMC7103976 DOI: 10.12998/wjcc.v8.i6.1002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/25/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023] Open
Abstract
The intestinal tract (i.e., the gut), is where the body’s nutrients are absorbed, and is simultaneously inhabited by numerous microbes. An increasing body of literature suggests a crucial role for the gut microbiome in modulating systemic inflammatory disease. Psoriasis is a chronic systemic inflammatory disease and its pathogenesis is related to the interaction between genetic susceptibility, immune response and environmental triggers. The omics era has allowed physicians to assess different aspects of psoriasis pathogenesis such as the microbiome, infectome, and autoinfectome. Furthermore, diet appears to play an important role in modulating disease activity, perhaps by influencing gut microbes. Given these observations, we aimed to summarize the current knowledge regarding skin-microbiome-gut-nutrients and psoriasis.
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Affiliation(s)
- Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, United States
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan 20122, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20122, Italy
| | - Nicola Luigi Bragazzi
- Postgraduate School of Public Health, Department of Health Sciences, University of Genoa, Genoa 16132, Italy
| | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, United States
| | - Paolo Daniele Maria Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan 20122, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20122, Italy
| | - Sebastiano Leone
- Department of Medicine, Division of Infectious diseases, “San Giuseppe Moscati” Hospital, Avellino 83100, Italy
| | - Alessia Pacifico
- San Gallicano Dermatological Institute, IRCCS, Rome 00144, Italy
| | - Danica Tiodorovic
- Dermatology Clinic, Medical Faculty, Nis University, Nis 18000, Serbia
| | - Sveva Di Franco
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Aniello Alfieri
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Marco Fiore
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
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Krahel JA, Baran A, Kamiński TW, Maciaszek M, Flisiak I. Methotrexate Decreases the Level of PCSK9-A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data. J Clin Med 2020; 9:jcm9040910. [PMID: 32225075 PMCID: PMC7230388 DOI: 10.3390/jcm9040910] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) exerts an important role in inflammatory processes, lipids homeostasis, and cardiometabolic disorders that are closely associated with psoriasis. The aim of the study was to analyze the clinical and diagnostic value of serum PCSK9 concentrations and their connections with disease severity, inflammation, metabolic syndrome, and impact of systemic therapies in psoriatic patients. The study enrolled thirty-five patients with active plaque-type psoriasis and eighteen healthy volunteers served as controls. Blood samples were obtained before and after 12 weeks of treatment with methotrexate or acitretin. Serum PCSK9 concentrations were measured by the ELISA (Enzyme-Linked Immunosorbent Assay) commercial kits. Morphological and biochemical parameters were assayed using routine laboratory techniques. Psoriatic patients showed significantly elevated levels of PCSK9 compared to controls (p < 0.01), mostly in patients with a mild and moderate course of psoriasis. PCSK9 concentrations correlated positively with BMI and triglyceride levels (p < 0.05). Interestingly, PCSK9 had a strong negative correlation with low-density lipoprotein levels and total cholesterol (p < 0.05). Three months of monotherapy with methotrexate significantly reduced PCSK9 level (p < 0.05), on the contrary, the acitretin group showed a further increase of PCSK9 levels (p < 0.05). PCSK9 seems to be a novel marker of psoriasis and a putative explanation of lipid disturbances, which are common in patients with psoriasis and are vital for the further developing of metabolic syndrome. Methotrexate should be considered as a treatment of choice in patients with an elevated PCSK9 concentration.
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Affiliation(s)
- Julita Anna Krahel
- Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St., 15-540 Bialystok, Poland; (A.B.); (I.F.)
- Correspondence: ; Tel. & Fax: +48-8-5740-9570
| | - Anna Baran
- Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St., 15-540 Bialystok, Poland; (A.B.); (I.F.)
| | - Tomasz W. Kamiński
- Department of Farmacodynamics, Medical University of Bialystok, Mickiewicza 2c St., 15-222 Bialystok, Poland;
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Magdalena Maciaszek
- Department of Infectious Diseases and Hepatology Medical University of Bialystok, Zurawia 14 St., 15-540 Bialystok, Poland;
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St., 15-540 Bialystok, Poland; (A.B.); (I.F.)
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Ritchlin CT, Kavanaugh A, Merola JF, Schett G, Scher JU, Warren RB, Gottlieb AB, Assudani D, Bedford-Rice K, Coarse J, Ink B, McInnes IB. Bimekizumab in patients with active psoriatic arthritis: results from a 48-week, randomised, double-blind, placebo-controlled, dose-ranging phase 2b trial. Lancet 2020; 395:427-440. [PMID: 32035552 DOI: 10.1016/s0140-6736(19)33161-7] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Dual neutralisation of interleukin 17A (IL17A) and interleukin 17F (IL17F) is a potential novel therapeutic approach in psoriatic arthritis. We assessed bimekizumab, a monoclonal antibody that selectively neutralises IL17A and IL17F, in patients with active psoriatic arthritis. METHODS BE ACTIVE was a randomised, double-blind, placebo-controlled, dose-ranging phase 2b study done at 41 sites in the Czech Republic, Germany, Hungary, Poland, Russia, and the USA. Eligible patients aged 18 years or older with active adult-onset psoriatic arthritis and symptoms for at least 6 months were randomly assigned (1:1:1:1:1) to placebo, 16 mg bimekizumab, 160 mg bimekizumab, 160 mg bimekizumab with a one-off 320 mg loading dose, or 320 mg bimekizumab, which were administered as subcutaneous injections every 4 weeks for 12 weeks. After 12 weeks, patients assigned to the placebo and 16 mg bimekizumab groups were randomly reassigned (1:1) to either 160 mg or 320 mg bimekizumab, and all other patients remained on their originally assigned initial dose up to 48 weeks. Both participants and researchers were blinded to treatment allocation in the first 12 weeks, and blinded to the dose of bimekizumab thereafter. The primary endpoint was the proportion of patients with at least 50% improvement in the American College of Rheumatology response criteria at week 12, which was assessed in all patients who received at least one dose of study treatment and had a valid measurement of the primary efficacy endpoint at baseline. The trial, including all follow-up, has been completed. This trial is registered with ClinicalTrials.gov, NCT02969525. FINDINGS Between Oct 27, 2016, and July 16, 2018, 308 patients were screened, and 206 were randomly assigned: 42 to the placebo group, and 41 each to the four bimekizumab groups. At 12 weeks, compared with the placebo group, significantly more patients in the 16 mg bimekizumab (odds ratio [OR] 4·2 [95% CI 1·1-15·2]; p=0·032), 160 mg bimekizumab (8·1 [2·3-28·7]; p=0·0012), and 160 mg (loading dose) bimekizumab (9·7 [2·7-34·3]; p=0·0004) groups achieved an ACR50 response. At 12 weeks, 24 (57%) of 42 patients in the placebo group and 68 (41%) of the 164 patients in the bimekizumab groups reported treatment-emergent adverse events. Most of these adverse events were mild or moderate. Serious treatment-emergent adverse events occurred in nine patients, eight of whom were receiving bimekizumab. No deaths or cases of inflammatory bowel disease were reported. INTERPRETATION Bimekizumab doses of 16 mg and 160 mg (with or without a 320 mg loading dose) were associated with significant improvements in ACR50 compared with placebo, with an acceptable safety profile. Our results support phase 3 investigation of bimekizumab as a treatment for psoriatic arthritis. FUNDING UCB Pharma.
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Affiliation(s)
| | - Arthur Kavanaugh
- University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Joseph F Merola
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Georg Schett
- Department of Medicine 3, Friedrich Alexander University Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jose U Scher
- Department of Medicine, New York University Langone Health, New York, NY, USA
| | - Richard B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester National Institute for Health Research Biomedical Research Centre, Manchester, UK
| | - Alice B Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Damiani G, Bragazzi N, Garbarino S, Chattu VK, Shapiro CM, Pacifico A, Malagoli P, Pigatto PDM, Conic RR, Tiodorovic D, Watad A, Adawi M. Psoriatic and psoriatic arthritis patients with and without jet-lag: does it matter for disease severity scores? Insights and implications from a pilot, prospective study. Chronobiol Int 2019; 36:1733-1740. [PMID: 31645138 PMCID: PMC6832868 DOI: 10.1080/07420528.2019.1678629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 10/04/2019] [Indexed: 12/13/2022]
Abstract
Background: Jet-lag may affect air-travelers crossing at least two time-zones and has several health-care implications. It occurs when the human biological rhythms are out of synch with respect to the day-night cycle at the country destination. Its effect in psoriasis is missing. We aimed to evaluate the effect of Jet-lag in psoriatic patients' management. Methods: This is a prospective observational study that enrolled psoriatic patients that underwent a flight: patients who experienced jet-lag were compared to patients who did not experience jet-lag. Before the flight, a dermatologist recorded clinical and demographical data with particular attention to Psoriasis Area Severity Index (PASI) and Disease Activity in Psoriatic Arthritis (DAPSA). Patients performed Self-Administered Psoriasis Area Severity Index (SAPASI), the Dermatology Life Quality Index (DLQI) and the pruritus Visual Analog Scale (VAS) scores. After the flight, patients completed the SAPASI, DLQI and pruritus-VAS scores. Results: The sample recruited comprised of 70 psoriatic patients aged 42.4 ± 9.7 years (median 42.5 years). Thirty (42.9%) were males, mean BMI was 25.5 ± 2.2 kg/m2. Average disease duration was 15.2 ± 7.1 years, and 20 (28.6%) subjects had developed PsA. Average hours of flight were 5.4 ± 3.5 (median 3.5 h), with 34 (48.6%) subjects reporting jet-lag. At the multivariate regression analysis, the change in the SAPASI score resulted correlated with jet-lag (regression coefficient 1.63, p = .0092), as well the change in the DLQI score (regression coefficient = 1.73, p = .0009), but no change on the pruritus VAS scale was found. Conclusions: The present study suggests that jet-lag may influence disease severity and DLQI scores, but not itch in psoriatic patients.
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Affiliation(s)
- G. Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
- Young Dermatologists Italian Network, Centro Studi GISED, Bergamo, Italy
| | - N.L. Bragazzi
- Young Dermatologists Italian Network, Centro Studi GISED, Bergamo, Italy
- Postgraduate School of Public Health, Department of Health Sciences, University of Genoa, Genoa, Italy
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - S. Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - V. K. Chattu
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Youthdale Child and Adolescent Sleep Centre, Toronto, Ontario, Canada
| | - C. M. Shapiro
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Youthdale Child and Adolescent Sleep Centre, Toronto, Ontario, Canada
| | - A. Pacifico
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - P. Malagoli
- Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - P. D. M. Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - R. R.Z. Conic
- Department of Surgery, University of Maryland, Baltimore, MD, USA
| | - D. Tiodorovic
- Dermatology Clinic, Medical Faculty, Nis University, Nis, Serbia
| | - A. Watad
- Department of Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M. Adawi
- Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
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30
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Blaszczak AM, Dunaway S, Ali Alikhan M, Kelly S, Levin D, Kaffenberger J. Safety of systemic therapies in the treatment of psoriasis with concomitant cirrhosis: a retrospective study. Int J Dermatol 2019; 58:e228-e229. [PMID: 31334835 DOI: 10.1111/ijd.14556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/22/2019] [Accepted: 05/31/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Spencer Dunaway
- The University of Cincinnati Medical Center, Cincinnati, OH, USA
| | | | - Sean Kelly
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Douglas Levin
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
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31
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Damiani G, Pacifico A, Linder DM, Pigatto PDM, Conic R, Grada A, Bragazzi NL. Nanodermatology-based solutions for psoriasis: State-of-the art and future prospects. Dermatol Ther 2019; 32:e13113. [PMID: 31600849 DOI: 10.1111/dth.13113] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/04/2019] [Indexed: 12/24/2022]
Abstract
Nanodermatology is an emerging, multidisciplinary science, arising from the convergence of nanotechnology, pharmacology, physics/biophysics, chemistry/biochemistry, chemical engineering, material science, and clinical medicine. Nanodermatology deals with (a) skin biology, anatomy, and physiology at the nanoscale ("skin nanobiology"), (b) diagnosis performed by means of novel diagnostic devices, assisted by nanobiotechnologies ("nanodiagnosis"), and (c) treatment through innovative therapeutic agents, including phototherapy ("photonanotherapy"/"photonanodermatology") and systemic/topical drug administration ("nanotherapy") at the nanoscale, and drug delivery-such as transdermal or dermal drug delivery (TDDD/DDD)-enhanced and improved by nanostructures and nanodrugs ("nanodrug delivery"). Nanodermatology, as a super-specialized branch of dermatology, is a quite recent specialty: the "Nanodermatology Society" founded by the eminent dermatologist Dr. Adnan Nasir, was established in 2010, with the aim of bringing together different stakeholders, including dermatologists, nanotechnology scientists, policy-makers and regulators, as well as students and medical residents. Psoriasis has a prevalence of 2-3% worldwide and imposes a severe clinical and societal burden. Nanodermatology-based solutions appear promising for the proper treatment and management of psoriasis, assisting and enhancing different steps of the process of health-care delivery: from the diagnosis to the therapeutics, paving the way for a personalized approach, based on the specific dysregulated biomarkers.
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Affiliation(s)
- Giovanni Damiani
- Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo, Italy.,Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | | | | | - Paolo D M Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Rosalynn Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Ayman Grada
- Department of Dermatology, Laboratory of Cutaneous Wound Healing, Boston University School of Medicine, Boston, Massachusetts
| | - Nicola L Bragazzi
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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32
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Pakchotanon R, Ye JY, Cook RJ, Chandran V, Gladman DD. Liver Abnormalities in Patients with Psoriatic Arthritis. J Rheumatol 2019; 47:847-853. [PMID: 31615918 DOI: 10.3899/jrheum.181312] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE We aimed to determine the prevalence and incidence, and to identify the factors associated with liver abnormalities in patients with psoriatic arthritis (PsA). METHODS From a longitudinal cohort study, we identified PsA patients with either elevated serum transaminase or alkaline phosphatase levels or liver disease after the first visit to the PsA clinic (cases). Controls were subjects from the same cohort who never had such abnormalities or liver disease. Cases and controls were matched 1:1 by sex, age at the first clinic visit, and followup duration; variables at the onset of the first appearance of liver test abnormality associated with liver abnormalities were identified using univariate logistic and multivariate logistic regression analyses. RESULTS Among 1061 patients followed in the PsA clinic, 343 had liver abnormalities. Two hundred fifty-six patients who developed liver abnormalities after the first visit were identified as cases, and 718 patients were identified as controls. The prevalence of liver abnormalities was 32% and the incidence was 39/1000 patient-years where there were 256 cases over 6533 total person-years in the PsA cohort. Liver abnormalities were detected after a mean (SD) followup duration of 8.3 ± 7.8 years. The common causes of liver abnormalities were drug-induced hepatitis and fatty liver. Independent factors associated with liver abnormalities were higher body mass index (BMI), daily alcohol intake, higher damaged joint count, elevated C-reactive protein, and use of methotrexate, leflunomide, or tumor necrosis factor inhibitors. CONCLUSION Liver abnormalities are common among patients with PsA and are associated with higher BMI, more severe disease, and certain therapies.
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Affiliation(s)
- Rattapol Pakchotanon
- From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo; University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto; Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine, Bangkok, Thailand.,R. Pakchotanon, MD, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine; J.Y. Ye, Biostatistician, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; R.J. Cook, PhD, Professor, Department of Statistics and Actuarial Science, University of Waterloo; V. Chandran, MBBS, MD, DM, PhD, Assistant Professor, University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Co-Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Senior Scientist, Krembil Research Institute, Toronto Western Hospital, University Health Network
| | - Justine Yang Ye
- From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo; University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto; Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine, Bangkok, Thailand.,R. Pakchotanon, MD, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine; J.Y. Ye, Biostatistician, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; R.J. Cook, PhD, Professor, Department of Statistics and Actuarial Science, University of Waterloo; V. Chandran, MBBS, MD, DM, PhD, Assistant Professor, University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Co-Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Senior Scientist, Krembil Research Institute, Toronto Western Hospital, University Health Network
| | - Richard J Cook
- From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo; University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto; Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine, Bangkok, Thailand.,R. Pakchotanon, MD, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine; J.Y. Ye, Biostatistician, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; R.J. Cook, PhD, Professor, Department of Statistics and Actuarial Science, University of Waterloo; V. Chandran, MBBS, MD, DM, PhD, Assistant Professor, University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Co-Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Senior Scientist, Krembil Research Institute, Toronto Western Hospital, University Health Network
| | - Vinod Chandran
- From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo; University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto; Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine, Bangkok, Thailand.,R. Pakchotanon, MD, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine; J.Y. Ye, Biostatistician, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; R.J. Cook, PhD, Professor, Department of Statistics and Actuarial Science, University of Waterloo; V. Chandran, MBBS, MD, DM, PhD, Assistant Professor, University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Co-Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Senior Scientist, Krembil Research Institute, Toronto Western Hospital, University Health Network
| | - Dafna D Gladman
- From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo; University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto; Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine, Bangkok, Thailand. .,R. Pakchotanon, MD, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, and Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutlao Hospital and College of Medicine; J.Y. Ye, Biostatistician, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; R.J. Cook, PhD, Professor, Department of Statistics and Actuarial Science, University of Waterloo; V. Chandran, MBBS, MD, DM, PhD, Assistant Professor, University of Toronto, Department of Medicine, Division of Rheumatology, University of Toronto, Co-Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Senior Scientist, Krembil Research Institute, Toronto Western Hospital, University Health Network.
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Kocic H, Damiani G, Stamenkovic B, Tirant M, Jovic A, Tiodorovic D, Peris K. Dietary compounds as potential modulators of microRNA expression in psoriasis. Ther Adv Chronic Dis 2019; 10:2040622319864805. [PMID: 31431821 PMCID: PMC6686315 DOI: 10.1177/2040622319864805] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 06/28/2019] [Indexed: 12/11/2022] Open
Abstract
Nutrigenomic DNA reprogramming in different chronic diseases and cancer has been assessed through the stimulation of gene expression and mRNA synthesis versus DNA silencing by CpG DNA modification (methylation); histone modification (acetylation, methylation) and expression of small noncoding RNAs, known as microRNAs (miRNAs). With regard to the specific nutrigenomic effects in psoriasis, the influence of specific diets on inflammatory cell signaling transcriptional factors such as nuclear factor (NF)-κB and Wnt signaling pathways, on disease-related specific cytokine expression, pro/antioxidant balance, keratinocyte proliferation/apoptosis and on proliferation/differentiation ratio have been documented; however, the influence of dietary compounds on the balance between 'good and bad' miRNA expression has not been considered. This review aims to summarize knowledge about aberrant microRNAs expression in psoriasis and to emphasize the potential impact of some dietary compounds on endogenous miRNA synthesis in experimental conditions in vivo and in vitro. Among the aberrantly expressed miRNAs in psoriasis, one of the most prominently upregulated seems to be miR-21. The beneficial effects of phenolic compounds (curcumin and resveratrol), vitamin D, methyl donors, and omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) are discussed. Highly expressed miR-155 has been downregulated by flavonoids (through a quercetin-rich diet) and by vitamin D. Quercetin has been effective in modulating miR-146a. On the other hand, downregulated miR-125b expression was restored by vitamin D, Coenzyme Q10 and by microelement selenium. In conclusion, the miRNA profile, together with other 'omics', may constitute a multifaceted approach to explore the impact of diet on psoriasis prevention and treatment.
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Affiliation(s)
- Hristina Kocic
- Clinic for Dermatology Clinical Center University Nis, Klinicki Centar Nis, Bul Dr Zorana Djindjica 48, Nis, 18000, Serbia
| | - Giovanni Damiani
- Unita Operativa di Dermatologia, IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universita degli Studi di Milano, Milano, Italy
| | - Bojana Stamenkovic
- Department of Rheumatology, Institut za Kardiovaskularne Bolesti Niska Banja University Nis, Nis, Serbia
| | | | - Andrija Jovic
- Dermatology, Clinic for Dermatology University Clinical Center Nis, Nis, Serbia
| | - Danica Tiodorovic
- Dermatology, Clinic for Dermatology, Medical Faculty University Nis, Nis, Serbia
| | - Ketty Peris
- Dermatology, Institute of Dermatology, Catholic University, Roma, Italy
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Salem I, Kimak M, Conic R, Bragazzi NL, Watad A, Adawi M, Bridgewood C, Pacifico A, Santus P, Rizzi M, Petrou S, Colombo D, Fiore M, Pigatto PDM, Damiani G. Neutrophilic Dermatoses and Their Implication in Pathophysiology of Asthma and Other Respiratory Comorbidities: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7315274. [PMID: 31281845 PMCID: PMC6590566 DOI: 10.1155/2019/7315274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/14/2019] [Indexed: 01/20/2023]
Abstract
Neutrophilic dermatoses (ND) are a polymorphous group of noncontagious dermatological disorders that share the common histological feature of a sterile cutaneous infiltration of mature neutrophils. Clinical manifestations can vary from nodules, pustules, and bulla to erosions and ulcerations. The etiopathogenesis of neutrophilic dermatoses has continuously evolved. Accumulating genetic, clinical, and histological evidence point to NDs being classified in the spectrum of autoinflammatory conditions. However, unlike the monogenic autoinflammatory syndromes where a clear multiple change in the inflammasome structure/function is demonstrated, NDs display several proinflammatory abnormalities, mainly driven by IL-1, IL-17, and tumor necrosis factor-alpha (TNF-a). Additionally, because of the frequent association with extracutaneous manifestations where neutrophils seem to play a crucial role, it was plausible also to consider NDs as a cutaneous presentation of a systemic neutrophilic condition. Neutrophilic dermatoses are more frequently recognized in association with respiratory disorders than by chance alone. The combination of the two, particularly in the context of their overlapping immune responses mediated primarily by neutrophils, raises the likelihood of a common neutrophilic systemic disease or an aberrant innate immunity disorder. Associated respiratory conditions can serve as a trigger or may develop or be exacerbated secondary to the uncontrolled skin disorder. Physicians should be aware of the possible pulmonary comorbidities and apply this knowledge in the three steps of patients' management, work-up, diagnosis, and treatment. In this review, we attempt to unravel the pathophysiological mechanisms of this association and also present some evidence for the role of targeted therapy in the treatment of both conditions.
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Affiliation(s)
- Iman Salem
- Department of Dermatology, Case Western Reserve University, Cleveland, USA
| | - Mark Kimak
- Department of Dermatology, Case Western Reserve University, Cleveland, USA
| | - Rosalynn Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, USA
| | - Nicola L. Bragazzi
- Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy
| | - Abdulla Watad
- Department of Medicine “B”, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK
| | - Mohammad Adawi
- Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
| | - Charlie Bridgewood
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK
| | | | - Pierachille Santus
- Department of Biomedical Sciences L. Sacco, University of Milan, Milan, Italy
- Respiratory Unit, Center for Sleep and Respiratory Disorders, “Luigi Sacco” University Hospital, Milan, Italy
| | - Maurizio Rizzi
- Respiratory Unit, Center for Sleep and Respiratory Disorders, “Luigi Sacco” University Hospital, Milan, Italy
| | - Stephen Petrou
- Emergency Medicine, Good Samaritan Hospital Medical Center, New York, USA
| | - Delia Colombo
- Department of Pharmacology, University of Milan, Milan, Italy
| | - Marco Fiore
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Paolo D. M. Pigatto
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, USA
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Young Dermatologists Italian Network, Centro Studi GISED, Bergamo, Italy
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Damiani G, Leone S, Fajgenbaum K, Bragazzi NL, Pacifico A, Conic RRZ, Pigatto PDM, Maiorana C, Poli P, Berti E, Pace MC, Malagoli P, Bettoli V, Fiore M. Nonalcoholic fatty liver disease prevalence in an Italian cohort of patients with hidradenitis suppurativa: A multi-center retrospective analysis. World J Hepatol 2019; 11:391-401. [PMID: 31114643 PMCID: PMC6504856 DOI: 10.4254/wjh.v11.i4.391] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 02/25/2019] [Accepted: 03/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Furthermore, NASH is the more aggressive necro-inflammatory form, which may accumulate fibrosis and result in End stage liver disease (ESLD). NAFLD is also linked to systemic inflammatory conditions such as psoriasis. NAFLD is currently the most common cause of ESLD in Western countries, becoming a serious public health concern. Hidradenitis suppurativa (HS) is a systemic inflammatory/autoinflammatory disease of the terminal follicular epithelium of the apocrine gland with a prevalence of 0.05% to 4.10%. Due to its systemic inflammatory behavior several comorbidities were recently associated, however liver ones were scarcely assessed.
AIM To evaluate the prevalence and characteristics of NASH/NAFL in HS patients.
METHODS This retrospective study is a sub-analysis of a larger study carried out in 4 Italian dermatological centers. In this cohort, there were 83 patients: 51 patients with HS only, 20 patients with HS/NAFL and 12 with HS/NASH.
RESULTS Inflammatory comorbidities were present in 3.9% of HS only patients, 25% of HS/NAFL patients and 58.3% of HS/NASH patients (P < 0.001). Similarly, mean Autoinflammatory Disease Damage Index (ADDI) was significantly higher among patients with HS/NASH (5.3 ± 2.2, P < 0.001) compared to patients with HS/NAFL or HS only (2.8 ± 1.6 and 2.6 ± 1.4 respectively). Furthermore, ADDI correlates with IHS4 in HS, HS/NAFL and HS/NASH. Diabetic patients have higher Hurley score than not diabetic ones. Ultrasound examination was significantly different in the three groups.
CONCLUSION HS patients displayed a high prevalence of NASH/NAFLD and ultrasound examination should be particularly addressed to patients that display high ADDI scores.
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Affiliation(s)
- Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44195, United States
- Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo 24100, Italy
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20100, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20161, Italy
| | - Sebastiano Leone
- Division of Infectious Diseases, “San Giuseppe Moscati” Hospital, Avellino 83100, Italy
| | - Kristen Fajgenbaum
- University of North Carolina School of Medicine, Chapel Hill, NC 27516, United States
| | - Nicola L Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Gevova 16132, Italy
| | - Alessia Pacifico
- San Gallicano Dermatological Institute, IRCCS, Rome 00144, Italy
| | - Rosalynn RZ Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44195, United States
| | - Paolo DM Pigatto
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20100, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20161, Italy
| | - Carlo Maiorana
- Center for Jawbone Atrophies Policlinico Hospital, University of Milan School of Dentistry, Milan 20123, Italy
| | - Pierpaolo Poli
- Center for Jawbone Atrophies Policlinico Hospital, University of Milan School of Dentistry, Milan 20123, Italy
| | - Emilio Berti
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan 20122, Italy
| | - Maria C Pace
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | | | - Vincenzo Bettoli
- Department of Clinical and Experimental Dermatology, O.C. of Dermatology, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara 44121, Italy
| | - Marco Fiore
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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Damiani G, Conic RRZ, Pigatto PDM, Bragazzi NL, Pacifico A, Malagoli P. From randomized clinical trials to real life data. An Italian clinical experience with ixekizumab and its management. Dermatol Ther 2019; 32:e12886. [PMID: 30942952 DOI: 10.1111/dth.12886] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/19/2019] [Accepted: 03/26/2019] [Indexed: 12/24/2022]
Abstract
Interleukin(IL)-17 inhibitors display higher efficacy than both TNFi and IL-12/23i, which increased the goal psoriasis area severity index (PASI) from 75 to PASI 90 or even PASI 100. Ixekizumab, a recombinant, humanized IgG4 monoclonal antibody targeting IL-17A displayed a high efficacy and safety in RCTs, namely UNCOVER-2 and UNCOVER-3. However, few studies examined real-life data for these medications, and those which exist highlight discrepancies in efficacy and safety between RCTs and real-life data, likely due to the heterogeneity of patients treated outside of trials. Thus, we performed a single center large prospective observational study (RLSD) that enrolled 47 psoriatic patients followed for 20 weeks and we compared the obtained data with the UNCOVER studies. At week 20 in RLSD versus UNCOVER-3 both PASI-90 and PASI-100 results were similar, whilst at week 12, the RLSD cohort obtained higher PASI 90 (76 vs 69,3%) and PASI-100 (55 vs 39%) than UNCOVER cohorts. Interestingly we also reported higher injection-site related pain that disappeared after week 12. In conclusion, real-life data together with RCTs contribute to enrich the information background available to dermatologists in daily practice.
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Affiliation(s)
- Giovanni Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Clinical Dermatology, IRCCS Istituto Ortopedico Galezzi, Milan, Italy
| | - Rosalynn R Z Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Paolo D M Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galezzi, Milan, Italy
| | - Nicola L Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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- Young Dermatologists Italian Network, GISED, Bergamo, Italy
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Systemic Sclerosis is Linked to Psoriasis and May Impact on Patients' Survival: A Large Cohort Study. J Clin Med 2019; 8:jcm8040521. [PMID: 30995800 PMCID: PMC6517892 DOI: 10.3390/jcm8040521] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/12/2022] Open
Abstract
Although skin manifestations are quite common in systemic sclerosis (SSc), a link between SSc and psoriasis (PsO) has been poorly investigated. We assessed the Clalit medical database in a cohort study to compare the prevalence of PsO between SSc-patients and SSc-free controls. We also evaluated the SSc-related autoantibodies’ role in the co-existence of the two conditions. Survival analysis was performed using both univariate (Kaplan–Meier, log-rank test) and multivariate (Cox proportional-hazards technique) analyses. Our cohort of 2,431 SSc-patients was age- and gender-matched with 12,710 controls (case-control match 1:5.2). There were 150 (1.2%) cases of PsO among controls and 47 (1.9%) among SSc-patients (p = 0.0027). A SSc diagnosis was an independent risk factor for PsO with an odds ratio (OR) of 2.16 (95%CI 1.38–3.39, p = 0.0008). Among SSc-patients, 98.6% with PsO were antinuclear antibodies (ANA)-negative. In terms of survival, the mortality rate in SSc-patients with PsO was lower than SSc without PsO (14.9% vs. 26%, p < 0.0001). At the multivariate-analysis, SSc-patients with PsO compared to SSc-patients without PsO had an OR for death of 0.44 (95%CI 0.19–0.99, p < 0.05). SSc is independently associated with PsO. The cases with concurrent PsO and SSc are almost exclusively ANA-negative and may exhibit a better survival.
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Association of Multiple Sclerosis with Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies. Am J Clin Dermatol 2019; 20:201-208. [PMID: 30361954 DOI: 10.1007/s40257-018-0399-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies have reported the occurrence of psoriasis together with multiple sclerosis (MS). Although similar predisposing genes and pathomechanisms have been hypothesized, the relationship between the two remains obscure. OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the association between psoriasis and MS. METHODS We searched MEDLINE, Embase, and CENTRAL in July 2018 for case-control, cross-sectional, or cohort studies that examined either the odds or risk of psoriasis in subjects with multiple sclerosis. The risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis was used to calculate the odds ratio (OR) for case-control/cross-sectional studies and hazard ratio (HR) for cohort studies. RESULTS We included 10 publications that reported a total of 11 studies (5 case-control, 4 cross-sectional and 2 cohort studies). The case-control and cross-sectional studies included 18,456 MS patients and 870,149 controls, while the two cohort studies involved 25,187 MS patients and 227,225 controls in total. Three studies were rated with a high risk of bias in comparability, non-response rate, and selection of controls. MS was associated with increased odds (OR 1.29; 95% confidence interval [CI] 1.14-1.45) and risk for psoriasis (HR 1.92; 95% CI 1.32-2.80). CONCLUSION Patients with MS display both increased prevalence and incidence of psoriasis.
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Damiani G, Cazzaniga S, Naldi L. Use of fumaric acid derivatives in Italian reference centers for psoriasis. Ital J Dermatol Venerol 2019; 156:36-41. [PMID: 30636394 DOI: 10.23736/s2784-8671.18.06032-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several therapies are available for psoriasis, including in some countries oral fumaric acid derivatives (FADs). Even if FADs are not available in the Italian market, they can be prescribed and reimbursed by the National Health Service, on request from the treating physician, when considered as a valuable option in selected patient. METHODS We performed a retrospective analysis of the PsoReal registry data, restricted to adult psoriatic patients enrolled between 2009 and 2017. Demographic and clinical data were collected together with information on systemic therapies prescribed for psoriasis, drug shifts and adverse effects. We focused our analysis on FADs compared with other systemic drugs. RESULTS From the registry data, a total of 17,064 patients were extracted, and 11,592 patients (67.9%), fulfilled inclusion criteria. The majority of them had chronic plaque psoriasis, the mean disease duration was 17.1±12.6 years, and the mean PASI was 17.8±10.9, with 51.5% presenting a moderate Ps (PASI between 10 and 20). A total of 36 patients (0.3%) were treated by FADs. The average treatment duration of conventional (9.0±10.0 months) and biological agents (13.7±11.6 months) was lower compared to the duration of FADs (28.1±20.1, P value<0.001). FADs were used at an average dosage of 361.0±146.3 mg/day and FADs treated patients displayed an overall lower healthcare cost compared with other drugs. CONCLUSIONS The current study confirms previous European data about efficacy and safety of FADs and suggests a decrease of healthcare costs for FADs treated patients as compared to other treatments.
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Affiliation(s)
- Giovanni Damiani
- Young Dermatologists Italian Network (YDIN), Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Bergamo, Italy - .,Unit of Clinical Dermatology, Department of Biomedical, Surgical and Dental Sciences, IRCCS Galeazzi Orthopedic Institute, University of Milan, Milan, Italy - .,Centro Studi GISED, Bergamo, Italy -
| | - Simone Cazzaniga
- Centro Studi GISED, Bergamo, Italy.,Department of Dermatology, Inselspital University Hospital, Bern, Switzerland
| | - Luigi Naldi
- Centro Studi GISED, Bergamo, Italy.,Department of Dermatology, San Bortolo Hospital, AULSS8, Vicenza, Italy
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Damiani G, Conic RRZ, de Vita V, Costanzo A, Regazzini R, Pigatto PDM, Bragazzi NL, Pacifico A, Malagoli P. When IL-17 inhibitors fail: Real-life evidence to switch from secukinumab to adalimumab or ustekinumab. Dermatol Ther 2018; 32:e12793. [PMID: 30515970 DOI: 10.1111/dth.12793] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 01/04/2023]
Abstract
Psoriasis is a chronic, systemic inflammatory disease that in the moderate to severe forms may benefit of biologics, namely TNF and IL-12/23 and IL-17 inhibitors. Loss of response, lack of response, or discontinuation due to adverse events represent a concrete therapeutic challenge for dermatologists that have to switch patients to other treatments. Although some evidences already exist toward the switch from IL-12/23 and TNF inhibitors to IL-17 inhibitors, conversely nothing is present toward the switch from IL-17 inhibitors to IL-12/23 and TNF inhibitors. We performed a real-life study enrolling 50 patients randomly switched to adalimuamb, a TNF inhibitor, or ustekinumab, an IL-12/23 inhibitor. Our observational study suggests that switching from IL-17i to TNFi and IL-12/23i is a safe and effective therapeutic strategy.
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Affiliation(s)
- Giovanni Damiani
- Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo, Italy.,Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Rosalynn R Z Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Valerio de Vita
- Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo, Italy
| | - Antonio Costanzo
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Paolo D M Pigatto
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Nicola L Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3140682. [PMID: 30345297 PMCID: PMC6174805 DOI: 10.1155/2018/3140682] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/25/2018] [Accepted: 08/12/2018] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic inflammatory systemic disease characterized by a wide range of comorbidities. Respiratory comorbidities are currently poorly characterized and with discordant results. The systemic state of inflammation caused by psoriasis acts de novo on respiratory tissues and amplifies preexisting inflammation from asthma or chronic obstructive pulmonary disease. Because the lungs act as a gas exchanger between the internal and external environment, the impact of chronic psoriasis inflammation may be easily assessed through the analysis of exhaled breath. The fraction of exhaled nitric oxide test (FeNO) is a potential noninvasive solution that can provide quantitative and qualitative indices of respiratory airway inflammation. FeNO is routinely used to screen and manage asthmatic patients. Recent pilot studies contain encouraging data that underscore its possible use with systemic inflammatory nonpulmonary diseases, such as psoriasis. FeNO may therefore be a useful tool to evaluate underestimated airway inflammation and at the same time globally evaluate the impact of systemically antipsoriatic therapies.
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Li F, Li H, Luo S, Ran Y, Xie X, Wang Y, Zheng M, Wang M, Zhao Z, Li X. Evaluation of the effect of andrographolide and methotrexate combined therapy in complete Freund's adjuvant induced arthritis with reduced hepatotoxicity. Biomed Pharmacother 2018; 106:637-645. [PMID: 29990853 DOI: 10.1016/j.biopha.2018.07.001] [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] [Received: 05/24/2018] [Revised: 06/23/2018] [Accepted: 07/01/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Methotrexate is one of the most widely used disease-modifying anti-rheumatic drugs. The hepatotoxicity of methotrexate resulted in poor compliance with therapy. The current study was designed to analyse the combined therapy of andrographolide (AD) and methotrexate (MTX) for complete Freund's adjuvant (CFA)-induced arthritis, focusing on hepatoprotective effects, oxidative stress and arthritic-related cytokines. METHOD Wistar rats were injected with CFA into the right hind paw. Ten days post-CFA injection, the Wistar rats were administered with 1% CMC-Na solution, methotrexate (2 mg/kg/week), AD (50 mg/kg/d) and combined therapy for 35 days. The anti-arthritic effect was assessed by paw volume, X-ray and serum tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1β levels. Serum samples were also analysed for glutamic oxaloacetic transaminases (GOT), serum glutamic pyruvic transaminase (GPT), alkaline phosphatase (AKP) and lactate dehydrogenase (LDH). Liver tissue samples were used to examine the cellular antioxidant defence activities using catalase activity (CAT) and GSH as well as GSH-Px and MDA. Histopathology analysis was conducted to evaluate liver damage. RESULTS AD treatment strengthened the anti-arthritic capacity of MTX. AD and MTX-combined therapy additively reduced the inflammatory symptoms in CFA rats. The combined therapy of AD and MTX showed hepatoprotective effect indicated by an improvement in the serum marker, possibly due to antioxidant action and confirmed by liver histopathological changes. Furthermore, the combined therapy significantly reduced serum TNF-α, IL-6 and IL-1β levels. CONCLUSIONS A combined therapy of AD and methotrexate significantly alleviated MTX-induced hepatocellular injury and strengthened the anti-arthritic effect. Further clinical studies should be done to further verify the possibility of combined its clinical usage.
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Affiliation(s)
- Fenfen Li
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China; Department of Pathophysiology, College of Basic Medical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - He Li
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China; Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450001, Henan Province, PR China
| | - Shasha Luo
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Yantao Ran
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Xiaoqian Xie
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Yale Wang
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Ming Zheng
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Mengzhen Wang
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Zeyue Zhao
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China
| | - Xiaotian Li
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue, Zhengzhou 450001, Henan Province, PR China.
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Saliva as a Future Field in Psoriasis Research. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7290913. [PMID: 29888276 PMCID: PMC5985113 DOI: 10.1155/2018/7290913] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/11/2018] [Indexed: 02/06/2023]
Abstract
Psoriasis is a skin inflammatory disease characterized by an increased body of comorbidities, including parodontopathy. Despite the visibility of skin lesions, prognostic biomarkers, related to disease monitoring and therapeutic effectiveness, are still missing. Although several markers have been studied, none of them has been identified as an independent prognostic factor. This concise review aims to summarize the current knowledge and results in saliva research applied to psoriasis. Combination of different markers could improve the prognostic prediction in patients with psoriasis. Future studies are needed to implement research on salivary biomarkers and their prognostic/therapeutic effects in the management of patients with psoriasis.
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