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Schaeffer L, Ben-Anaya N, Sorbe C, Rustenbach SJ, Mrowietz U, Augustin M. Real-world outcomes and drug survival of brodalumab: results from the German Psoriasis Registry PsoBest. J DERMATOL TREAT 2024; 35:2340107. [PMID: 38636941 DOI: 10.1080/09546634.2024.2340107] [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: 03/04/2024] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
Brodalumab, a human monoclonal antibody that targets interleukin-17 receptor A (IL-17RA), is approved in the US and EU for treatment of adults with moderate-to-severe plaque psoriasis. Although brodalumab has demonstrated efficacy and safety vs placebo in clinical trials of patients with psoriasis and psoriatic arthritis (PsA), real-world evidence is needed to evaluate long-term effectiveness and safety of brodalumab in routine care. This interim analysis of the German Psoriasis Registry PsoBest examined patient profiles, treatment outcomes, and drug survival of first-time use of brodalumab for 12 months in adult patients with moderate-to-severe plaque-type psoriasis (with and without PsA) (data cutoff: June 30, 2021). Clinician and patient-reported outcomes of the total cohort (n = 227; PsA, n = 38) indicated a rapid response to brodalumab treatment within the first 3 months, which was maintained up to 12 months. The overall one-year drug survival rate was 76.2%, the mean time to discontinuation was 8.3 months. Reasons for discontinuation were mainly loss/lack of effectiveness, followed by adverse events, contraindication and skin clearance. In sum, brodalumab demonstrated rapid and sustained effectiveness and was well-tolerated over 12 months in German patients with moderate-to-severe psoriasis and PsA in a real-world setting.
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Affiliation(s)
- Lisa Schaeffer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Nesrine Ben-Anaya
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christina Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Stephan Jeff Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ulrich Mrowietz
- Psoriasis Centre, Clinic for Dermatology, University Medical Centre Schleswig-Holstein, Campus Kiel, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Marruganti C, Romandini M, Gaeta C, Trovato E, Cinotti E, Rubegni P, D'Aiuto F, Grandini S. Treatment of periodontitis ameliorates the severity and extent of psoriasis-A randomized clinical trial. J Periodontal Res 2024. [PMID: 38899599 DOI: 10.1111/jre.13314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
AIM To assess the impact of non-surgical periodontitis treatment over conventional dermatological treatment on the severity and extent of psoriasis in patients affected by comorbid psoriasis and periodontitis. METHODS Seventy-four patients affected by both psoriasis and Stages I-IV periodontitis were randomized to receive either Steps 1-2 (non-surgical) of periodontal therapy (test group; n = 37) or no treatment (control group; n = 37). The two groups were balanced in terms of psoriasis medications, with the majority of the included patients undergoing biologics (74.0%) as monotherapy, while minor proportions were under systemic medications (13.7%) or none/topical/phototherapy (12.3%). The psoriasis area severity index (PASI) was regarded as the primary outcome. The body surface area (BSA) and the dermatology life quality index (DLQI) were additionally considered as dermatological outcomes. Probing pocket depth, recession depth, clinical attachment level periodontal inflamed surface area, and [full mouth plaque score] etc, periodontal inflamed surface area, and full-mouth plaque and bleeding scores (FMPS/FMBS) were also measured. RESULTS Periodontal therapy in the test group led to statistically significant lower PASI scores at 10 weeks (mean = 3.15; standard deviation [SD] = 3.78) compared to the control group (mean = 7.11; SD = 6.09) (mean difference [MD] = -4.0; 95% confidence interval [CI]: -6.3, -1.6; p = .001). The test group also showed improvements in BSA (MD = -4.3) and periodontal parameters compared to the control group. DLQI only showed a non-statistically significant tendency (MD = -2.0). CONCLUSION Steps 1-2 of periodontal therapy showed an additional effect over conventional dermatological treatment in reducing the severity and extent of psoriasis (Clinicaltrials.gov: NCT05311501).
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Affiliation(s)
- Crystal Marruganti
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Carlo Gaeta
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Emanuele Trovato
- Unit of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | - Elisa Cinotti
- Unit of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Unit of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | | | - Simone Grandini
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Anyfanti P, Triantafyllou A, Lazaridis A, Malliora A, Margouta A, Chionidou A, Nikolaidou B, Kotsis V, Gkaliagkousi E. Short-Term Variability of Both Brachial and Aortic Blood Pressure is Increased in Patients with Immune-mediated Chronic Inflammation. High Blood Press Cardiovasc Prev 2024:10.1007/s40292-024-00651-3. [PMID: 38819777 DOI: 10.1007/s40292-024-00651-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Blood pressure (BP) variability (BPV) has emerged as an indicator of subclinical organ damage and an independent predictor of cardiovascular disease (CVD) morbidity and mortality in high-risk populations. AIM We aimed to assess short-term variability of both brachial and aortic BP in psoriasis, a common immune-mediated inflammatory disorder characterized by increased CVD risk. METHODS Psoriasis patients and non-psoriasis individuals had their BP assessed throughout a 24 h period (Mobil-O-Graph device). Brachial and aortic BPV during the 24 h and the respective daytime and nighttime periods was calculated from relevant ambulatory BP profiles. In-house software was applied to automatically calculate average real variability (ARV) of brachial and aortic systolic (bSBP, aSBP) and diastolic BP (bDPB, aDBP), and the weighted standard deviation (wSD) of 24 h bSBP/aSBP. 24 h pulse wave velocity (PWV) and augmentation index (AIx) were used as widely applied markers of arterial stiffness. RESULTS Psoriasis patients (n = 74) presented increased ARV of 24 h and daytime bSBP/aSBP, and increased ARV of 24 h and daytime bDBP/aDBP, compared to controls (n = 40). PWV and AIx correlated with ARV of 24 h bSBP/aSBP, daytime bSBP/aSBP, while PWV further correlated with ARV of nighttime aSBP. The observed associations with PWV, yet not AIx, with indices of BPV remained significant after adjusting for CVD risk factors. CONCLUSIONS This is the first study reporting increased 24 h variability of both brachial and aortic BP in psoriasis. The association of short-term BPV with arterial stiffness implies a potential role of BPV in terms of CVD risk stratification in patients with chronic immune-mediated inflammation.
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Affiliation(s)
- Panagiota Anyfanti
- Second Medical Department, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Anastasia Malliora
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Anastasia Margouta
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Agapi Chionidou
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Barbara Nikolaidou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Vasileios Kotsis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece.
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Dhaher SA, Hilfi NZ, Abdullah MA. Non-alcoholic Fatty Liver Disease Among Iraqi Patients With Psoriasis: A Case-Control Study. Cureus 2024; 16:e57487. [PMID: 38707119 PMCID: PMC11066695 DOI: 10.7759/cureus.57487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Several studies have shown that patients with psoriasis have a higher risk of developing NAFLD. Obesity, metabolic syndrome, and cytokine-mediated inflammation might be the link between psoriasis and NAFLD. AIMS This study aims to investigate the prevalence of NAFLD among psoriatic Iraqi patients and examine the relationship with disease severity using the Psoriasis Area and Severity Index (PASI) score and the correlation with different clinical and laboratory parameters. SUBJECTS AND METHODS A case-control study on 130 psoriatic patients and 130 age-, sex-, and BMI-matched healthy controls was conducted at the Department of Dermatology in Basra Teaching Hospital from November 2022 to October 2023. All demographic and clinical data were collected using a pre-designed questionnaire, and NAFLD was diagnosed through a FibroScan examination performed on each participant. The severity of psoriasis was determined using the PASI score. Fasting glucose, liver enzymes, and lipid profile levels were investigated, and metabolic syndrome was identified. RESULTS The prevalence of NAFLD was significantly higher in our psoriatic patients than in the control group (66.2% vs. 42.3%, OR=2.6, P<0.01). Psoriatic patients were found to have more severe NAFLD than the controls, as evidenced by their steatosis and fibrosis staging (P<0.01). In patients with psoriasis, NAFLD was associated with a higher prevalence of diabetes (17.4%) and metabolic syndrome (55.8%). Furthermore, psoriatic patients with NAFLD had significantly higher values of BMI, waist circumference, PASI score, as well as serum alanine transaminase (ALT), triglyceride, cholesterol, low-density lipoprotein (LDL), and fasting glucose levels. The study also found a significant positive correlation between the psoriasis severity based on PASI and the steatosis score. Metabolic syndrome, PASI, BMI, serum triglycerides, LDL, and age are the independent predictors of NAFLD. CONCLUSIONS NAFLD is highly prevalent among psoriatic patients affecting more than half of them and closely associated with metabolic syndrome and severity of psoriasis. Routine screening for NAFLD may be necessary in psoriatic patients particularly when considering the use of hepatotoxic drug therapy.
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Affiliation(s)
- Samer A Dhaher
- Dermatology, College of Medicine, University of Basrah, Basrah, IRQ
| | - Noora Z Hilfi
- Dermatology, College of Medicine, University of Basrah, Basrah, IRQ
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Esen Baris M, Kuscu Akdeniz F, Unal I, Guven Yilmaz S. Alterations in Retinal Vascularity in Severe Psoriasis. Ocul Immunol Inflamm 2024; 32:276-280. [PMID: 36731518 DOI: 10.1080/09273948.2023.2166536] [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: 09/15/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the changes in retinal vascularity in patients with severe psoriasis. MATERIALS AND METHODS Patients with severe psoriasis [psoriasis area-severity index (PASI) >10] who did not get any systemic treatment in the last year and do not have any ocular diseases were included. All patients underwent detailed ophthalmological examination, including optical coherence tomography (OCT) and OCT angiography (OCTA). Vessel densities (VD) of Superficial (SCP) and deep (DCP) capillary plexus, foveal avascular zone (FAZ) diameter, central retinal thickness (CRT) were analyzed and compared with age-sex matched healthy adults. RESULTS Fifty-three patients (13 F, 40 M) and 56 controls (16 F, 40 M) were included in the study. VD of SCP (50.4%±3.9 vs. 51.4%±3.2) and DCP (52.6%±6.4 vs. 55.4%±5.7) were lower in psoriasis group compared to controls (p < .05). Presence of psoriatic arthritis was related with an increased CRT (p = .000), larger FAZ and decreased foveal VD in SCP (p = .01, p = .02, respectively). CONCLUSION Severe psoriasis causes a decrease in retinal blood flow and presence of psoriatic arthritis is related with decreased foveal VD.
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Affiliation(s)
- Mine Esen Baris
- Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Funda Kuscu Akdeniz
- Department of Dermatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Idil Unal
- Department of Dermatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Suzan Guven Yilmaz
- Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
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Chan AA, Tran PT, Lee DJ. Quantitative Aggregation of Microbiome Sequencing Data Provides Insights into the Associations between the Skin Microbiome and Psoriasis. JID INNOVATIONS 2024; 4:100249. [PMID: 38282647 PMCID: PMC10810833 DOI: 10.1016/j.xjidi.2023.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/18/2023] [Accepted: 10/24/2023] [Indexed: 01/30/2024] Open
Abstract
Although prior studies have reported distinct skin microbiome profiles associated with psoriasis, differences in methods and analyses limit generalizable conclusions. Individual studies have actually reported conflicting findings; for example, Propionibacterium and Staphylococcus have been significantly associated with both psoriatic lesions and healthy skin. Qualitative reviews have attempted to summarize this body of work, but there is great variability across the studies' findings and methods. To better unify these data, we created a meta-analysis of all publicly available datasets by utilizing a uniform bioinformatics pipeline and reference database to investigate associations of the skin microbiome in psoriasis. A total of 977 skin swab samples (341 lesional, 295 nonlesional, and 341 healthy) from 6 studies were analyzed. The aggregated analysis revealed a higher relative abundance of microorganisms, including Staphylococcus aureus and Corynebacterium simulans, among others, from patients with psoriasis than those from healthy swab samples; in addition, Cutibacterium acnes, Lawsonella unclassified, and S warneri were significantly higher in healthy samples. Furthermore, comparison of functional pathways predicted from 16S gene markers showed that L-ornithine biosynthesis and L-histidine biosynthesis were lower in psoriatic lesions than in healthy controls. Taken together, this meta-analysis allows for a more generalizable association between the skin microbiome and psoriasis.
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Affiliation(s)
| | - Patrick T Tran
- Division of Dermatology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Delphine J Lee
- The Lundquist Institute, Torrance, California, USA
- Division of Dermatology, Harbor-UCLA Medical Center, Torrance, California, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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Wahba MAWA, El-Gazzar NM, Elsharaby RM, Tabra SA. DKK-1 in psoriatic arthritis: Correlation with disease activity and enthesopathy. REUMATOLOGIA CLINICA 2024; 20:14-19. [PMID: 38233008 DOI: 10.1016/j.reumae.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/08/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a complex inflammatory disease with varied clinical characteristics. A pathognomonic characteristic of PsA is enthesitis. Entheseal inflammation ultimately leads to the production of new bone (enthesophytes). Dickkopf-related protein-1 (DKK-1) is a wingless (Wnt) inhibitor that inhibits osteoblast function. OBJECTIVES Assessment of the serum level of DKK-1 and its association with disease activity and enthesopathy in PsA patients. METHODS This observational case-control study included 50 PsA patients and 50 healthy volunteers matched for age and gender. All participants were subjected to full medical history, clinical assessment, PSA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis were determined by the Psoriasis Area and Severity Index (PASI). Ultrasonographic assessment of the entheses was done in accordance with the Madrid Sonographic Enthesitis Index (MASEI). Serum level of DKK-1 and correlation with disease activity and enthesopathy in PsA patients were assessed. RESULTS There was no significant difference between patients and controls regarding age and sex. The mean value of SPARCC index, DAPSA score and PASI score were 6.74±4.58, 33.24±15.26, and 8.35±10.93, respectively. There was significant difference between patients and controls regarding the serum levels of DKK-1 and MASEI score (p<0.0001). There was a significant positive correlation between serum DKK-1 and MASEI (r: 0.43527, p: 0.00158), MASEI inflammatory (r: 0.37958, p: 0.00655), and MASEI damage (r: 0.38384, p: 0.00593). CONCLUSIONS Serum DKK-1 levels were elevated in PsA patients and were found to be correlated with MASEI score for enthesopathy.
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Wang Y, Tian Z, Huang S, Dang N. Tripterygium wilfordii Hook. F. and Its Extracts for Psoriasis: Efficacy and Mechanism. Drug Des Devel Ther 2023; 17:3767-3781. [PMID: 38144417 PMCID: PMC10749103 DOI: 10.2147/dddt.s439534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Psoriasis is an inflammatory autoimmune skin condition that is clinically marked by chronic erythema and scaling. The traditional Chinese herb Tripterygium wilfordii Hook. F. (TwHF) is commonly used in the treatment of immune-related skin illnesses, such as psoriasis. In clinical studies, PASI (Psoriasis Area and Severity Index) were dramatically decreased by TwHF and its extracts. Their benefits for psoriasis also include relief from psoriasis symptoms such as itching, dryness, overall lesion scores and quality of life. And the pathological mechanisms include anti-inflammation, immunomodulation and potentially signaling pathway modulations, which are achieved by modulating type-3 inflammatory cytokines including IL-22, IL-23, and IL-17 as well as immune cells like Th17 lymphocytes, γδT cells, and interfering with IFN-SOCS1, NF-κB and IL- 36α signaling pathways. TwHF and its extracts may cause various adverse drug reactions, such as gastrointestinal responses, aberrant hepatocytes, reproductive issues, and liver function impairment, but at adequate doses, they are regarded as an alternative therapy for the treatment of psoriasis. In this review, the effectiveness and mechanisms of TwHF and its extracts in psoriasis treatment are elucidated.
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Affiliation(s)
- Yingchao Wang
- Department of Dermatology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Dermatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Zhaochun Tian
- Science and Technology Innovation Center, Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Shuhong Huang
- School of Clinical and Basic Medical Sciences, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Ningning Dang
- Department of Dermatology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Dermatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
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Liu Y, Fu Y, Zhu Z, Chen S, Tong L, Wei Q. Glycyrol Prevents the Progression of Psoriasis-like Skin Inflammation via Immunosuppressive and Anti-Inflammatory Actions. Int J Mol Sci 2023; 24:17335. [PMID: 38139164 PMCID: PMC10744267 DOI: 10.3390/ijms242417335] [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: 10/23/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Glycyrol (GC) is one natural active product. Imiquimod-induced psoriasis-like Balb/c mouse models were established. The model mice were intraperitoneally injected with cyclosporine A (CsA) and GC for 8 days followed by a series of biological detections. GC had little toxicity according to the levels of peripheral blood cells, hemoglobin, blood urea nitrogen (BUN), and serum creatinine (CRE), while CsA significantly increased the levels of BUN and CRE. GC decreased the splenic index and reduced the expressions of IL-6, IL-23, and CXCL-3 in the model mice and IL-6, CXCL-1, and CXCL-2 in the inflammatory HaCaT cells. The half inhibition concentration (IC50) of GC on HaCaT cells was 29.72 μmol/L, resulting in improved apoptosis, enhanced expressions of p21, BAX, and BIK, and reduced expressions of BCL-2. GC is an immunosuppressive agent against psoriasis-like symptoms by anti-inflammatory effects, which provides a strategy for the discovery of anti-psoriatic natural products.
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Affiliation(s)
| | | | | | | | - Li Tong
- Beijing Key Laboratory of Genetic Engineering Drug and Biotechnology, Department of Biochemistry and Molecular Biology, College of Life Sciences, Beijing Normal University, Beijing 100875, China; (Y.L.); (Y.F.); (Z.Z.); (S.C.)
| | - Qun Wei
- Beijing Key Laboratory of Genetic Engineering Drug and Biotechnology, Department of Biochemistry and Molecular Biology, College of Life Sciences, Beijing Normal University, Beijing 100875, China; (Y.L.); (Y.F.); (Z.Z.); (S.C.)
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Matwiejuk M, Myśliwiec H, Lukaszuk B, Lewoc M, Malla H, Myśliwiec P, Dadan J, Chabowski A, Flisiak I. Crosstalk between Serum and Skin Sphingolipids in Psoriasis. Int J Mol Sci 2023; 24:14872. [PMID: 37834321 PMCID: PMC10573408 DOI: 10.3390/ijms241914872] [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: 08/27/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Psoriasis is a chronic, complex, immunological disorder, which may lead to many different systemic complications. Sphingolipids, including ceramide, are bioactive lipids, which take part in the regulation of immune reactions, cell growth, and apoptosis. Twenty psoriatic patients and twenty-eight control subjects were included in the study. Skin (both lesional and non-lesional) and serum samples were collected from both the control group and the psoriatic patients. The levels of sphingosine (SFO), sphingosine-1-phosphate (S1P), sphingomyelin, sphinganine (SFA), sphinganine-1-phosphate (SFA1P), and ceramide (CER) were assessed in both tissue (t) and serum (s) samples using high-performance liquid chromatography (HPLC). We identified elevated serum levels of SFO, S1P, SFA, and SFA1P in psoriatic patients when compared to healthy individuals. As far as the lesional skin and serum of psoriatic patients are concerned, we demonstrated positive associations between CER_t and CER_s, SFA_t and CER_s, and SFO_t and CER_s. Additionally, we found negative correlations in the non-lesional skin and serum of psoriatic patients, including SFO_t vs. SFO_s, CER_t vs. SFA_s, CER_t vs. SFO_s, and SFO_t vs. SFA_s. Finally, we observed a positive correlation between S1P and SFA1P in both the serum samples of psoriatic patients and the serum samples of the control group. In this study, we did not observe any correlations between psoriasis area and severity index (PASI) scores and sphingolipid levels. In conclusion, our findings indicate an interplay between skin and serum lipids in psoriatic patients, which is not observed in healthy individuals.
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Affiliation(s)
- Mateusz Matwiejuk
- Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland; (M.M.)
| | - Hanna Myśliwiec
- Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland; (M.M.)
| | - Bartlomiej Lukaszuk
- Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland; (B.L.)
| | - Marta Lewoc
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Hend Malla
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Piotr Myśliwiec
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Jacek Dadan
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland; (B.L.)
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland; (M.M.)
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Zhang XJ, Lin JR, Ou MX, Yan HW, Liu SN, Dai L, Gong FQ. Factors associated with quality of life in Chinese people with psoriasis: a cross-sectional study. BMC Public Health 2023; 23:1860. [PMID: 37749489 PMCID: PMC10521450 DOI: 10.1186/s12889-023-16758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The ultimate goal of medical care is to eradicate disease and restore normality to a person's life. Quality of life (QOL) is a concern as dermatologists and researchers strive to find better drug treatments. However, there have been few reports on the factors associated with QOL among Chinese people with psoriasis. METHODS A total of 185 people with psoriasis were surveyed to assess their sociodemographic status, disease-related information, psychosocial status, and QOL. The questionnaires included a sociodemographic questionnaire, the Athens Insomnia Scale, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, the Psychosocial Adaptation Questionnaire of Chronic Skin Disease and the Dermatology Life Quality Index. Multiple stepwise regression and path analysis were used to study the factors associated with QOL among Chinese people with psoriasis and to analyse the relationship between them. RESULTS The results showed that the presence of anxiety/depression, lesion area, sleep disorders, psychosocial adaptation, and sex could jointly predict 62.1% of the variance in QOL among Chinese people with psoriasis. According to previous theories and the literature, a path model was established for five variables. Four internal variables could be effectively explained. The values of the explanatory variables were 62.1% (F(1056) = 61.020, p = 0.000) for QOL, 71.8% (F(2433) = 117.370, p = 0.000) for anxiety/depression, 44.0% (F(660) = 36.935, p = 0.000) for sleep disorders, and 66.9% (F(6886) = 93.556, p = 0.000) for psychosocial adaptation. The path analysis confirmed that 9 paths were consistent with the predicted path, and 3 paths were not confirmed. CONCLUSION To improve QOL among Chinese people with psoriasis, attention should be given to the presence of anxiety/depression, lesion area, sleep disorders, psychosocial adaptation and sex differences. Therefore, health care programs for psoriasis should include physical, psychological and social aspects.
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Affiliation(s)
- Xiu-Jie Zhang
- School of Public Health, China Medical University, Shenyang, China
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jing-Rong Lin
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Min-Xing Ou
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hong-Wei Yan
- Department of Dermatology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Sheng-Nan Liu
- Department of Dermatology, Dalian Dermatology Hospital, Dalian, China
| | - Lu Dai
- Department of Dermatology, Shenyang Dermatology Hospital, Shenyang, China
| | - Fu-Qing Gong
- School of Public Health, China Medical University, Shenyang, China.
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12
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Reich A, Pinter A, Maul JT, Vender RB, Torres T, Brnabic A, Haustrup N, Reed C, Schuster C, Riedl E. Speed of clinical improvement in the real-world setting from patient-reported Psoriasis Symptoms and Signs Diary: Secondary outcomes from the Psoriasis Study of Health Outcomes through 12 weeks. J Eur Acad Dermatol Venereol 2023; 37:1825-1840. [PMID: 37147855 DOI: 10.1111/jdv.19161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Rapid skin improvement is a key treatment goal of patients with moderate-to-severe psoriasis (PsO). OBJECTIVES To compare the speed of clinical improvement of approved biologics on the symptoms and signs of psoriasis assessed by patients using the validated Psoriasis Symptoms and Signs Diary (PSSD) through 12 weeks. METHODS Psoriasis Study of Health Outcomes (PSoHO) is an international, prospective, non-interventional study that compares the effectiveness of anti-interleukin (IL)-17A biologics versus other biologics, together with pairwise comparisons of ixekizumab versus five individual biologics in patients with PsO. Using the PSSD 7-day recall period, patients assessed the symptoms (itch, skin tightness, burning, stinging and pain) and signs (dryness, cracking, scaling, shedding/flaking, redness and bleeding) of their psoriasis (0-10). Symptom and sign summary scores (0-100) are derived from the average of individual scores. Percentage change in summary scores and proportion of patients with clinically meaningful improvements (CMI) in PSSD summary and individual scores are evaluated weekly. Longitudinal PSSD data are reported as observed with treatment comparisons analysed using mixed model for repeated measures (MMRM) and generalized linear mixed models (GLMM). RESULTS Across cohorts and treatments, eligible patients (n = 1654) had comparable baseline PSSD scores. From Week 1, the anti-IL-17A cohort achieved significantly larger score improvements in PSSD summary scores and a higher proportion of patients showed CMIs compared to the other biologics cohort through 12 weeks. Lower PSSD scores were associated with a greater proportion of patients reporting their psoriasis as no longer impacting their quality-of-life (DLQI 0,1) and a high level of clinical response (PASI100). Results also indicate a relationship between an early CMI in PSSD score at Week 2 and PASI100 score at Week 12. CONCLUSIONS Treatment with anti-IL-17A biologics, particularly ixekizumab, resulted in rapid and sustained patient-reported improvements in psoriasis symptoms and signs compared with other biologics in a real-world setting.
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Affiliation(s)
- A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - A Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J-T Maul
- Department of Dermatology and Venereology, University Hospital of Zürich and Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - R B Vender
- Dermatrials Research Inc. and Venderm Consulting, Hamilton, Ontario, Canada
| | - T Torres
- Department of Dermatology and Dermatology Research Unit, Centro Hospitalar Universitário do Porto, University of Porto, Porto, Portugal
| | - A Brnabic
- Eli Lilly and Company, Indiana, Indianapolis, USA
| | - N Haustrup
- Eli Lilly and Company, Indiana, Indianapolis, USA
| | - C Reed
- Eli Lilly and Company, Indiana, Indianapolis, USA
| | - C Schuster
- Eli Lilly and Company, Indiana, Indianapolis, USA
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - E Riedl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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Dos Reis Annunciato D, Oliveira TL, Magalhães VO, de Medeiros Pinheiro M. Extra-musculoskeletal manifestations driving the therapeutic decision-making in patients with Spondyloarthritis: a 12-month follow-up prospective cohort study. Adv Rheumatol 2023; 63:44. [PMID: 37626417 DOI: 10.1186/s42358-023-00324-0] [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: 02/20/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The extra-musculoskeletal manifestations (EMMs) such as recurrent acute anterior uveitis (rAAU), psoriasis (Ps), and inflammatory bowel disease (IBD), are related to the Spondyloarthritis (SpA), as well as they are associated with disease activity and poor prognosis. However, there are no data addressing its relevance regarding therapeutic decision-making in clinical practice. OBJECTIVE To evaluate the impact of EMMs to drive the treatment decision-making in patients with SpA in a 12-month follow-up. PATIENTS AND METHODS SpA patients, according to the axial and peripheral ASAS classification criteria, as well as CASPAR criteria, with any active EMM, defined as main entry criteria, were included in this longitudinal cohort study. Individuals with a history of any disease or condition that could be associated with some of the studied endpoints, including neoplasms and infectious diseases, were excluded. Specific tools related to each EMM, including Psoriasis Area Severity Index (PASI), ophthalmologic evaluation, according to the Standardization of Uveitis Nomenclature (SUN) criteria, and gut complaints were used at baseline and during the 3-, 6- and 12-month of follow-up as outcomes measures over time. Descriptive and inferential analyses were used appropriately, including Pearson's correlation test, chi-squared test, and ANOVA. P value less than 0.05 was considered as significant. RESULTS A total of 560 patients were enrolled, of whom 472 meet the eligibility criteria. The majority (N = 274; 59.6%) had one or more EMM related to SpA umbrella concept. Among the EMM, the one that most influenced therapeutic decision-making was psoriasis (28.5%), followed by uveitis (17.5%) and IBD (5.5%), regardless of musculoskeletal manifestations. Clinical improvement of EMMs outcomes was observed in most patients over 12-month follow-up, especially in those with rAAU and IBD (P < 0.001). CONCLUSION Our results showed that EMMs guided the therapeutic decision-making in half of SpA patients, regardless of musculoskeletal condition, suggesting the inter-disciplinarity among the rheumatologist, ophthalmologist, dermatologist, and gastroenterologist plays a crucial role to manage them.
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Affiliation(s)
- Danielle Dos Reis Annunciato
- Spondyloarthritis Section, Rheumatology Division, Federal University of São Paulo (Unifesp/EPM), Borges Lagoa Street, 913/ 51-53, Vila Clementino, São Paulo, SP, 04038-034, Brazil
| | - Thauana Luiza Oliveira
- Spondyloarthritis Section, Rheumatology Division, Federal University of São Paulo (Unifesp/EPM), Borges Lagoa Street, 913/ 51-53, Vila Clementino, São Paulo, SP, 04038-034, Brazil
| | - Vanessa Oliveira Magalhães
- Spondyloarthritis Section, Rheumatology Division, Federal University of São Paulo (Unifesp/EPM), Borges Lagoa Street, 913/ 51-53, Vila Clementino, São Paulo, SP, 04038-034, Brazil
| | - Marcelo de Medeiros Pinheiro
- Spondyloarthritis Section, Rheumatology Division, Federal University of São Paulo (Unifesp/EPM), Borges Lagoa Street, 913/ 51-53, Vila Clementino, São Paulo, SP, 04038-034, Brazil.
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14
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Suriano ES, Souza MDM, Kobata CM, Santos FHY, Mimica MJ. Efficacy of an adjuvant Lactobacillus rhamnosus formula in improving skin lesions as assessed by PASI in patients with plaque psoriasis from a university-affiliated, tertiary-referral hospital in São Paulo (Brazil): a parallel, double-blind, randomized clinical trial. Arch Dermatol Res 2023; 315:1621-1629. [PMID: 36757438 DOI: 10.1007/s00403-023-02553-1] [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: 10/01/2022] [Revised: 12/03/2022] [Accepted: 01/22/2023] [Indexed: 02/10/2023]
Abstract
Psoriasis is an inflammatory disease of the skin, characterized by erythematous plaques. It is rather common, affecting 2-4% of the population in western countries. Psoriasis' etiology encompasses both genetic and environmental factors. Evidence suggests that the latter reflect the importance of changes in the microbiome for developing the disease. Thus, it is hypothesized that gut microbiome manipulation may arise as a way of treating psoriasis. However, few trials assessed the use of probiotics in psoriasis, although promising results were detected in small studies. Our objective was to assess the efficacy of adjuvant probiotics (Lactobacillus rhamnosus) in treating plaque psoriasis patients. This was a randomized, parallel, placebo-controlled, double-blind trial with two arms: experimental (n = 50) and control (n = 53). Inclusion of subjects and data gathering lasted from November 2020 to August 2021. Subjects were consecutive plaque psoriasis patients under regular follow-up in the Dermatology unit of a university-affiliated, tertiary-referral hospital in São Paulo (Brazil). Eligibility criteria included being over 18 years old, having plaque psoriasis and not having other skin diseases, neoplasms nor systemic inflammatory diseases. Subjects received standard-of-care plus probiotics (Lactobacillus rhamnosus formula). Controls received standard-of-care plus placebo. Primary outcome was skin lesion improvement as assessed by psoriasis area of severity index (PASI) at six months. Secondary outcome was quality-of-life as assessed by dermatology life quality index (DLQI) at six months. Regarding within-group analyses, changes in both PASI and DLQI were non-significant for the experimental group (mean PASI decreased by 1.58, p = 0.105, and mean DLQI increased by 0.05, p = 0.873) and significant for controls (mean PASI decreased by 1.90, p = 0.019, and mean DLQI decreased by 3.33, p = 0.031). Between-group analyses returned non-significant results (p = 0.620). Our findings do not support the hypothesis that gut microbiome modulation via ingestion of Lactobacillus rhamnosus produces clinical improvement in psoriasis patients. Further research is encouraged.Trial registration: Retrospectively registered at the Brazilian Clinical Trials Registry (RBR-8js7t83) on 08/02/2022.
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Affiliation(s)
- Enrico Stefano Suriano
- Santa Casa de São Paulo Medical School, R. Dr. Cesário Mota Júnior, 61 Vila Buarque, São Paulo, SP, 01221020, Brazil.
- Rua Corrientes, 135, Apartment 42W, Lapa, São Paulo, SP, 05076010, Brazil.
| | - Marília Diogo Moço Souza
- Santa Casa de São Paulo Medical School, R. Dr. Cesário Mota Júnior, 61 Vila Buarque, São Paulo, SP, 01221020, Brazil
| | - Clarice Marie Kobata
- Santa Casa de São Paulo Medical School, R. Dr. Cesário Mota Júnior, 61 Vila Buarque, São Paulo, SP, 01221020, Brazil
| | - Felipe Henrique Yazawa Santos
- Santa Casa de São Paulo Medical School, R. Dr. Cesário Mota Júnior, 61 Vila Buarque, São Paulo, SP, 01221020, Brazil
| | - Marcelo Jenné Mimica
- Santa Casa de São Paulo Medical School, R. Dr. Cesário Mota Júnior, 61 Vila Buarque, São Paulo, SP, 01221020, Brazil
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Matwiejuk M, Mysliwiec H, Lukaszuk B, Lewoc M, Malla H, Mysliwiec P, Dadan J, Chabowski A, Flisiak I. The Interplay between Bioactive Sphingolipids in the Psoriatic Skin and the Severity of the Disease. Int J Mol Sci 2023; 24:11336. [PMID: 37511095 PMCID: PMC10378918 DOI: 10.3390/ijms241411336] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Psoriasis is a complex chronic immunologically mediated disease that may involve skin, nails, and joints. It is characterized by hyperproliferation, deregulated differentiation, and impaired apoptosis of keratinocytes. Sphingolipids, namely ceramide, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate, are signal molecules that may regulate cell growth, immune reactions, and apoptosis. Fifteen patients with psoriasis and seventeen healthy persons were enrolled in the study. Skin samples were taken from psoriatic lesions and non-lesional areas. Tissue concentration of ceramides, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate was measured by liquid chromatography. We assessed that all levels of ceramides, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate were higher in lesioned psoriatic skin than in non-affected skin. The profile of bioactive lipids in the lesional skin of patients with psoriasis differed significantly from non-involved psoriatic skin and skin in healthy subjects.
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Affiliation(s)
- Mateusz Matwiejuk
- Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland
| | - Hanna Mysliwiec
- Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland
| | - Bartłomiej Lukaszuk
- Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Marta Lewoc
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Hend Malla
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Piotr Mysliwiec
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Jacek Dadan
- 1st Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland
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Moreira CR, de Alcântara CC, Flauzino T, Martin LMM, Lozovoy MAB, Reiche EMV, Simão ANC. IL36G genetic variant is independently associated with susceptibility, severity and joint involvement in psoriasis. Mol Immunol 2023; 159:69-75. [PMID: 37285630 DOI: 10.1016/j.molimm.2023.05.010] [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: 01/30/2023] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
Psoriasis (PsO) is a chronic, immune-mediated, inflammatory and polygenic dermatosis associated with both physical and psychological burden that can be triggered by injury, trauma, infections and medications. The etiology of PsO is not fully elucidated but genetic, epigenetic and environmental factors are all likely to play a role. A case-control study was carried out to evaluate the frequency of the IL36G C>T (rs13392494) and the IL36G A>G (rs7584409) variants and their association with susceptibility, joint involvement and severity of PsO. The study included 154 patients with PsO and 154 controls from Brazilian population. The severity of PsO was assessed by the Psoriasis Area and Severity Index (PASI). The IL36G (rs13392494 and rs7584409) variants were genotyped by allelic discrimination assay using the real-time polymerase chain reaction. The association between the IL36G genetic variants and the study variables was analyzed in allelic, dominant, codominant, overdominant, recessive, and haplotype models. The main results were that PsO patients were older (p < 0.001) and had higher body mass index (p < 0.001) than controls; 95.8% of the patients had plaque PsO, 16.1% had psoriatic arthritis (PsA), and 27.9% had PASI > 10. The IL36G rs1339294 variant showed no association with PsO in all genetic models while the IL36G rs7584409 variant showed a protective effect in PsO. However, the G allele of the IL36G rs7584409 in the dominant model was positively associated with PASI > 10 (p = 0.031). Moreover, patients with the GG genotype of the IL36G rs7584409 variant had about 5.0 times more chance of PsA than those with the AA genotype (p = 0.014). Regarding the haplotypes, the C/A in a recessive model (CACA versus C/G and T/A carriers) was associated with PsO (p = 0.035) while the C/G haplotype in a dominant model (C/A carriers versus C/G and T/A carriers) showed a protective effect for PsO (p = 0.041). In conclusion, the G allele of the IL36G rs7584409 variant was associated with protection to PsO; however, in patients with PsO, this same allele was associated with moderate to severe disease and PsA. These results suggest that the IL36G rs7584409 variant may be used as a possible genetic biomarker to predict severity and joint involvement of PsO.
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Affiliation(s)
- Cássio Rafael Moreira
- Outpatient Clinic of Dermatology, University Hospital, State University of Londrina, Londrina, PR, Brazil
| | | | - Tamires Flauzino
- Laboratory of Research in Applied Immunology, State University of Londrina, Londrina, PR, Brazil
| | - Ligia Marcia Mario Martin
- Outpatient Clinic of Dermatology, University Hospital, State University of Londrina, Londrina, PR, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Laboratory of Research in Applied Immunology, State University of Londrina, Londrina, PR, Brazil; Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil.
| | - Andréa Name Colado Simão
- Laboratory of Research in Applied Immunology, State University of Londrina, Londrina, PR, Brazil; Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
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17
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Wang J, Zhu Q, Li F, Xiao M, Liu J. Clinical, dermoscopic, and ultrasonic monitoring of the response to biologic treatment in patients with moderate-to-severe plaque psoriasis. Front Med (Lausanne) 2023; 10:1162873. [PMID: 37435540 PMCID: PMC10330810 DOI: 10.3389/fmed.2023.1162873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/02/2023] [Indexed: 07/13/2023] Open
Abstract
Background Assessment of therapeutic response of psoriasis has relied traditionally on clinical observation, and effective non-invasive tools are desirable. Objectives To investigate the value of dermoscopy and high-frequency ultrasound (HFUS) in the monitoring of psoriatic lesions treated with biologics. Methods Patients with moderate-to-severe plaque psoriasis treated with biologics were evaluated by clinical, dermoscopic, and ultrasonic scores at weeks 0, 4, 8, and 12. Clinical scores, including Psoriasis Area Severity Index (PASI) and target lesion score (TLS), were evaluated at representative lesions. Dermoscopy was performed to assess the red background, vessels, and scales on a 4-point scale as well as the presence of hyperpigmentation, hemorrhagic spots, and linear vessels. HFUS was performed to measure the thicknesses of the superficial hyperechoic band and subepidermal hypoechoic band (SLEB). The correlation between clinical, dermoscopic, and ultrasonic evaluation was also analyzed. Results In total, 24 patients were analyzed and achieved 85.3 and 87.5% reduction of PASI and TLS, respectively, after 12 weeks of treatment. The red background, vessels, and scales scores under dermoscopy were reduced by 78.5, 84.1, and 86.5%, respectively. Some patients developed hyperpigmentation and linear vessels after treatment. Hemorrhagic dots slowly subside over the therapeutic course. Ultrasonic scores were significantly improved with an average reduction of 53.9% in superficial hyperechoic band thickness and 89.9% in SLEB thickness. TLS in the clinical variables, scales in dermoscopic variables, and SLEB in ultrasonic variables decreased the most significantly in the early stage of treatment (week 4) with 55.4, 57.7, and 59.1% (P > 0.05), respectively. Most of the variables, including the red background, vessels, scales, and SLEB thickness, were strongly correlated with TLS. High correlations were also found between the SLEB thickness and the red background or vessels scores, and between the superficial hyperechoic band thickness and the scales scores. Conclusion Both dermoscopy and HFUS were useful in the therapeutic monitoring of moderate-to-severe plaque psoriasis.
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Affiliation(s)
- Juncheng Wang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Qingli Zhu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Li
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Mengsu Xiao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Liu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
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18
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Elsherbeni MB, Neinaa YMEH, Fawzy MM, Elwan NM. Impact of NB-UVB phototherapy on Caveolin-1 expression in chronic plaque psoriasis. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:218-225. [PMID: 35860958 DOI: 10.1111/phpp.12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/26/2022] [Accepted: 07/15/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Caveolin-1 (Cav-1) is a significant structural and regulatory constituent of cell membranes that has been implicated in cell kinetics and inflammation. OBJECTIVE To assess Cav-1 expression in psoriasis before and after phototherapy. PATIENTS AND METHODS Thirty psoriasis cases and 30 healthy controls were recruited. Cases were managed with narrow band-ultraviolet B (NB-UVB) phototherapy at frequency three times per week for 12 weeks. From every case, two biopsy specimens were gained from psoriatic lesions (pre and post phototherapy), in addition to one from apparently normal skin of psoriasis cases. Regarding the control group, one biopsy was taken from a matched site. All were studied for Cav-1 antibody immuno-expression. RESULTS There was a significant decrease in Cav-1 expression in psoriatic lesions compared to both the apparently normal skin of psoriasis patients and standard control skin of healthy individuals. After NB-UVB phototherapy, significant upregulation of Cav-1 immunostaining score was observed in previously psoriatic skin when compared to that before treatment. In addition, there were significant negative correlations between Cav-1 immunostaining score and the clinical scores of psoriasis severity including; the erythema, scaling, and induration (ESI) score and the patient psoriasis area and severity index (PASI) score. CONCLUSION Induction of Cav-1 expression may be a likely pathway for the effectiveness of NB-UVB in psoriasis. Cav-1 may be a useful marker for evaluation of psoriasis severity, disease progression, and therapeutic efficacy.
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Affiliation(s)
- Marwa B Elsherbeni
- Dermatology Department, Kafr El Sheikh Hospital of Dermatology and Leprosy, Kafr El Sheikh, Egypt
| | - Yomna Mazid El-Hamd Neinaa
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
- Dermatopathology Unite, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed M Fawzy
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nagwa M Elwan
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
- Dermatopathology Unite, Faculty of Medicine, Tanta University, Tanta, Egypt
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Schöner L, Kuklinski D, Geissler A, Busse R, Pross C. A composite measure for patient-reported outcomes in orthopedic care: design principles and validity checks. Qual Life Res 2023:10.1007/s11136-023-03395-0. [PMID: 36964454 PMCID: PMC10329084 DOI: 10.1007/s11136-023-03395-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND The complex, multidimensional nature of healthcare quality makes provider and treatment decisions based on quality difficult. Patient-reported outcome (PRO) measures can enhance patient centricity and involvement. The proliferation of PRO measures, however, requires a simplification to improve comprehensibility. Composite measures can simplify complex data without sacrificing the underlying information. OBJECTIVE AND METHODS We propose a five-step development approach to combine different PRO into one composite measure (PRO-CM): (i) theoretical framework and metric selection, (ii) initial data analysis, (iii) rescaling, (iv) weighting and aggregation, and (v) sensitivity and uncertainty analysis. We evaluate different rescaling, weighting, and aggregation methods by utilizing data of 3145 hip and 2605 knee replacement patients, to identify the most advantageous development approach for a PRO-CM that reflects quality variations from a patient perspective. RESULTS The comparison of different methods within steps (iii) and (iv) reveals the following methods as most advantageous: (iii) rescaling via z-score standardization and (iv) applying differential weights and additive aggregation. The resulting PRO-CM is most sensitive to variations in physical health. Changing weighting schemes impacts the PRO-CM most directly, while it proves more robust towards different rescaling and aggregation approaches. CONCLUSION Combining multiple PRO provides a holistic picture of patients' health improvement. The PRO-CM can enhance patient understanding and simplify reporting and monitoring of PRO. However, the development methodology of a PRO-CM needs to be justified and transparent to ensure that it is comprehensible and replicable. This is essential to address the well-known problems associated with composites, such as misinterpretation and lack of trust.
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Affiliation(s)
- Lukas Schöner
- Department of Health Care Management, Technical University Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany.
| | - David Kuklinski
- Department of Health Care Management, University of St. Gallen, St. Gallen, Switzerland
| | - Alexander Geissler
- Department of Health Care Management, University of St. Gallen, St. Gallen, Switzerland
| | - Reinhard Busse
- Department of Health Care Management, Technical University Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany
| | - Christoph Pross
- Department of Health Care Management, Technical University Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany
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Lee LL, Huo AP, Chen SL. Experiences and coping behaviours of patients with psoriasis: a qualitative study. J DERMATOL TREAT 2023; 34:2193661. [PMID: 36942918 DOI: 10.1080/09546634.2023.2193661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Psoriasis is a complex, chronic, lifelong inflammatory skin disease characterized by the development of erythematous, indurated, scaly, pruritic and often painful skin plaques, and it is currently incurable. It profoundly affects psychological wellbeing and social functioning and has significant associated co-morbidities. To improve clinical approaches, understanding of the experiences of patients with psoriasis is needed. OBJECTIVE To explore the experiences and coping behaviours of patients with psoriasis. METHODS A qualitative study approach was conducted. Through semi-structured interviews, 20 patients with psoriasis were recruited from general practices and specialist dermatology practices in a regional teaching hospital in Taiwan. Recorded interviews were transcribed and analysed by content analysis. RESULTS Three themes and nine subthemes were identified: 1. Symptoms distress: (a) trouble with scaling, (b) bothersome itching, and (c) complex pain experiences; 2. Psychological distress: (a) encountering discrimination and (b) feeling stigmatised; 3. Managing psoriasis: (a) coping with symptoms, (b) seeking alternative methods, (c) using biologic agents, and (d) changing thinking and coexisting with the disease. CONCLUSION The experience of patients with psoriasis has significant negative impacts on their lives. The findings of this study can provide healthcare professionals with a reference for the care of patients with psoriasis.
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Affiliation(s)
- Lin-Lin Lee
- Department of Nursing, Hungkuang University, Taichung 433304, Taiwan
| | - An-Ping Huo
- Department of Internal Medicine, Jen-Ai Hospital, Dali, Taichung 412224, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, Hungkuang University, Taichung 433304, Taiwan
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Yang Q, Wang J, Mi N, Zou Y. Literature Overview of the Relation Between Psoriasis and Alzheimer. Neuropsychiatr Dis Treat 2023; 19:461-468. [PMID: 36879948 PMCID: PMC9985423 DOI: 10.2147/ndt.s403854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
The most common type of dementia disease is Alzheimer, which placing a heavy burden on the healthcare system all over the world. At the same time, psoriasis is also one of the most common health problems, as a skin disease. Alzheimer's disease (AD) is more often in patients with psoriasis than in the general people. Several evidence has proved the relation between AD and psoriasis through immune-mediated pathophysiologic processes. This review aims to summary the potential relation between AD and psoriasis, and provide suggestions based on the relationship at the same time. Neurologists, dermatologists should pay attention to the relationship between Alzheimer's disease and psoriasis. Dermatology and neurology need referral each other when it is necessary.
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Affiliation(s)
- Qian Yang
- Department of Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Jing Wang
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Ningyu Mi
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Yulin Zou
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Department of Dermatology, Jinzhou Medical University Graduate Training Base, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
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Raj R, Londhe ND, Sonawane R. PsLSNetV2: End to end deep learning system for measurement of area score of psoriasis regions in color images. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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23
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Ahmad MZ, Mohammed AA, Algahtani MS, Mishra A, Ahmad J. Nanoscale Topical Pharmacotherapy in Management of Psoriasis: Contemporary Research and Scope. J Funct Biomater 2022; 14:jfb14010019. [PMID: 36662067 PMCID: PMC9867016 DOI: 10.3390/jfb14010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
Psoriasis is a typical dermal condition that has been anticipated since prehistoric times when it was mistakenly implicit in being a variant of leprosy. It is an atypical organ-specific autoimmune disorder, which is triggered by the activation of T-cells and/or B-cells. Until now, the pathophysiology of this disease is not completely explicated and still, many research investigations are ongoing. Different approaches have been investigated to treat this dreadful skin disease using various anti-psoriatic drugs of different modes of action through smart drug-delivery systems. Nevertheless, there is no ideal therapy for a complete cure of psoriasis owing to the dearth of an ideal drug-delivery system for anti-psoriatic drugs. The conventional pharmacotherapy approaches for the treatment of psoriasis demand various classes of anti-psoriatic drugs with optimum benefit/risk ratio and insignificant untoward effects. The advancement in nanoscale drug delivery had a great impact on the establishment of a nanomedicine-based therapy for better management of psoriasis in recent times. Nanodrug carriers are exploited to design and develop nanomedicine-based therapy for psoriasis. It has a promising future in the improvement of the therapeutic efficacy of conventional anti-psoriatic drugs. The present manuscript aims to discuss the pathophysiology, conventional pharmacotherapy, and contemporary research in the area of nanoscale topical drug delivery systems for better management of psoriasis including the significance of targeted pharmacotherapy in psoriasis.
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Affiliation(s)
- Mohammad Zaki Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Saudi Arabia
| | - Abdul Aleem Mohammed
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Saudi Arabia
| | - Mohammed S. Algahtani
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Saudi Arabia
| | - Awanish Mishra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati 781101, Assam, India
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Saudi Arabia
- Correspondence: or
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Lamana A, Castro-Vázquez D, de la Fuente H, Triguero-Martínez A, Martínez-Hernández R, Revenga M, Villanueva-Romero R, Llamas-Velasco M, Chicharro P, Juarranz Y, Marazuela M, Sales-Sanz M, García-Vicuña R, Tomero E, González-Álvaro I, Martínez C, Gomariz RP. VIP/VPAC Axis Expression in Immune-Mediated Inflammatory Disorders: Associated miRNA Signatures. Int J Mol Sci 2022; 23:ijms23158578. [PMID: 35955723 PMCID: PMC9369218 DOI: 10.3390/ijms23158578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/04/2022] Open
Abstract
Few studies have considered immune-mediated inflammatory disorders (IMID) together, which is necessary to adequately understand them given they share common mechanisms. Our goal was to investigate the expression of vasoactive intestinal peptide (VIP) and its receptors VPAC1 and VPAC2 in selected IMID, analyze the effect of biological therapies on them, and identify miRNA signatures associated with their expression. Serum VIP levels and mRNA of VPAC and miRNA expression in peripheral blood mononuclear cells were analyzed from 52 patients with psoriasis, rheumatoid arthritis, Graves’ disease, or spondyloarthritis and from 38 healthy subjects. IMID patients showed higher levels of VIP and increased expression of VPAC2 compared to controls (p < 0.0001 and p < 0.0192, respectively). Receiver operating characteristic curve analysis showed that the levels of VIP or VPAC2 expression were adequate discriminators capable of identifying IMID. Treatment of IMID patients with anti-TNFα and anti-IL12/23 significantly affected serum VIP levels. We identified miRNA signatures associated with levels of serum VIP and VPAC2 expression, which correlated with IMID diagnosis of the patients. The results indicate that the expression of VIP/VPAC2 is able of identify IMIDs and open up a line of research based on the association between the VIP/VPAC axis and miRNA signatures in immune-mediated diseases.
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Affiliation(s)
- Amalia Lamana
- Department of Cell Biology, Facultad de Biología y Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.L.); (D.C.-V.); (R.V.-R.); (Y.J.)
| | - David Castro-Vázquez
- Department of Cell Biology, Facultad de Biología y Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.L.); (D.C.-V.); (R.V.-R.); (Y.J.)
| | - Hortensia de la Fuente
- Department of Immunology, Instituto de Investigación Princesa, Hospital Universitario de La Princesa, 28006 Madrid, Spain;
| | - Ana Triguero-Martínez
- Department of Rheumatology, Instituto de Investigación Princesa Madrid, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (A.T.-M.); (R.G.-V.); (E.T.); (I.G.-Á.)
| | - Rebeca Martínez-Hernández
- Department of Endocrinology, Instituto de Investigación Princesa, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (R.M.-H.); (M.M.)
| | - Marcelino Revenga
- Department of Rheumatology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
- Department of Medicine and Medical Specialties, Universidad de Alcalá, 28805 Alcalá de Henares, Spain
| | - Raúl Villanueva-Romero
- Department of Cell Biology, Facultad de Biología y Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.L.); (D.C.-V.); (R.V.-R.); (Y.J.)
| | - Mar Llamas-Velasco
- Department of Dermatology, Instituto de Investigación Princesa, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (M.L.-V.); (P.C.)
| | - Pablo Chicharro
- Department of Dermatology, Instituto de Investigación Princesa, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (M.L.-V.); (P.C.)
| | - Yasmina Juarranz
- Department of Cell Biology, Facultad de Biología y Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.L.); (D.C.-V.); (R.V.-R.); (Y.J.)
| | - Mónica Marazuela
- Department of Endocrinology, Instituto de Investigación Princesa, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (R.M.-H.); (M.M.)
| | - Marco Sales-Sanz
- Department of Ophthalmology, Hospital Universitario Ramón y Cajal-IRYCIS, 28034 Madrid, Spain;
| | - Rosario García-Vicuña
- Department of Rheumatology, Instituto de Investigación Princesa Madrid, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (A.T.-M.); (R.G.-V.); (E.T.); (I.G.-Á.)
| | - Eva Tomero
- Department of Rheumatology, Instituto de Investigación Princesa Madrid, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (A.T.-M.); (R.G.-V.); (E.T.); (I.G.-Á.)
| | - Isidoro González-Álvaro
- Department of Rheumatology, Instituto de Investigación Princesa Madrid, Hospital Universitario de La Princesa, 28006 Madrid, Spain; (A.T.-M.); (R.G.-V.); (E.T.); (I.G.-Á.)
| | - Carmen Martínez
- Department of Cell Biology, Facultad de Biología y Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.L.); (D.C.-V.); (R.V.-R.); (Y.J.)
- Correspondence: (C.M.); (R.P.G.); Tel.: +34-91-3944971 (R.P.G.)
| | - Rosa P. Gomariz
- Department of Cell Biology, Facultad de Biología y Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.L.); (D.C.-V.); (R.V.-R.); (Y.J.)
- Correspondence: (C.M.); (R.P.G.); Tel.: +34-91-3944971 (R.P.G.)
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Tognetti L, Damiani F, Marrocco C, Mariotti G, Trovato E, Cinotti E, Marcolongo P, Pellegrino M, Rubegni P. Evaluation of 11-β hydroxysteroid dehydrogenase type 1 in cutaneous fibroblasts cultures of psoriatic lesional skin before and after narrow band-UVB phototherapy. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:391-394. [PMID: 34743342 PMCID: PMC9541928 DOI: 10.1111/phpp.12752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Linda Tognetti
- Department of ClinicalDermatology Unit and Skin Bank UnitSurgical and NeurosciencesUniversity of SienaSienaItaly
| | - Francesco Damiani
- Department of Molecular and Developmental MedicineUniversity of SienaSienaItaly
| | - Camilla Marrocco
- Department of ClinicalDermatology Unit and Skin Bank UnitSurgical and NeurosciencesUniversity of SienaSienaItaly
| | - Giancarlo Mariotti
- Department of ClinicalDermatology Unit and Skin Bank UnitSurgical and NeurosciencesUniversity of SienaSienaItaly
| | - Emanuele Trovato
- Department of ClinicalDermatology Unit and Skin Bank UnitSurgical and NeurosciencesUniversity of SienaSienaItaly
| | - Elisa Cinotti
- Department of ClinicalDermatology Unit and Skin Bank UnitSurgical and NeurosciencesUniversity of SienaSienaItaly
| | - Paola Marcolongo
- Department of Molecular and Developmental MedicineUniversity of SienaSienaItaly
| | | | - Pietro Rubegni
- Department of ClinicalDermatology Unit and Skin Bank UnitSurgical and NeurosciencesUniversity of SienaSienaItaly
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Siriyong T, Ontong JC, Khochitmet L, Naunklab P, Phungtammasan S, Chanwanitsakul S, Terbtothakun P, Voravuthikunchai SP. Successful treatment of refractory erythrodermic psoriasis with traditional Thai herbal medicine. Explore (NY) 2022; 19:396-404. [PMID: 35810121 DOI: 10.1016/j.explore.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/17/2022] [Accepted: 06/29/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Thai herbal formulations have been used traditionally in Thailand for the treatment of psoriasis. However, there is still a lack of scientific data supporting the effects of Thai herbal formulations in psoriasis treatment. OBJECTIVES This study aimed to demonstrate the therapeutic effects of Thai herbal formulations for the treatment of erythrodermic psoriasis. MATERIALS AND METHODS All Thai herbal formulations (haematic tonic, lymphatic treatment, skin treatment) were obtained from a traditional Thai medicine doctor, Mr. Somporn Chanwanitsakul. The effects of Thai herbal formulations in a patient with erythrodermic psoriasis were assessed for four weeks. Primary outcome, psoriasis area and severity index (PASI) and secondary outcome, safety data and dermatology life quality index (DLQI) measurements were evaluated at baseline and four weeks. Then, in vitro biological activities (antioxidant, anti-microbial, cytotoxic effects, and anti-inflammatory) of Thai herbal formulations were determined to promote the therapeutic effects. RESULTS Thai herbal formulations were safe and effective in the treatment of erythrodermic psoriasis and had a modest positive impact on the DQLI of the patient. In addition, in vitro studies have shown that all Thai herbal formulations revealed remarkable anti-oxidant and anti-inflammatory potential to support their therapeutic activities. However, the Thai herbal formulations possessed weak intrinsic antibacterial activities against all tested bacterial strains (MIC and MBC E. coli, S. aureus, S. pyogenes, P. aeruginosa: > 256 µg/ml). CONCLUSION The findings indicated that successful treatment of erythrodermic psoriasis with Thai herbal formulations was involved in their anti-oxidant and anti-inflammatory activities. They could be considered as an alternative treatment for refractory erythrodermic psoriasis.
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Krajina I, Stupin A, Šola M, Mihalj M. Oxidative Stress Induced by High Salt Diet—Possible Implications for Development and Clinical Manifestation of Cutaneous Inflammation and Endothelial Dysfunction in Psoriasis vulgaris. Antioxidants (Basel) 2022; 11:antiox11071269. [PMID: 35883760 PMCID: PMC9311978 DOI: 10.3390/antiox11071269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023] Open
Abstract
Although oxidative stress is recognized as an important effector mechanism of the immune system, uncontrolled formation of reactive oxygen and nitrogen species promotes excessive tissue damage and leads to disease development. In view of this, increased dietary salt intake has been found to damage redox systems in the vessel wall, resulting in endothelial dysfunction associated with NO uncoupling, inflammation, vascular wall remodeling and, eventually, atherosclerosis. Several studies have reported increased systemic oxidative stress accompanied by reduced antioxidant capacity following a high salt diet. In addition, vigorous ionic effects on the immune mechanisms, such as (trans)differentiation of T lymphocytes are emerging, which together with the evidence of NaCl accumulation in certain tissues warrants a re-examination of the data derived from in vitro research, in which the ionic influence was excluded. Psoriasis vulgaris (PV), as a primarily Th17-driven inflammatory skin disease with proven inflammation-induced accumulation of sodium chloride in the skin, merits our interest in the role of oxidative stress in the pathogenesis of PV, as well as in the possible beneficial effects that could be achieved through modulation of dietary salt intake and antioxidant supplementation.
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Affiliation(s)
- Ivana Krajina
- Department of Dermatology and Venereology, Osijek University Hospital, J. Huttlera 4, HR-31000 Osijek, Croatia;
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Ana Stupin
- Scientific Center of Excellence for Personalized Health Care, Josip Juraj Strossmayer University of Osijek, Trg Svetog Trojstva 3, HR-31000 Osijek, Croatia;
- Institute and Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Marija Šola
- Department of Dermatology and Venereology, Osijek University Hospital, J. Huttlera 4, HR-31000 Osijek, Croatia;
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Correspondence: (M.Š.); (M.M.); Tel.: +385-31-512-800 (M.M.)
| | - Martina Mihalj
- Department of Dermatology and Venereology, Osijek University Hospital, J. Huttlera 4, HR-31000 Osijek, Croatia;
- Scientific Center of Excellence for Personalized Health Care, Josip Juraj Strossmayer University of Osijek, Trg Svetog Trojstva 3, HR-31000 Osijek, Croatia;
- Institute and Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Correspondence: (M.Š.); (M.M.); Tel.: +385-31-512-800 (M.M.)
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A Pilot Study to Assess the Reliability of Digital Image-Based PASI Scores Across Patient Skin Tones and Provider Training Levels. Dermatol Ther (Heidelb) 2022; 12:1685-1695. [PMID: 35727498 PMCID: PMC9276898 DOI: 10.1007/s13555-022-00750-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/20/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction The ability to perform psoriasis skin assessments remotely through digital image-based psoriasis area and severity index (DIB-PASI) would be a valuable tool for psoriasis clinical trials. An ideal teledermatological assessment would be robust across patients of diverse skin tones as well as across assessors of varying experience levels. In this pilot study, we evaluated the reliability of face-to-face (FTF) versus DIB-PASI scores determined by trained clinical assessors with a spectrum of experience and with patients of different skin tones. Methods Fourteen subjects of varying skin tones with moderate-to-severe plaque psoriasis were treated with adalimumab. In-person PASI assessments and digital photography were performed in the clinic at weeks 0, 12, and 24. Photographs were reviewed by four independent assessors to derive a digital image-based PASI score. The concordance of face-to-face PASI (FTF-PASI) and DIB-PASI were analyzed across patient and assessor factors. Results Overall concordance between FTF-PASI and DIB-PASI was high (ICC 0.82, p < 0.0001), with good agreement across individual assessors. When analyzed by PASI score component or body region, digital assessors also demonstrated good agreement with the FTF assessor. Similarly, DIB-PASI showed high concordance with FTF-PASI for patients with light skin tones and patients with medium-to-dark skin tones, and across clinical training levels. Conclusion Overall, PASI scores derived from digital images showed good agreement with those determined in person. Importantly, these remote assessments were reliable for both light and medium-to-dark skin tones, and robust to training level of the assessor. The findings from this pilot study lay the foundation for expanding teledermatology-based clinical trials for patients with psoriasis and enabling accurate, remote monitoring of disease severity and therapy response. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-022-00750-w.
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Parmar PK, Sharma N, Wasil Kabeer S, Rohit A, Bansal AK. Nanocrystal-based gel of apremilast ameliorates imiquimod-induced psoriasis by suppressing inflammatory responses. Int J Pharm 2022; 622:121873. [PMID: 35640806 DOI: 10.1016/j.ijpharm.2022.121873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 10/18/2022]
Abstract
Apremilast is 'difficult-to-deliver' in stratum corneum and viable layers (viable epidermis, dermis) owing to its modest lipophilicity and poor aqueous solubility, respectively. The objective of the present research was to develop apremilast nanocrystal-based gel for enhanced anti-psoriatic efficacy for the treatment of psoriasis. Nanosuspension was generated by wet media milling with a mean particle size of 200 nm. In-vivoefficacy of nanocrystal-based gels was evaluated in the imiquimod-induced psoriatic plaque model. Nanocrystal-based gel (1% and 3% w/w) improved phenotypic, histopathological features of psoriatic skin and attenuated splenic hypertrophy, psoriasis area severity scoring. Enzyme-linked immunosorbent assay was performed to evaluate levels of psoriatic biochemical markers indicating a significant decrease in the concentration of cytokines such as IL-23, IL-17A, IL-6 and TNF-α by nanocrystal-based gels (1% and 3% w/w) over disease induced group. Skin irritation study revealed that nanocrystal-based gel was significantly less irritating than the positive control. These results suggest that nanocrystal-based gel of apremilast can be an effective strategy for the management of psoriasis.
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Affiliation(s)
- Prashantkumar K Parmar
- Solid State Pharmaceutics Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Sector-67, S.A.S. Nagar, Mohali, Punjab 160 062, India
| | - Nisha Sharma
- Laboratory of Epigenetics and Diseases, Department of Pharmacology and Toxicology, NIPER, Sector-67, S.A.S. Nagar, Mohali, Punjab 160 062, India
| | - Shaheen Wasil Kabeer
- Laboratory of Epigenetics and Diseases, Department of Pharmacology and Toxicology, NIPER, Sector-67, S.A.S. Nagar, Mohali, Punjab 160 062, India
| | - Aastha Rohit
- Solid State Pharmaceutics Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Sector-67, S.A.S. Nagar, Mohali, Punjab 160 062, India
| | - Arvind K Bansal
- Solid State Pharmaceutics Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Sector-67, S.A.S. Nagar, Mohali, Punjab 160 062, India.
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Phytoecdysteroids from Serratula coronata L. for Psoriatic Skincare. Molecules 2022; 27:molecules27113471. [PMID: 35684408 PMCID: PMC9181847 DOI: 10.3390/molecules27113471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 12/10/2022] Open
Abstract
Phytoecdysones from Serratula coronata seem to be promising agents for skincare in patients with psoriasis. The aim of the study was to determine the effects of creams containing the extract of S. coronata on psoriatic lesions. Creams with different formulas were prepared: 0-Lekobaza®, 1-Lekobaza®, S. coronata, 2-Lekobaza®, Salicylic acid, 3-Lekobaza®, S. coronata, Salicylic acid. After examination of skin penetration and biosafety, the designated cream was applied twice daily for 6 weeks on 72 psoriatic plaques located on elbows or knees. The lesions were assessed at baseline and follow-up of 6 weeks. The lesions area was measured, and severity of scaling, erythema, and infiltration was assessed using a 5-point scale (from 0—none to 4—very severe). Skin hydration and structure, pH, transepidermal water loss, erythema, and melanin index were analyzed instrumentally. Creams 1, 2, and 3 significantly reduced the area of psoriatic plaques. Improvement in erythema and infiltration was observed for creams 1 and 3. Creams 1–3 reduced scaling. Our study confirmed a beneficial effect of creams containing S. coronata extract on psoriatic lesions.
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Sbidian E, Chaimani A, Garcia-Doval I, Doney L, Dressler C, Hua C, Hughes C, Naldi L, Afach S, Le Cleach L. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev 2022; 5:CD011535. [PMID: 35603936 PMCID: PMC9125768 DOI: 10.1002/14651858.cd011535.pub5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psoriasis is an immune-mediated disease with either skin or joints manifestations, or both, and it has a major impact on quality of life. Although there is currently no cure for psoriasis, various treatment strategies allow sustained control of disease signs and symptoms. The relative benefit of these treatments remains unclear due to the limited number of trials comparing them directly head-to-head, which is why we chose to conduct a network meta-analysis. OBJECTIVES To compare the efficacy and safety of non-biological systemic agents, small molecules, and biologics for people with moderate-to-severe psoriasis using a network meta-analysis, and to provide a ranking of these treatments according to their efficacy and safety. SEARCH METHODS For this update of the living systematic review, we updated our searches of the following databases monthly to October 2021: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase. SELECTION CRITERIA Randomised controlled trials (RCTs) of systemic treatments in adults over 18 years with moderate-to-severe plaque psoriasis, at any stage of treatment, compared to placebo or another active agent. The primary outcomes were: proportion of participants who achieved clear or almost clear skin, that is, at least Psoriasis Area and Severity Index (PASI) 90; proportion of participants with serious adverse events (SAEs) at induction phase (8 to 24 weeks after randomisation). DATA COLLECTION AND ANALYSIS We conducted duplicate study selection, data extraction, risk of bias assessment and analyses. We synthesised data using pairwise and network meta-analysis (NMA) to compare treatments and rank them according to effectiveness (PASI 90 score) and acceptability (inverse of SAEs). We assessed the certainty of NMA evidence for the two primary outcomes and all comparisons using CINeMA, as very low, low, moderate, or high. We contacted study authors when data were unclear or missing. We used the surface under the cumulative ranking curve (SUCRA) to infer treatment hierarchy, from 0% (worst for effectiveness or safety) to 100% (best for effectiveness or safety). MAIN RESULTS This update includes an additional 19 studies, taking the total number of included studies to 167, and randomised participants to 58,912, 67.2% men, mainly recruited from hospitals. Average age was 44.5 years, mean PASI score at baseline was 20.4 (range: 9.5 to 39). Most studies were placebo-controlled (57%). We assessed a total of 20 treatments. Most (140) trials were multicentric (two to 231 centres). One-third of the studies (57/167) had high risk of bias; 23 unclear risk, and most (87) low risk. Most studies (127/167) declared funding by a pharmaceutical company, and 24 studies did not report a funding source. Network meta-analysis at class level showed that all interventions (non-biological systemic agents, small molecules, and biological treatments) showed a higher proportion of patients reaching PASI 90 than placebo. Anti-IL17 treatment showed a higher proportion of patients reaching PASI 90 compared to all the interventions, except anti-IL23. Biologic treatments anti-IL17, anti-IL12/23, anti-IL23 and anti-TNF alpha showed a higher proportion of patients reaching PASI 90 than the non-biological systemic agents. For reaching PASI 90, the most effective drugs when compared to placebo were (SUCRA rank order, all high-certainty evidence): infliximab (risk ratio (RR) 50.19, 95% CI 20.92 to 120.45), bimekizumab (RR 30.27, 95% CI 25.45 to 36.01), ixekizumab (RR 30.19, 95% CI 25.38 to 35.93), risankizumab (RR 28.75, 95% CI 24.03 to 34.39). Clinical effectiveness of these drugs was similar when compared against each other. Bimekizumab, ixekizumab and risankizumab showed a higher proportion of patients reaching PASI 90 than other anti-IL17 drugs (secukinumab and brodalumab) and guselkumab. Infliximab, anti-IL17 drugs (bimekizumab, ixekizumab, secukinumab and brodalumab) and anti-IL23 drugs (risankizumab and guselkumab) except tildrakizumab showed a higher proportion of patients reaching PASI 90 than ustekinumab and three anti-TNF alpha agents (adalimumab, certolizumab and etanercept). Ustekinumab was superior to certolizumab; adalimumab and ustekinumab were superior to etanercept. No significant difference was shown between apremilast and two non-biological drugs: ciclosporin and methotrexate. We found no significant difference between any of the interventions and the placebo for the risk of SAEs. The risk of SAEs was significantly lower for participants on methotrexate compared with most of the interventions. Nevertheless, the SAE analyses were based on a very low number of events with low- to moderate-certainty for all the comparisons (except methotrexate versus placebo, which was high-certainty). The findings therefore have to be viewed with caution. For other efficacy outcomes (PASI 75 and Physician Global Assessment (PGA) 0/1), the results were similar to the results for PASI 90. Information on quality of life was often poorly reported and was absent for several of the interventions. AUTHORS' CONCLUSIONS Our review shows that, compared to placebo, the biologics infliximab, bimekizumab, ixekizumab, and risankizumab were the most effective treatments for achieving PASI 90 in people with moderate-to-severe psoriasis on the basis of high-certainty evidence. This NMA evidence is limited to induction therapy (outcomes measured from 8 to 24 weeks after randomisation), and is not sufficient for evaluating longer-term outcomes in this chronic disease. Moreover, we found low numbers of studies for some of the interventions, and the young age (mean 44.5 years) and high level of disease severity (PASI 20.4 at baseline) may not be typical of patients seen in daily clinical practice. We found no significant difference in the assessed interventions and placebo in terms of SAEs, and the safety evidence for most interventions was low to moderate quality. More randomised trials directly comparing active agents are needed, and these should include systematic subgroup analyses (sex, age, ethnicity, comorbidities, psoriatic arthritis). To provide long-term information on the safety of treatments included in this review, an evaluation of non-randomised studies and postmarketing reports from regulatory agencies is needed. Editorial note: This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Emilie Sbidian
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Clinical Investigation Centre, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Anna Chaimani
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, F-75004, Paris, France
- Cochrane France, Paris, France
| | - Ignacio Garcia-Doval
- Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Liz Doney
- Cochrane Skin, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Corinna Dressler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Camille Hua
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Carolyn Hughes
- c/o Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - Luigi Naldi
- Centro Studi GISED (Italian Group for Epidemiologic Research in Dermatology) - FROM (Research Foundation of Ospedale Maggiore Bergamo), Padiglione Mazzoleni - Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Sivem Afach
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Laurence Le Cleach
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
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Aljefri YE, Ghaddaf AA, Alkhunani TA, Alkhamisi TA, Alahmadi RA, Alamri AM, Alraddadi AA. Efficacy and Safety of Apremilast Monotherapy in moderate-to-severe Plaque Psoriasis: A Systematic Review and Meta-analysis. Dermatol Ther 2022; 35:e15544. [PMID: 35499185 DOI: 10.1111/dth.15544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/29/2022] [Accepted: 04/23/2022] [Indexed: 12/01/2022]
Abstract
Psoriasis is a chronic, inflammatory, immune-mediated disease of the skin and joints. Plaque psoriasis is the most common clinical phenotype of psoriasis. Apremilast is an oral phosphodiesterase type 4 inhibitor recently approved by the US Food and Drug Administration (FDA) for the management of plaque psoriasis. To assess the efficacy and safety of apremilast monotherapy for the treatment of moderate-to-severe plaque psoriasis. This systematic review included randomized controlled trials (RCTs) comparing apremilast 20 mg twice daily (BID) and 30 mg BID with placebo for its efficacy on plaque psoriasis. We searched the Embase, Medline, and CENTRAL databases. We sought to evaluate the following outcomes: psoriasis area and severity index score (PASI)-50, PASI-75, PASI-90, static Physician Global Assessment (sPGA), and adverse events. The risk ratio (RR) was used to represent dichotomous outcomes and adverse events, and the data were pooled using the inverse variance weighting method. Eight RCTs that enrolled 2635 participants were deemed eligible. Apremilast 30 mg BID and 20 mg BID were significantly more efficacious than placebo in achieving PASI-75 over 16 weeks (RR = 4.60, 95% CI 3.29-6.41, and RR = 3.15, 95% CI 1.96-5.07, respectively). Apremilast 30 mg BID showed a significantly higher rate of adverse events than the placebo (RR = 1.24, 95% CI 1.16-1.33), whereas apremilast 20 mg BID did not exhibit any significant difference (RR = 1.13, 95% CI 0.91-1.42). This meta-analysis demonstrated that apremilast monotherapy is an effective therapeutic option for moderate-to-severe plaque psoriasis with acceptable tolerability and safety profile.
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Affiliation(s)
- Yara E Aljefri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah A Ghaddaf
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Tala A Alkhunani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Taif A Alkhamisi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rana A Alahmadi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Awadh M Alamri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,Department of Dermatology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ali A Alraddadi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,Department of Dermatology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Farag AGA, Shoaib MAA, Labeeb AZ, Sleem AS, Hussien HAAEW, Elshaib ME, Hanout HMA. S100A8 (rs3806232) gene polymorphism and S100A8 serum level in psoriasis vulgaris patients: A preliminary study. J Cosmet Dermatol 2022; 21:4974-4982. [PMID: 35316567 DOI: 10.1111/jocd.14928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/06/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND S100A8 single nucleotide polymorphism (SNP) and S100A8 blood level are related to many inflammatory disorders with no available conclusion in psoriasis. AIM to evaluate the possible role of S100A8 in psoriasis pathogenesis through analyzing its S100A8 (rs3806232) gene polymorphism and S100A8 serum level in psoriasis vulgaris patients, in addition to correlate the detected results with severity psoriasis in those patients. METHODS This case-control study was conducted on 50 patients having psoriasis vulgaris, and 26 controls. Severity of psoriasis was evaluated using psoriasis area and severity index (PASI) score. S100A8 serum level and S100A8 (rs3806232) SNP were evaluated by ELISA and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) respectively. RESULTS Serum S100A8 level was significantly higher in psoriatic patients than controls and was positively correlated with PASI score (r=0.826, p<0.001). S100A8 (rs3806232) AA genotype and A allele were significantly increased among psoriasis patients than controls (p<0.001) increasing risk of psoriasis development by about 5, 12 and 6 times than AG, GG and G allele. AA genotype was significantly associated with psoriasis severity (p=0.005), and high S100A8 serum levels (P= 0.018). CONCLUSIONS Circulating S100A8 could associated with disease severity and have an active role in psoriasis pathogenesis. S100A8 (rs3806232) SNP (AA genotype and A allele) might contribute to development and severity of psoriasis in the Egyptian population.
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Affiliation(s)
- Azza Gaber Antar Farag
- Dermatology, Andrology and STDs department, Faculty of Medicine, Menoufia University, Egypt
| | | | - Azza Zagloul Labeeb
- Microbiology and Immunology department, Faculty of Medicine, Menoufia University, Egypt
| | - Asmaa Shaaban Sleem
- Microbiology and Immunology department, Faculty of Medicine, Menoufia University, Egypt
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Carrascosa J, Puig L, Belinchón Romero I, Salgado-Boquete L, del Alcázar E, Andrés Lencina J, Moreno D, de la Cueva P. [Translated article] Practical Update of the Recommendations Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPs) on the Treatment of Psoriasis with Biologic Therapy. Part 1. Concepts and General Management of Psoriasis With Biologic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Carrascosa JM, Puig L, Belinchón Romero I, Salgado-Boquete L, Del Alcázar E, Andrés Lencina JJ, Moreno D, de la Cueva P. Practical update of the Recommendations Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPS) on the Treatment of Psoriasis with Biologic Therapy. Part 1. Concepts and General Management of Psoriasis with Biologic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:261-277. [PMID: 35526919 DOI: 10.1016/j.ad.2021.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A new, updated AEDV Psoriasis Group consensus document on the treatment of moderate to severe psoriasis was needed owing to the approval, in recent years, of a large number of new drugs and changes in the treatment paradigm. METHODOLOGY The consensus document was developed using the nominal group technique and a scoping review. First, a designated coordinator selected a group of Psoriasis Group members for the panel. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. Based on these reviews, the coordinator drew up a set of proposed recommendations, which were then discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. RESULTS The present guidelines include general principles for the treatment of patients with moderate to severe psoriasis and also define treatment goals and criteria for the indication of biologic therapy and the selection of initial and subsequent therapies. Practical issues, such as treatment failure and maintenance of response, are also addressed.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, España.
| | - L Puig
- Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - I Belinchón Romero
- Departamento de Dermatología, Hospital General Universitario de Alicante-ISABIAL, Universidad Miguel Hernández de Elche, Alicante, España
| | - L Salgado-Boquete
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - E Del Alcázar
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, España
| | - J J Andrés Lencina
- Servicio de Dermatología, Hospital Universitario Vega Baja, Alicante, España
| | - D Moreno
- Departamento de Dermatología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, España
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Song Z, Huang YY, Hou KQ, Liu L, Zhou F, Huang Y, Wan G, Luo HB, Xiong XF. Discovery and Structural Optimization of Toddacoumalone Derivatives as Novel PDE4 Inhibitors for the Topical Treatment of Psoriasis. J Med Chem 2022; 65:4238-4254. [PMID: 35188767 DOI: 10.1021/acs.jmedchem.1c02058] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Psoriasis is a common immune-mediated skin disorder manifesting in abnormal skin plaques, and phosphodiesterase 4 (PDE4) is an effective target for the treatment of inflammatory diseases such as psoriasis. Toddacoumalone is a natural PDE4 inhibitor with moderate potency and imperfect drug-like properties. To discover novel and potent PDE4 inhibitors with considerable druggability, a series of toddacoumalone derivatives were designed and synthesized, leading to the compound (2R,4S)-6-ethyl-2-(2-hydroxyethyl)-2,8-dimethyl-4-(2-methylprop-1-en-1-yl)-2,3,4,6-tetrahydro-5H-pyrano[3,2-c][1,8]naphthyridin-5-one (33a) with high inhibitory potency (IC50 = 3.1 nM), satisfactory selectivity, favorable skin permeability, and a well-characterized binding mechanism. Encouragingly, topical administration of 33a exhibited remarkable therapeutic effects in an imiquimod-induced psoriasis mouse model.
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Affiliation(s)
- Zhendong Song
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
| | - Yi-You Huang
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China.,Key Laboratory of Tropical Biological Resources of Ministry of Education, School of Pharmaceutical Sciences, Hainan University, 570228 Haikou, P. R. China
| | - Ke-Qiang Hou
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
| | - Lu Liu
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
| | - Feng Zhou
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
| | - Yue Huang
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
| | - Guohui Wan
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
| | - Hai-Bin Luo
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China.,Key Laboratory of Tropical Biological Resources of Ministry of Education, School of Pharmaceutical Sciences, Hainan University, 570228 Haikou, P. R. China
| | - Xiao-Feng Xiong
- National-Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Province Engineering Laboratory for Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, 510006 Guangzhou, P. R. China
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Endpoints for extraintestinal manifestations in inflammatory bowel disease trials: the EXTRA consensus from the International Organization for the Study of Inflammatory Bowel Diseases. Lancet Gastroenterol Hepatol 2022; 7:254-261. [DOI: 10.1016/s2468-1253(21)00297-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 12/14/2022]
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Li G, Sun L, Qiu Y, Hou Y, Du L, Zhao K, Qian J, Liu J, Ma T. Efficacy of nano-modified Runji ointment in the treatment of mild and moderate psoriasis with blood dryness syndrome: a study protocol for a double-blind randomized controlled trial. Medicine (Baltimore) 2021; 100:e28178. [PMID: 34967353 PMCID: PMC8718181 DOI: 10.1097/md.0000000000028178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 11/19/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Psoriasis is a common, recurrent, immune skin disease, which seriously affects patients' quality of life. In clinical practice, modified Runji ointment can effectively treat mild-to-moderate psoriasis with blood dryness syndrome, but there is a lack of high-quality evidence-based medical evidence. This trial aims to evaluate the efficacy and safety of nano-modified Runji ointment in the treatment of mild-to-moderate psoriasis with blood dryness syndrome. METHODS/DESIGN This study will be a randomized double-blind placebo-controlled trial. A total of 80 patients will be recruited and randomly divided into an intervention group (nano-modified Runji ointment group) and a placebo group at a ratio of 1:1. All included patients will receive 8 weeks of nano-modified Runji ointment or placebo ointment respectively, twice a day. The primary outcome will be the change in psoriasis area and disease severity index score at week 8 compared to baseline. The secondary outcomes will be rash area score, pruritus score, Dermatology Life Quality Index score, traditional Chinese medicine symptom score and adverse events. DISCUSSION This study may provide high-quality evidence for the efficacy of nano-modified Runji ointment in the treatment of mild to moderate psoriasis with blood dryness syndrome. The results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION ChiCTR, ChiCTR2000034292. Registered July 1, 2020, https://www.chictr.org.cn/edit.aspx?pid=55884&htm=4.
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Affiliation(s)
- Guanru Li
- Department of Dermatology, Beijing Traditional Chinese Medicine Hospital Shunyi Hospital, Shunyi District, Beijing, China
| | - Liyun Sun
- Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine, Dongcheng District, Beijing, China
| | - Yue Qiu
- Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine, Dongcheng District, Beijing, China
| | - Yaquan Hou
- Dongcheng District Yongdingmenwai Community Health Center, Beijing, China
| | - Libo Du
- Institute of Chemistry, Chinese Academy of Sciences, Haidian District, Beijing, China
| | - Kaixuan Zhao
- Department of Dermatology, Handan Mingren Hospital, Hebei Province, China
| | - Jiali Qian
- Department of Dermatology, Beijing Traditional Chinese Medicine Hospital Shunyi Hospital, Shunyi District, Beijing, China
| | - Jiuli Liu
- Department of Dermatology, Beijing Traditional Chinese Medicine Hospital Shunyi Hospital, Shunyi District, Beijing, China
| | - Tengfei Ma
- Department of Dermatology, Beijing Traditional Chinese Medicine Hospital Shunyi Hospital, Shunyi District, Beijing, China
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Zhong H, Yang H, Mao Z, Chai X, Li S. Impact of moderate-to-severe psoriasis on quality of life in China: a qualitative study. Health Qual Life Outcomes 2021; 19:271. [PMID: 34952591 PMCID: PMC8709994 DOI: 10.1186/s12955-021-01902-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/05/2021] [Indexed: 02/03/2023] Open
Abstract
Purpose Psoriasis is a serious health problem. Since limited research has investigated the impact of psoriasis on the quality of life of patients with moderate-to-severe psoriasis, this study aimed to explore this issue. Methods A qualitative study was conducted with 22 psoriasis patients from two cities in Shandong province of eastern China participating in one-to-one semi-structured in-depth interviews. Results Thematic analysis generated five major themes: (1) Symptoms, symptoms management and pain; (2) Functioning and activities of daily living (ADLs); (3) Psychological impact; (4) Social impact; (5) Employment and finances. Conclusion Our study detailed the effects of psoriasis on patients’ symptoms, symptoms management and pain, functioning and activities of daily living (ADLs), psychological impact, social impact, employment and finances. These data can provide a reference for studying the quality of life in patients with psoriasis.
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Affiliation(s)
- Hua Zhong
- Department of Dermatology, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Huan Yang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.,Center for Health Preference Research, Shandong University, Jinan, 250012, China
| | - Zhuxin Mao
- School of Insurance, Southwestern University of Finance and Economics, Chengdu, 611130, China
| | - Xiaoyun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.,Center for Health Preference Research, Shandong University, Jinan, 250012, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China. .,Center for Health Preference Research, Shandong University, Jinan, 250012, China.
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Prtina A, Rašeta Simović N, Milivojac T, Vujnić M, Grabež M, Djuric D, Stojiljković MP, Soldat Stanković V, Čolić MJ, Škrbić R. The Effect of Three-Month Vitamin D Supplementation on the Levels of Homocysteine Metabolism Markers and Inflammatory Cytokines in Sera of Psoriatic Patients. Biomolecules 2021; 11:biom11121865. [PMID: 34944509 PMCID: PMC8699679 DOI: 10.3390/biom11121865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
Psoriasis is an autoimmune and inflammatory skin disease. Psoriatic patients express higher levels of plasma homocysteine (Hcy) concentration and pro-inflammatory mediators than healthy people; this is frequently associated with vitamin D deficiency. The aim of this clinical study was to investigate the effects of high doses of vitamin D supplementation on the parameters of Hcy metabolism and cytokines in sera of psoriatic patients. This prospective study was conducted on 40 psoriatic patients who had the vitamin D deficiency. All patients received vitamin D 5000 IU/day for three months. Clinical and biochemical measurements were taken at baseline and at follow up (3 months). The results showed that the severity of clinical features, measured by the psoriasis area severity index (PASI) score, were considerably improved in patients after vitamin D supplementation. After vitamin D supplementation, most of the patients (n = 25 or 62.5%) had mild clinical form (p < 0.001). After twelve weeks of intervention period, there were significant increases in vitamin D and B12 serum levels in comparison to the levels that had been measured at the beginning of the study (56.77 ± 14.66 nmol/L and 301.08 ± 95.02 pg/mL vs. 103.85 ± 32.20 nmol/L and 362.81 ± 118.56 pg/mL, respectively; p < 0.001). Moreover, serum levels of Hcy and folate were significantly lower at the end of the study in comparison with the initial levels (12.45 ± 1.92 µmol/L and 8.01 ± 3.88 mg/mL vs. 10.38 ± 1.66 µmol/L and 6.27 ± 2.60 mg/mL, respectively). High doses of vitamin D supplementation led to a significant decrease in pro-inflammatory cytokines (IFN-ɤ, TNF-α, IL-1β, IL-6, IL-8, and IL-17) and high-sensitivity C-reactive protein (hsCRP), whereas the production of anti-inflammatory cytokines (IL-10, IL-5) was up-regulated. In conclusion, supplementation with high doses of vitamin D could be one of the possible preventive and therapeutic measures to reduce systemic inflammation in psoriatic patients.
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Affiliation(s)
- Alma Prtina
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Nela Rašeta Simović
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Tatjana Milivojac
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Milorad Vujnić
- Center for Biomedical Research, Department of Pathophysiology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina; (A.P.); (N.R.S.); (T.M.); (M.V.)
| | - Milkica Grabež
- Department of Preventive Medicine, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Dragan Djuric
- Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Miloš P. Stojiljković
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Valentina Soldat Stanković
- Internal Medicine Clinic, University Clinical Center of the Republic of Srpska, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Miodrag J. Čolić
- Medical Faculty Foča, University of East Sarajevo, 73300 Foča, Bosnia and Herzegovina;
| | - Ranko Škrbić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
- Correspondence: ; Tel.: +387-51-234-101
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Applicability of the Geographic Tongue Area and Severity Index among Healthcare Professionals: A Cross-Sectional Clinical Validation of a Newly Developed Geographic Tongue Scoring System. J Clin Med 2021; 10:jcm10235493. [PMID: 34884195 PMCID: PMC8658609 DOI: 10.3390/jcm10235493] [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: 09/17/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 02/08/2023] Open
Abstract
Geographic tongue (GT) is a chronic condition of unknown aetiology, with no defined parameters to establish the protocol for evidence-based management. Validation of a newly developed and proposed clinical index to assess the severity of GT could assist in its diagnosis, especially in cases associated with systemic dermatological diseases in the form of psoriasis. OBJECTIVE To verify the applicability of the geographic tongue area and severity index (GTASI). This involved healthcare professionals from different specialties to evaluate the usefulness of the GTASI in supporting GT classification, as well as the follow-up process. METHODS One hundred cases of previously diagnosed GT were initially evaluated by three independent, experienced researchers/clinicians to obtain a standardised classification baseline. Subsequently, nine cases of GT were selected, three cases for each category-mild, moderate and severe. These stages were professionally evaluated by 51 healthcare professionals from three groups: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 specialist dermatologists (24%) during a cross-sectional survey. RESULTS The quantitative and qualitative assessment based on experts' opinions in the cross-sectional survey demonstrated an acceptable, similar level of GT clinical diagnosis (p > 0.05), with coherence between the various groups of professionals critically appraising the GTASI. An apparent divergence was observed for the moderate GT category, as well as in the group of less experienced evaluators. CONCLUSION Whilst the validation of GTASI applicability was successfully executed, the general dental practitioners, specialists in oral medicine and dermatologists were equally capable of correct GT diagnosis and appropriately rating its severity. These coherent results were especially replicated among the experienced clinicians. The validation of the newly proposed index confirmed its reliability as a feasible instrument in oral medicine, with the prospect of its wider implementation in clinical practice.
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Solvin ÅØ, Chawla K, Olsen LC, Hegre SA, Danielsen K, Jenssen M, Furberg AS, Saunes M, Hveem K, Saetrom P, Løset M. MicroRNA profiling of psoriatic skin identifies 11 miRNAs associated with disease severity. Exp Dermatol 2021; 31:535-547. [PMID: 34748247 DOI: 10.1111/exd.14497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 12/18/2022]
Abstract
MicroRNAs (miRNAs) are small non-coding RNAs that have emerged as central regulators of gene expression and powerful biomarkers of disease. Much is yet unknown about their role in psoriasis pathology. To globally characterize the miRNAome of psoriatic skin, skin biopsies were collected from psoriatic cases (n = 75) and non-psoriatic controls (n = 46) and RNA sequenced. Count data were meta-analysed with a previously published dataset (cases, n = 24, controls, n = 20), increasing the number of psoriatic cases fourfold from previously published studies. Differential gene expression analyses were performed comparing lesional psoriatic (PP), non-lesional psoriatic (PN) and control (NN) skin. Further, functional enrichment and cell-specific analyses were performed. Across all contrasts, we identified 439 significantly differentially expressed miRNAs (DEMs), of which 85 were novel for psoriasis and 11 were related to disease severity. Meta-analyses identified 20 DEMs between PN and NN, suggesting an inherent change in the constitution of all skin in psoriasis. By integrating the miRNA transcriptome with mRNA target interactions, we identified several functionally enriched terms, including "thyroid hormone signalling," "insulin resistance" and various infectious diseases. Cell-specific expression analyses revealed that the upregulated DEMs were enriched in epithelial and immune cells. This study provides the most comprehensive overview of the miRNAome in psoriatic skin to date and identifies a miRNA signature related to psoriasis severity. Our results may represent molecular links between psoriasis and related comorbidities and have outlined potential directions for future functional studies to identify biomarkers and treatment targets.
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Affiliation(s)
- Åshild Ø Solvin
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Konika Chawla
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Bioinformatics Core Facility, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lene C Olsen
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Bioinformatics Core Facility, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Siv Anita Hegre
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Bioinformatics Core Facility, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kjersti Danielsen
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway
| | - Marita Jenssen
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway
| | - Anne-Sofie Furberg
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.,Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Marit Saunes
- Department of Dermatology, Clinic of Orthopaedy, Rheumatology and Dermatology, St. Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Pål Saetrom
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Bioinformatics Core Facility, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Computer Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Mari Løset
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Dermatology, Clinic of Orthopaedy, Rheumatology and Dermatology, St. Olavs Hospital Trondheim University Hospital, Trondheim, Norway
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Sanad EMK, Nazmy NN, Abd-El Hamid El Sayed R, Hamed AM. Interleukin-17A gene single nucleotide polymorphism and its relation to fungal growth in psoriatic patients: A preliminary study. J Cosmet Dermatol 2021; 21:3059-3067. [PMID: 34741574 DOI: 10.1111/jocd.14551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although dysbiosis and the role of the microbiome in the pathogenesis of inflammatory skin diseases have been intensively investigated, fungal colonization or infection has received minimal attention. AIMS To isolate and identify different fungal species namely Candida, Dermatophytes, Malassezia, and Aspergillus from plaque psoriasis patients, evaluate the association of IL-17A gene single nucleotide polymorphisms (SNPs) with psoriasis, and to reveal the relation between IL-17A gene SNPs and the fungal presence within the psoriatic plaques. PATIENTS/METHODS Fifty plaque psoriasis patients and fifty healthy age and sex volunteers as controls were enrolled in this study. From psoriatic plaques, mycological isolation was done by direct microscopic examination (10% KOH mount), culture onto the three sets of media then species identification by phenotypic procedures. Genomic DNA extraction and genotyping for IL-17A (rs10484879) SNPs using polymerase chain reaction and restriction fragment length polymorphism were also done. RESULTS Psoriasis cases showed higher frequency of fungal growth 86% vs. 14% in controls; (p < 0.001). The frequency of IL-17A GA, AA, and total polymorphism (GA+AA) genotypes in psoriasis cases was significantly higher than in controls. There was non-significant association between different IL-17A genotypes and fungal growth except Aspergillus flavus, which decreased gradually with GG, GA, and AA (37.5%, 20.8%, and 0%, respectively). CONCLUSIONS Psoriasis cases are significantly associated with fungal growth, which may be a contributing factor in its pathogenesis. SNPs of IL-17A (rs10484879) G/A gene led to increased susceptibility toward pathogenesis of psoriasis. Fungal growth and IL-17A GA+AA genotypes are suggested to be independent predictors of psoriasis susceptibility.
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Affiliation(s)
- Eman M K Sanad
- Faculty of Medicine, Department of Dermatology, Benha University, Benha, Egypt
| | - Nader N Nazmy
- Faculty of Medicine, Department of Dermatology, Benha University, Benha, Egypt
| | | | - Ahmed M Hamed
- Faculty of Medicine, Department of Dermatology, Benha University, Benha, Egypt
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Chen X, Xiang H, Tan L, Zhou J, Tang J, Hu X, Yang M. Psoriasis Is Associated With Myosteatosis but Not Sarcopenia: A Case-Control Study. Front Med (Lausanne) 2021; 8:754932. [PMID: 34722590 PMCID: PMC8554055 DOI: 10.3389/fmed.2021.754932] [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: 08/07/2021] [Accepted: 09/21/2021] [Indexed: 02/05/2023] Open
Abstract
Background: The link between psoriasis and body fat (or obesity) has been well established. However, there are no reports detailing the possible relationship between psoriasis and fat infiltration in skeletal muscle, also known as myosteatosis. A recent study reported the possible association between psoriasis, arthritis, and sarcopenia (the loss of skeletal muscle mass or function). The present study aimed to explore the possible associations of chronic plaque psoriasis with myosteatosis and sarcopenia. Methods: We conducted a case-control study. In-patients with chronic plaque psoriasis were retrospectively recruited. Healthy controls were prospectively and continuously recruited. Unenhanced cross-sectional chest computed tomography images at the 12th thoracic vertebral level were analyzed using Mimics software. Skeletal muscle area (SMA), skeletal muscle radiodensity (SMD), and intermuscular adiposity tissue (IMAT) were measured. The skeletal muscle index (SMI) was calculated as SMA/height2. The percentage of IMAT (IMAT%) was calculated as IMAT/SMA × 100%. Myosteatosis was defined by SMD or IMAT%, whereas sarcopenia was defined by SMI. Propensity score matching was performed to adjust for the main confounders. Logistic regression models were used to evaluate the associations of psoriasis with myosteatosis and sarcopenia. Results: We included 155 psoriasis patients and 512 healthy controls. After propensity score matching, we retained 310 controls. The prevalence of sarcopenia was not significantly different between the psoriasis and control groups (men: 9.8% vs. 14.4%, p = 0.244; women: 7.0% vs. 11.7%, p = 0.548). Psoriasis patients were more prone to SMD-defined myosteatosis (men: 39.3% vs. 20.8%; women: 46.5% vs. 16.0%; both p < 0.001) and IMAT%-defined myosteatosis (men: 21.4% vs. 12.5%, p = 0.034; women: 46.5 vs. 28.7%, p = 0.042) than the control group. After adjustment for potential confounders, psoriasis was not significantly associated with sarcopenia (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.25–1.19, p = 0.136). However, psoriasis was associated with SMD-defined myosteatosis (OR 3.16, 95% CI 1.86–5.37, p < 0.001) and IMAT%-defined myosteatosis (OR 1.76, 95% CI 1.04–3.00; p = 0.037). Conclusions: Chronic plaque psoriasis is independently associated with myosteatosis but not sarcopenia. Since fat and muscle are considered endocrine organs and can drive the inflammatory process, further studies detailing the interaction between psoriasis, fat, and skeletal muscle are warranted.
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Affiliation(s)
- Xiaomei Chen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongmei Xiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Lingling Tan
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Zhou
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Tang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyi Hu
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Yang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
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Successful treatment of concomitant Crohn's disease and psoriasis with risankizumab. Eur J Gastroenterol Hepatol 2021; 33:1462-1464. [PMID: 34597287 DOI: 10.1097/meg.0000000000002115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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46
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Wagner MFMG, Theodoro TR, Filho CDASM, Oyafuso LKM, Pinhal MAS. Extracellular matrix alterations in the skin of patients affected by psoriasis. BMC Mol Cell Biol 2021; 22:55. [PMID: 34715781 PMCID: PMC8555298 DOI: 10.1186/s12860-021-00395-1] [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: 12/21/2020] [Accepted: 10/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease dependent upon a complex interaction between genetic predisposition and immunological factors. It is characterized by skin lesions throughout the body, causing great morbidity and affecting life quality. The present study aimed to evaluate the protein and mRNA expression of heparanase-1 (HPSE), heparanase-2 (HPSE2), syndecan-1 (SYND1), metalloproteinases (MMP2, MMP9), and tissue inhibitor metalloproteinases 2 (TIMP2) in skin samples. METHODS From each psoriasis patient, two samples were collected, one sample from a psoriasis plaque (n = 23) and the other sample from non-affected skin (n = 23), as well as tissue collected by blepharoplasty from control individuals (n = 18). Protein expression was investigated by immunohistochemistry, followed by digital quantification. Quantitative RT-PCR obtained mRNA expression. Statistical analyses were done, and p values < 0.05 were considered significant. RESULTS A significant increase in protein and mRNA expression was observed in both heparanases (HPSE and HPSE2), and higher protein levels of MMP9 and TIMP2 were observed in the psoriasis plaque compared to the non-affected skin. The data point to a probable activation of MMP2 by TIMP2. Moreover, there was a significant increase in HPSE2, SYND1, MMP9, and TIMP2 in non-affected skin samples from patients with psoriasis than in the control sample (tissue obtained by individuals who do not have psoriasis). CONCLUSIONS These results show a possible correlation between the characteristic inflammatory process and alterations in the expression of the extracellular matrix in psoriasis. The increased expression of HPSE2, SYND1, MMP9, and TIMP2, even in the absence of psoriatic plaque, indicates that these molecules may be involved with extracellular matrix changes in the initial alterations the psoriatic process and may be candidates for the development of target treatments.
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Affiliation(s)
| | - Thérèse Rachell Theodoro
- Biochemistry Department of Centro Universitário Saúde ABC (FMABC), Avenida Lauro Gomes 2000, Santo André, São Paulo, CEP 09060870, Brazil
| | | | | | - Maria Aparecida Silva Pinhal
- Biochemistry Department of Centro Universitário Saúde ABC (FMABC), Avenida Lauro Gomes 2000, Santo André, São Paulo, CEP 09060870, Brazil.
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Kaiser H, Kvist-Hansen A, Becker C, Wang X, McCauley BD, Krakauer M, Gørtz PM, Henningsen KMA, Zachariae C, Skov L, Hansen PR. Multiscale Biology of Cardiovascular Risk in Psoriasis: Protocol for a Case-Control Study. JMIR Res Protoc 2021; 10:e28669. [PMID: 34581684 PMCID: PMC8512189 DOI: 10.2196/28669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background Patients with psoriasis have increased risk of cardiovascular disease (CVD) independent of traditional risk factors. The molecular mechanisms underlying the psoriasis-CVD connection are not fully understood. Advances in high-throughput molecular profiling technologies and computational analysis techniques offer new opportunities to improve the understanding of disease connections. Objective We aim to characterize the complexity of cardiovascular risk in patients with psoriasis by integrating deep phenotypic data with systems biology techniques to perform comprehensive multiomic analyses and construct network models of the two interacting diseases. Methods The study aims to include 120 adult patients with psoriasis (60 with prior atherosclerotic CVD and 60 without CVD). Half of the patients are already receiving systemic antipsoriatic treatment. All patients complete a questionnaire, and a medical interview is conducted to collect medical history and information on, for example, socioeconomics, mental health, diet, and physical exercise. Participants are examined clinically with assessment of the Psoriasis Area and Severity Index and undergo imaging by transthoracic echocardiography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT), and carotid artery ultrasonography. Skin swabs are collected for analysis of microbiome metagenomics; skin biopsies and blood samples are collected for transcriptomic profiling by RNA sequencing; skin biopsies are collected for immunohistochemistry; plasma samples are collected for analyses of proteomics, lipidomics, and metabolomics; blood samples are collected for high-dimensional mass cytometry; and feces samples are collected for gut microbiome metagenomics. Bioinformatics and systems biology techniques are utilized to analyze the multiomic data and to integrate data into a network model of CVD in patients with psoriasis. Results Recruitment was completed in September 2020. Preliminary results of 18F-FDG-PET/CT data have recently been published, where vascular inflammation was reduced in the ascending aorta (P=.046) and aortic arch (P=.04) in patients treated with statins and was positively associated with inflammation in the visceral adipose tissue (P<.001), subcutaneous adipose tissue (P=.007), pericardial adipose tissue (P<.001), spleen (P=.001), and bone marrow (P<.001). Conclusions This systems biology approach with integration of multiomics and clinical data in patients with psoriasis with or without CVD is likely to provide novel insights into the biological mechanisms underlying these diseases and their interplay that can impact future treatment. International Registered Report Identifier (IRRID) DERR1-10.2196/28669
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Affiliation(s)
- Hannah Kaiser
- Department of Dermatology and Allergy, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.,Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | - Amanda Kvist-Hansen
- Department of Dermatology and Allergy, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.,Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | - Christine Becker
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Xing Wang
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Benjamin D McCauley
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Martin Krakauer
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Peter Michael Gørtz
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | | | - Claus Zachariae
- Department of Dermatology and Allergy, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Riis Hansen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Hagag MM, Ghazy MM, Elhelbawy NG. Tumor necrosis factor-α gene promoter -308 and -238 polymorphisms and its serum level in psoriasis. Biochem Biophys Rep 2021; 27:101050. [PMID: 34169157 PMCID: PMC8209664 DOI: 10.1016/j.bbrep.2021.101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 05/04/2021] [Accepted: 06/07/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic, immune-mediated, inflammatory skin disease affecting genetically predisposed individuals and requiring long-term treatment. The etiology of psoriasis is not fully understood. This article aimed to determine association between genetic polymorphisms in tumor necrosis factor-α (TNF -α) promoter -308 (rs1800629) and -238 (rs 361,525) and its serum level in psoriasis patients. METHODS The study was conducted on 70 patients with psoriasis and 70 age and sex-matched, healthy individuals. All patients were subjected to history taking and complete medical examination. The polymorphisms of TNF -α promoter gene -308 (rs1800629) and -238 (rs 361,525) were detected by real time PCR and Serum levels of TNF -α were measured by ELISA technique. RESULTS AG polymorphism and A allele of TNF-α -238 G/A (rs 361,525) were significantly more in patients than controls, whereas AG polymorphism and A allele of TNF-α -308 G/A (rs1800629) were significantly more in controls than patients. There were significant high levels of TNF-α in serum of patients in comparison to controls. CONCLUSIONS The AG polymorphism and A allele of TNF-α -238G/A (rs 361,525) may act as a risk factor for occurrence of psoriasis, whereas AG polymorphism and A allele of TNF-α -308G/A (rs1800629) may have protective role. There is pivotal role of TNF-α as a pro-inflammatory mediator in pathogenesis of psoriasis.
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Affiliation(s)
- Magda M. Hagag
- Dermatology, Andrology and Sexually Transmitted Diseases (STDs) Department, Faculty of Medicine, Menoufia University, Egypt
| | - Mai M. Ghazy
- Dermatology, Andrology and Sexually Transmitted Diseases (STDs) Department, Ministry of Health, Kafrelsheikh, Egypt
| | - Nesreen G. Elhelbawy
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Menoufia University, Egypt
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Raj R, Londhe ND, Sonawane R. Automated psoriasis lesion segmentation from unconstrained environment using residual U-Net with transfer learning. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 206:106123. [PMID: 33975181 DOI: 10.1016/j.cmpb.2021.106123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE The automatic segmentation of psoriasis lesions from digital images is a challenging task due to the unconstrained imaging environment and non-uniform background. Existing conventional or machine learning-based image processing methods for automatic psoriasis lesion segmentation have several limitations, such as dependency on manual features, human intervention, less and unreliable performance with an increase in data, manual pre-processing steps for removal of background or other artifacts, etc. METHODS: In this paper, we propose a fully automatic approach based on a deep learning model using the transfer learning paradigm for the segmentation of psoriasis lesions from the digital images of different body regions of the psoriasis patients. The proposed model is based on U-Net architecture whose encoder path utilizes a pre-trained residual network model as a backbone. The proposed model is retrained with a self-prepared psoriasis dataset and corresponding segmentation annotation of the lesion. RESULTS The performance of the proposed method is evaluated using a five-fold cross-validation technique. The proposed method achieves an average Dice Similarity Index of 0.948 and Jaccard Index of 0.901 for the intended task. The transfer learning provides an improvement in the segmentation performance of about 4.4% and 7.6% in Dice Similarity Index and Jaccard Index metric respectively, as compared to the training of the proposed model from scratch. CONCLUSIONS An extensive comparative analysis with the state-of-the-art segmentation models and existing literature validates the promising performance of the proposed framework. Hence, our proposed method will provide a basis for an objective area assessment of psoriasis lesions.
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Affiliation(s)
- Ritesh Raj
- Electrical Engineering Department, National Institute of Technology Raipur, Raipur, Chhattisgarh, 492010, India
| | - Narendra D Londhe
- Electrical Engineering Department, National Institute of Technology Raipur, Raipur, Chhattisgarh, 492010, India.
| | - Rajendra Sonawane
- Psoriasis Clinic and Research Centre, Psoriatreat, Pune, Maharashtra, 411004, India
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Xu H, Liu J, Niu M, Song S, Wei L, Chen G, Ding Y, Wang Y, Su Z, Wang H. Soluble IL-6R-mediated IL-6 trans-signaling activation contributes to the pathological development of psoriasis. J Mol Med (Berl) 2021; 99:1009-1020. [PMID: 33835216 DOI: 10.1007/s00109-021-02073-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 02/08/2023]
Abstract
IL-6 has been suggested to function as an autocrine mitogen in the psoriatic epidermis. The biological activity of IL-6 relies on interactions with its receptors, including the membrane-bound IL-6 receptor (mIL-6R) and soluble IL-6 receptor (sIL-6R). Our study presents data showing that the levels of plasma IL-6 and sIL-6R were elevated in psoriatic patients. Genotyping of two single-nucleotide polymorphisms (SNPs) in IL-6R (rs4845617 and rs2228145) demonstrated that the SNP IL-6R (rs4845617) rather than IL-6R (rs2228145) shows a significant association with psoriasis (P = 0.006). To verify the functions of sIL-6R, cultured keratinocytes and imiquimod (IMQ)-induced psoriatic model mice were treated with sIL-6R. We found that the presence of sIL-6R in the HaCaT cell culture medium enhanced the IL-6-induced Stat3 activation, which resulted in abnormal keratinocyte proliferation and aberrant differentiation. Furthermore, the application of sIL-6R in vivo accelerated the pathological development of the disease. Our results demonstrate for the first time that genetic polymorphisms in the IL-6R gene are associated with psoriasis disease phenotypes in a Chinese psoriatic patient population; sIL-6R-mediated trans-signaling pathway plays a pivotal role in keratinocyte proliferation and differentiation, suggesting potential therapeutics for psoriasis. KEY MESSAGES: Patients with psoriasis displayed higher levels of IL-6 and sIL-6R compared with healthy controls. Analysis of genotypes revealed that IL-6R rs4845617 GG genotype associated with the risk of psoriasis. Supplement of sIL-6R further enhanced IL-6-induced Stat3 activation in keratinocytes. In vivo administration of sIL-6R accelerated, whereas sgp130FC alleviated, the pathological development of psoriasis.
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Affiliation(s)
- Hui Xu
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China
| | - Jun Liu
- Department of Dermatology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, 210008, China
| | - Mengyuan Niu
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China
| | - Shiyu Song
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China
| | - Lulu Wei
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China
| | - Gang Chen
- Department of Esthetic Plastic Surgery, The First Affiliated Hospital of Nanjing University of TCM, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Yibing Ding
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China
| | - Yong Wang
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China
| | - Zhonglan Su
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
| | - Hongwei Wang
- Center for Translational Medicine, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, People's Republic of China.
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