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Gujarathi PP, Korat RH, Gujarathi PS. Preclinical techniques for drug discovery in psoriasis. Int Immunopharmacol 2024; 137:112378. [PMID: 38852518 DOI: 10.1016/j.intimp.2024.112378] [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: 03/02/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Psoriasis is a chronic, inflammatory, papulosquamous, noncontagious disease characterized by scaly, demarcated erythematous plaque, affecting skin, nails, and scalp. The IL-23/Th17 axis is the main operator in the development of psoriasis. Psoriasis is affecting worldwide, and new treatment options are urgently needed. Various local and systemic treatments are available for psoriasis but they only provide symptomatic relief because of numerous unknown mechanisms. Clinical trials demand overwhelming resources; therefore, drug development predominantly depends on the in-vivo, in-vitro, and ex-vivo techniques. Immediate attention is required to develop experimental techniques that completely imitate human psoriasis to assist drug development. This review portrays the various in-vivo, in-vitro, and ex-vivo techniques used in psoriasis research. It describes these techniques' characteristics, pathological presentations, and mechanisms. The experimental techniques of psoriasis provide significant information on disease progression mechanisms and possible therapeutic targets. However, until now, it has been challenging to invent a timely, affordable model that precisely imitates a human disease. Only the xenotransplantation model is reckoned as the closer, that mimics the complete genetic, and immunopathogenic event. Imiquimod-induced psoriasis and HaCat cell lines are popular among researchers because of their convenience, ease of use, and cost-effectiveness. There need to further improve the experimental techniques to best serve the disease imitation and meet the research goal.
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Affiliation(s)
- Pranjal P Gujarathi
- Department of Pharmacology, Vidhyadeep Institute of Pharmacy, Vidhyadeep University, Anita, Surat, Gujarat, India; Bhagwan Mahavir Centre for Advance Research, Bhagwan Mahavir College of Pharmacy, Bhagwan Mahavir University, Vesu, Surat, Gujarat, India.
| | - Rashmi H Korat
- Department of Pharmacognosy, Bhagwan Mahavir College of Pharmacy, Bhagwan Mahavir Univeristy, Vesu, Surat, Gujarat, India
| | - Piyush S Gujarathi
- Department of Community Medicine, Vidhyadeep Homeopathic Medical College and Research Centre, Vidhyadeep University, Anita, Surat, Gujarat, India
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Alzahrani SA, Alzamil FM, Aljuhni AM, Al Thaqfan NA, Alqahtani NY, Alwarwari SA, Alkharashi AA, Alzabadin RA, Alzehairi RA, Alhajlah AA. A Systematic Review Evaluating the Effectiveness of Several Biological Therapies for the Treatment of Skin Psoriasis. Cureus 2023; 15:e50588. [PMID: 38222196 PMCID: PMC10788124 DOI: 10.7759/cureus.50588] [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: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
Psoriasis is a chronic inflammatory skin illness that has the potential to manifest at any stage of life, it is most frequently observed in early adulthood. Biological drugs have significantly transformed the landscape of psoriasis treatment through the provision of focused therapy, which effectively mitigates inflammation and regulates the overproduction of skin cells. Notwithstanding the accessibility of these biological drugs, rigorous evaluations that juxtapose their safety and efficacy profiles are necessary. The objective of this study is to conduct a thorough investigation of the relative efficacy of these drugs in alleviating psoriasis symptoms and increasing the quality of life for patients by synthesizing the existing evidence. A comprehensive review was conducted to evaluate and compare the safety and effectiveness of different biochemical medicines utilized in the management of psoriasis. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, the review process was conducted among the available studies. A search was conducted across electronic databases, such as Web of Science, PubMed, and Embase, utilizing a combination of keywords and Mesh phrases pertaining to psoriasis, biological medications, and particular names of pharmaceuticals. In total, 475 studies were ascertained by the preliminary search of the database. After eliminating duplicate research, 358 distinct studies remained. After meticulous screening of titles and abstracts against the predefined inclusion criteria, 281 papers were deemed ineligible and thus excluded. For final inclusion, the whole texts of the remaining 77 studies were evaluated. Forty additional papers were removed during the full-text evaluation for a variety of reasons, including improper research design, or insufficient outcome data. Finally, 37 studies were included in this systematic review since they satisfied all inclusion criteria. The results of the current systematic review showed that all biological medications showed high efficacy in the treatment of skin psoriasis compared with placebo based on the clinical assessment outcomes using different tools such as PASI.
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Affiliation(s)
- Sattam A Alzahrani
- General Practice, Medical Graduate of Al-Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
| | - Fajer M Alzamil
- Dermatology, College of Medicine, Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
| | - Abdulaziz M Aljuhni
- General Practice, Medical Graduate of Al-Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
| | - Naif A Al Thaqfan
- General Practice, Medical Graduate of Al-Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
| | - Norah Y Alqahtani
- General Practice, Graduate of Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Sara A Alwarwari
- General Practice, Medical Graduate of Vision Colleges, Riyadh, SAU
| | - Abdullah A Alkharashi
- General Practice, Medical Graduate of Al-Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
| | - Rakan A Alzabadin
- General Practice, Medical Graduate of Al-Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
| | - Reema A Alzehairi
- Dermatology, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Abdullah A Alhajlah
- General Practice, Medical Graduate of Al-Imam Mohammed Bin Saud Islamic University, Riyadh, SAU
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Saep M, Shenoy MM, Rao ACK, Pinto M, Hegde SP, Iqbal AAM. A Clinical, Dermoscopic, and Histopathological Study of Follicular Psoriasis. Int J Trichology 2023; 15:127-132. [PMID: 38765718 PMCID: PMC11098143 DOI: 10.4103/ijt.ijt_168_20] [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: 11/10/2020] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 05/22/2024] Open
Abstract
Introduction Follicular psoriasis is one of the underdiagnosed clinical types of psoriasis. Literature is grossly limited to anecdotal case reports and series. Clinical and investigational aspects are not studied in depth. Materials and Methods A study was conducted to determine the frequency of follicular psoriasis, which includes cases with an exclusive or substantial number of follicular lesions. We analyzed the clinical, dermoscopic, and histopathological features of follicular psoriasis in a descriptive study. Results A total of 117 patients with psoriasis were screened. An exclusive or substantial number of follicular lesions were found in 22 patients. Four patients had exclusively follicular lesions and others were psoriasis vulgaris with follicular psoriasis. Dermoscopy revealed perifollicular scaling and white homogeneous area with normal terminal hair in all cases. Vascular features were visible in 14 cases and all had dotted vessels, with four having additional globules. Twenty patients revealed one or more features suggestive of follicular psoriasis on histopathology. Conclusion Follicular lesions can appear exclusively or can coexist with plaque type of lesions in psoriasis. They may indicate early psoriasis lesions. Dermoscopy is a useful and rapid tool to confirm the diagnosis of follicular psoriasis. Histopathology, though confirmatory, demands an astute interpretational skill. Diagnosis of follicular psoriasis can have therapeutic implications.
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Affiliation(s)
- Maqbool Saep
- Department of Dermatology, Venereology and Leprosy, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Manjunath Mala Shenoy
- Department of Dermatology, Venereology and Leprosy, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Anuradha C. K. Rao
- Department of Pathology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Malcolm Pinto
- Department of Dermatology, Venereology and Leprosy, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Spandana Prakash Hegde
- Department of Dermatology, Venereology and Leprosy, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Amina Asfiya M. Iqbal
- Department of Dermatology, Venereology and Leprosy, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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Aziz Hazari S, Kaur H, Karwasra R, Abourehab MAS, Ali Khan A, Kesharwani P. An overview of topical lipid-based and polymer-based nanocarriers for treatment of psoriasis. Int J Pharm 2023; 638:122938. [PMID: 37031809 DOI: 10.1016/j.ijpharm.2023.122938] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
Psoriasis is a consistently recurring, inflammatory skin disease, affecting about 2 - 5 % of the world population. Different types of psoriasis can be observed such as guttate psoriasis, pustular psoriasis, psoriatic arthritis, scalp psoriasis, flexural psoriasis etc. Several therapeutic approaches are available for the treatment of psoriasis. However, none of them are entirely safe and effective to treat the disease without compromising patient compliance. The traditional treatment plan is associated with harmful side effects such asimmune system suppression and damage of essential organs at high doses, which poses a challenge to treat psoriasis. Novel drug delivery systems are being developed to replace traditional therapy in order to address these shortcomings. Currently, nanoformulations have gained widespread application for treatment of psoriasis. Researchers have developed different types of lipid-based nanoparticles like liposomes, niosomes, ethosomes, transethosomes, nanostructured lipid carriers and solid lipid nanoparticles. These innovative formulations provide advantages in terms of reduction in dose, dosing frequency, dose-dependency with enhanced efficacy, improved encapsulation efficiency, controlled release, increased surface area, high bioavailability and greater stratum corneum permeability. This review highlights detailed and comparative discussion of lipid-based and polymer-based nanoparticles for psoriasis along with the pathophysiology and other treatments of psoriasis.
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Affiliation(s)
- Sahim Aziz Hazari
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Harsimran Kaur
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India
| | - Ritu Karwasra
- Central Council for Research in Unani Medicine, Ministry of AYUSH, Govt of India, New Delhi-110058, India
| | - Mohammed A S Abourehab
- Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Asim Ali Khan
- Central Council for Research in Unani Medicine, Ministry of Ayush, Janakpuri, New Delhi-110058, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India; Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical science, Chennai, India.
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Nanotechnology-based alternatives for the topical delivery of immunosuppressive agents in psoriasis. Int J Pharm 2023; 631:122535. [PMID: 36566826 PMCID: PMC9876733 DOI: 10.1016/j.ijpharm.2022.122535] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Psoriasis is a recurring, immune-mediated dermatological disorder. Many therapeutic agents are available for the treatment of psoriasis, including immunosuppressants and biologic treatments with immunosuppressant action. The employment of nanotechnology allows drug tailoring to achieve dermal targeting, improve efficacy and minimize undesirable effects. Here we discuss the use of the topical route in combination with nano-based drug delivery systems containing immunosuppressants for the management of psoriasis. This review is based on articles selected from 2011 to 2022, using the keywords "Psoriasis" AND "Immunosuppressants" AND "Nano*" in the main databases. Fifty-seven articles were retrieved, although only forty-two matched the inclusion criteria. Nanocarriers such as liposomes, ethosomes, niosomes, solid lipid nanoparticle, nanostructured lipid carriers and microspheres containing immunosuppressive drugs (methotrexate, cyclosporine, tacrolimus, and etanercept) were identified. The main findings of these studies are related to the improved in vitro/ex vivo permeation/penetration and therapeutic efficacy of nanoparticles in vitro and in vivo, compared to the drug in solution. Based on the studies discussed in this review, encapsulation in several types of nanocarriers decreases toxicity, dose, and dose frequency. Furthermore, it enables specific targeting of the active drug, pointing to the possibility of improving topical therapy for psoriasis. In conclusion, nanoformulations represent a novel and promising tool for psoriasis treatment.
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Mirghani H, Alharfy AAN, Alanazi AMM, Aljohani JKM, Aljohani RAA, Albalawi RHA, Aljohani RAA, Alqasmi Albalawi DM, Albalawi RHA, Mostafa MI. Diagnostic Test Accuracy of Genetic Tests in Diagnosing Psoriasis: A Systematic Review. Cureus 2022; 14:e31338. [PMID: 36514633 PMCID: PMC9741513 DOI: 10.7759/cureus.31338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/12/2022] Open
Abstract
The pathogenesis of psoriasis involves the interaction of several environmental and genetic factors. Predicting the disease risk cannot depend on individual genetic alleles. Consequently, some studies have evaluated the use of genetic risk scores that combine several psoriasis susceptibility loci to increase the accuracy of predicting/diagnosing the disease. This meta-analysis summarizes the evidence regarding using genetic risk scores (GRS) in the diagnosis or prediction of psoriasis. A search of MEDLINE/PubMed, the Latin American Caribbean Health Sciences Literature (LILACS) database, Cochrane Library, Scopus, Web of Science, and ProQuest was conducted in July 2022. The primary objective was to record the area under the curve (AUC) for GRS of psoriasis. Secondary objectives included characteristics of studies and patients. The risk of bias (ROB) was assessed using the PROBAST tool. Five studies fulfilled the eligibility criteria of this review. None of the studies described the clinical criteria (reference standard) that were employed to diagnose psoriasis. The AUCs of the 11 GRS models ranged from 0.6029-0.8583 (median: 0.75). Marked heterogeneity was detected (Cochran Q: 1250.051, p < 0.001, and I2 index: 99.2%). So, pooling of the results of the included studies was not performed. The ROB was high for all studies and clinical application was not described. Genetic risk scores are promising tools for the prediction of psoriasis with fair to good accuracy. However, further research is required to identify the most accurate combination of loci and to validate the scores in variable ethnicities.
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Affiliation(s)
- Hyder Mirghani
- Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, SAU
| | | | | | | | | | | | | | | | | | - Mohamed I Mostafa
- Department of Anatomy, Faculty of Medicine, University of Tabuk, Tabuk, SAU
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Babiker Mohamed MA, El-Malky AM, Abdelkarim WAA, Abdulmonem Salih Aabdeen M, Hassan Elobid Ahmed T, Sarsour HHH, Mohammed Mosa M, Amer YS, Khormi AAM, Alajlan A. Evidence-based clinical practice guidelines for the management of psoriasis: systematic review, critical appraisal, and quality assessment with the AGREE II instrument. J DERMATOL TREAT 2022; 33:2771-2781. [PMID: 35737878 DOI: 10.1080/09546634.2022.2083545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/22/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Psoriasis is considered one of the stubborn lifelong dermatologic diseases, making the patients seized in their social cage. Evidence-based clinical practice guidelines (CPGs) and expert opinions ensure that patients with psoriasis render the most recent and developed care. This systematic review assessed and compared the most recently approved international CPGs with the AGREE II instrument. METHODS After we identified our research question, we searched the bibliographic international databases to identify and screen for relevant and eligible guidelines that address the topic of interest. Four independent reviewers (Senior Expert Dermatologist in Psoriasis) have critically appraised the selected guidelines via the AGREE II instrument. We conducted inter-rater analysis and percent agreement among raters and calculation of intra-class correlation coefficient (ICC) 'Kappa'. RESULTS Out of 33 articles for CPGs, only Four eligible CPGs fulfill the inclusion criteria. Selected CPGs were critically appraised; first from the American College of Rheumatology that is also National Psoriasis Foundation (ACR/NPF-2018), second from the UK's National Institute for Health and Care Excellence (NICE-2017) for Psoriasis: Assessment and Management, third from the Saudi practical guidelines on the biologic treatment for Psoriasis (Saudi CPGs, 2015), and lastly from the American Academy of Dermatology (AAD/NPF-2019) Management and Treatment of Psoriasis with Awareness and Attention to Comorbidities. The complete assessments (OA) of two CPGs (AAD/NPF and NICE) scored greater than 80%; 'six domains' of AGREE II had greater score that is congruent with results; (1) scope and motive, (2) shareholder involvement, (3) rigor of growth, (4) clarity of speech, (5) validity, and (6) journalistic independence domains. Domain (3) scored (84, 71, and 90%), domain (5) (51%, 47, and 90%), domain (6) (70, 52, and 90%) for (Saudi CPGs, AAD/NPF, and NICE), respectively. Generally, the clinical recommendations were significantly better for NICE CPGs. CONCLUSIONS Four evidence-based 'CPGs' introduced a high-quality methodological analysis. NICE indicated the greatest quality followed by Saudi CPGs and AAD/NPF and all four CPGs were suggested for practice.
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Affiliation(s)
| | - Ahmed M El-Malky
- Public Health and Community Medicine Department, Theodor Bilharz Research Institute, Academy of Scientific Research, Ministry of Higher Education, Cairo, Egypt
- Morbidity and Mortality Review Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | - Munirah Mohammed Mosa
- College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yasser S Amer
- Pediatric Department, King Khalid University Hospital, Riyadh, Saudi Arabia
- Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia
- Quality Management Department, Clinical Practice Guidelines and Quality Research Unit, King Saud University Medical City, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
- Adaptation Working Group, Guidelines International Network, Perth, Scotland
| | - Abdulrahman Ali M Khormi
- Internal Medicine and Rheumatology - Prince Sattam University Medical College, Al-Kharj, Saudi Arabia
| | - Abdulmajeed Alajlan
- Dermatology Department, Faculty of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Foley P, Spelman L, Murrell DF, Mate E, Tronnberg R, Lowe PM. Secukinumab treatment showed improved quality of life in patients with chronic plaque psoriasis in Australia: Results from the HOPE study. Australas J Dermatol 2022; 63:312-320. [PMID: 35816576 PMCID: PMC9542143 DOI: 10.1111/ajd.13893] [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: 03/22/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psoriasis imposes a disease burden that can have a profound negative impact on patients' quality of life (QoL). HOPE was the first non-interventional study conducted in patients with severe chronic plaque psoriasis in Australia that evaluated health-related QoL in response to treatment with secukinumab. METHODS HOPE was a prospective, open-label, single-arm, multicentre, non-interventional, exploratory study in patients with severe chronic plaque psoriasis in Australia. The study investigated the change in QoL, using the Dermatology Life Quality Index (DLQI), Assessment Quality of Life-8 Dimension questionnaire (AQoL-8D) and Psoriasis Area and Severity Index (PASI), and safety profile in response to treatment with secukinumab 300 mg SC weekly for 4 weeks followed by monthly maintenance for 58 weeks. RESULTS At Week 14, the mean percentage reduction in total DLQI score from baseline was -82.4% (n = 65), which indicates a substantial improvement in QoL. This level of improvement was sustained up to Week ≥58, with a mean percentage change of -87.4%. The mean percentage change from baseline for AQoL-8D weighted total score decreased from Week 14 (41.1%) to Week 58 (35.2%), indicating an improvement in patients' QoL. A high proportion of patients achieved PASI 75/90/100 responses at Week 14 (97.0%/71.2%/34.8%), with rates sustained up to Week ≥58 (100%/87.9%/43.1%). The safety profile of secukinumab was favourable, with no cumulative or unexpected safety concerns. CONCLUSION Secukinumab treatment demonstrated a striking improvement in patients' QoL in the HOPE study, the first real-world study in patients with severe chronic plaque psoriasis in the Australian clinical setting.
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Affiliation(s)
- Peter Foley
- Skin Health Institute Inc., Carlton, Victoria, Australia.,St Vincent's Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, Australia
| | - Lynda Spelman
- Veracity Clinical Research Pty. Ltd., Woolloongabba, Queensland, Australia
| | - Dedee F Murrell
- Department of Dermatology, University of New South Wales, Sydney, New South Wales, Australia
| | - Eric Mate
- Novartis Pharmaceuticals, Australia Pty. Ltd., Macquarie Park, New South Wales, Australia
| | - Rebecca Tronnberg
- Novartis Pharmaceuticals, Australia Pty. Ltd., Macquarie Park, New South Wales, Australia
| | - Patricia M Lowe
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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Perrone V, Losi S, Maiorino A, Antonelli S, Giovannitti M, Giacomini E, Sangiorgi D, Degli Esposti L. Treatment Patterns and Pharmacoutilization in Patients Affected by Psoriasis: An Observational Study in an Italian Real-World Setting. Drugs Real World Outcomes 2022; 9:243-251. [PMID: 35041194 PMCID: PMC9114260 DOI: 10.1007/s40801-021-00290-3] [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] [Accepted: 12/28/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Real-world data can inform the use of biologics for psoriasis (PSO). OBJECTIVE The aim was to evaluate treatment patterns and analyze pharmacoutilization in PSO patients in a real-world Italian setting, with a focus on the biologics most recently introduced. METHODS An observational study based on administrative databases was conducted. Patients were included based on PSO diagnosis identified by either discharge diagnosis or exemption code or prescription of anti-psoriatic topical drugs (proxy of diagnosis). To describe patient characteristics and treatment patterns using the most up-to-date data, two different approaches were used: a cross-sectional study performed during 2016-2018, and a longitudinal study conducted with patients who received their first biological/targeted synthetic drugs (naïve patients) in 2014 and 2017 (the inclusion periods). RESULTS During 2016-2018, the number of prevalent patients diagnosed with PSO was 194,054 (2016), 210,830 (2017), and 225,171 (2018). The percentage of patients receiving biologics or targeted synthetic agents ranged from 1.5 to 2.1%. Among them, naïve patients receiving interleukin (IL) inhibitors increased from 37.5% (2016) to 69.4% (2018), while those receiving anti-tumor necrosis factor (anti-TNF) decreased from 62.5% (2016) to 30.6% (2018). The longitudinal analysis included 894 and 1218 naïve patients in 2014 and 2017, respectively, of whom 7.2% (2014) and 6.9% (2017) switched therapy after a mean of 7.1 (2014) and 6.9 (2017) months. Overall, 259 patients were prescribed ixekizumab starting in 2017, of whom 73% were naïve. Ixekizumab was prescribed as monotherapy to 52.5%. CONCLUSIONS The proportion of patients receiving biologics appeared constant over the years, with an increasing number of naïve patients being prescribed IL-17 inhibitors. Ixekizumab patients were mostly naïve.
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Affiliation(s)
- Valentina Perrone
- CliCon S.r.l., Società Benefit Health Economics and Outcomes Research, Via Murri, 9 40137, Bologna, Italy.
| | - Serena Losi
- Eli Lilly Italy S.p.A., Sesto Fiorentino, Italy
| | | | | | | | - Elisa Giacomini
- CliCon S.r.l., Società Benefit Health Economics and Outcomes Research, Via Murri, 9 40137, Bologna, Italy
| | - Diego Sangiorgi
- CliCon S.r.l., Società Benefit Health Economics and Outcomes Research, Via Murri, 9 40137, Bologna, Italy
| | - Luca Degli Esposti
- CliCon S.r.l., Società Benefit Health Economics and Outcomes Research, Via Murri, 9 40137, Bologna, Italy
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Chen WY, Chen SC, Hsu SY, Lin YA, Shih CM, Huang CY, Wang KH, Lee AW. Annoying Psoriasis and Atopic Dermatitis: A Narrative Review. Int J Mol Sci 2022; 23:ijms23094898. [PMID: 35563285 PMCID: PMC9104570 DOI: 10.3390/ijms23094898] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022] Open
Abstract
Skin is an important organ that mainly functions as a barrier. Skin diseases can damage a person's self-confidence and reduce their willingness to socialize, as well as their social behavior and willingness. When the skin appearance is abnormal, in addition to affecting the quality of life, it often leads to personal, social, and psychological dysfunction and even induces depression. Psoriasis and atopic dermatitis are common chronic skin diseases. Their prevalence in the world is 3-10%, and there is an increasing trend year by year. These congenital or acquired factors cause the dysfunction of the immune system and then destroy the barrier function of the skin. Because these patients are flooded with a variety of inflammatory mediators, this causes skin cells to be in chronic inflammation. Therefore, psoriasis and atopic dermatitis are also considered systemic chronic inflammatory diseases. In the healthcare systems of developed countries, it is unavoidable to spend high costs to relieve symptoms of psoriasis and atopic dermatitis patients, because psoriasis and atopic dermatitis have a great influence on individuals and society. Giving a lot of attention and developing effective treatment methods are the topics that the medical community must work on together. Therefore, we used a narrative review manuscript to discuss pathogenesis, clinical classification, incidence, and treatment options, including topical medication, systemic therapeutics, immunosuppressive medication for psoriasis, and atopic dermatitis, as well as also comparing the differences between these two diseases. We look forward to providing readers with comprehensive information on psoriasis and atopic dermatitis through this review article.
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Affiliation(s)
- Wei-Yu Chen
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (W.-Y.C.); (S.-C.C.); (S.-Y.H.); (Y.-A.L.)
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei 11031, Taiwan
| | - Shao-Chuan Chen
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (W.-Y.C.); (S.-C.C.); (S.-Y.H.); (Y.-A.L.)
| | - Shou-Yi Hsu
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (W.-Y.C.); (S.-C.C.); (S.-Y.H.); (Y.-A.L.)
| | - Yu-An Lin
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (W.-Y.C.); (S.-C.C.); (S.-Y.H.); (Y.-A.L.)
| | - Chun-Ming Shih
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (C.-M.S.); (C.-Y.H.)
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan
| | - Chun-Yao Huang
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (C.-M.S.); (C.-Y.H.)
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan
| | - Kuo-Hsien Wang
- Department of Dermatology, Taipei Medical University Hospital, Taipei 11031, Taiwan;
| | - Ai-Wei Lee
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (W.-Y.C.); (S.-C.C.); (S.-Y.H.); (Y.-A.L.)
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 3255)
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Sambhu COP, Prathibha CKB, Namboothiri KP, Anandaraman PVS. Management of psoriasis with Ayurveda Panchakarma and Manibhadragula as Shodhana Rasayana - a case report. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:473-479. [PMID: 34758243 DOI: 10.1515/jcim-2020-0433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/12/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Plaque Psoriasis is very embarrassing condition of skin as it produces itchy rashes and scaly lesions which may not respond well to the treatment. It can be correlated with Kitibhakushta which is one among the 18 types of Kushta (skin diseases). Several corticosteroids for skin applications are used now a day's which gives only temporary relief. CASE PRESENTATION A 36 years old moderate built male patient complains of blackish skin rashes with itching, pain and scaling all over the body for three months. Based on the symptoms, Dosha (Biological humors) involved were assessed as Kapha (binding factors) and Vata (vital force of life) and suggestive of Kitibhakushta. Diagnosis of the Plaque psoriasis was further confirmed by biopsy. Classical Kushta treatment was adopted here. As Poorvakarma (pre-operative procedures), Rukshana (Dehydrating therapy) was done and then Snehapana (intake of medicated ghee) was administered. Then classical Vamana (emetic therapy) and Virechana (purgative therapy) were performed. This took almost one month. After Samsarjana (special diet) patient was administered Manibhadragula as Shodhana Rasayana for a period of one month. RESULTS At the end of Manibhadragula intake, remarkable changes were observed in all the symptoms. There were significant changes seen in PASI, DLQI and photographs taken before and after treatment. CONCLUSIONS Here the special mode of administration of Manibhadragula as mentioned in Ashtanga Hridaya helps for Shodhana and the Shodhana itself has Rasayana action. Drugs also have Rasayana property. This made the authors to propose a new concept called Shodhana Rasayana. Classical treatment by considering the condition of Roga (disease) and Rogi (patient) helps for management of Kushta.
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Affiliation(s)
| | - Changuli Krishna Bhat Prathibha
- Department of Panchakarma, G S Ayurveda Medical College & Hospital, N.H-9, Near Railway Station Pilkhuwa, Dist:- Hapur, U.P., 245304, India
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12
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Psoriasis and Gut Microbiome-Current State of Art. Int J Mol Sci 2021; 22:ijms22094529. [PMID: 33926088 PMCID: PMC8123672 DOI: 10.3390/ijms22094529] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory disease that affects around 125 million people worldwide. Several studies concerning the gut microbiota composition and its role in disease pathogenesis recently demonstrated significant alterations among psoriatic patients. Certain parameters such as Firmicutes/Bacteroidetes ratio or Psoriasis Microbiome Index were developed in order to distinguish between psoriatic and healthy individuals. The “leaky gut syndrome” and bacterial translocation is considered by some authors as a triggering factor for the onset of the disease, as it promotes chronic systemic inflammation. The alterations were also found to resemble those in inflammatory bowel diseases, obesity and certain cardiovascular diseases. Microbiota dysbiosis, depletion in SCFAs production, increased amount of produced TMAO, dysregulation of the pathways affecting the balance between lymphocytes populations seem to be the most significant findings concerning gut physiology in psoriatic patients. The gut microbiota may serve as a potential response-to-treatment biomarker in certain cases of biological treatment. Oral probiotics administration as well as fecal microbial transplantation were most reported in bringing health benefits to psoriatic patients. However, the issue of psoriatic bacterial gut composition, its role and healing potential needs further investigation. Here we reviewed the literature on the current state of the relationship between psoriasis and gut microbiome.
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13
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Aschoff R, Martorell A, Anger T, Chayer D, Bewley A. Real-World Experience Using Topical Therapy-Calcipotriol and Betamethasone Dipropionate Foam in Adults with Beyond-Mild Psoriasis. Dermatol Ther (Heidelb) 2021; 11:555-569. [PMID: 33723715 PMCID: PMC8018991 DOI: 10.1007/s13555-021-00501-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/04/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Determining optimal treatment for moderate plaque psoriasis can be challenging. Recent studies have demonstrated the effectiveness of calcipotriol and betamethasone dipropionate (Cal/BD) foam in patients with moderate-to-severe plaque psoriasis. Methods This research explored the use of Cal/BD foam in patients with beyond-mild psoriasis (defined as patients eligible for topical treatment, systemic treatment, or combined topical/systemic treatments) using an online questionnaire, retrospective medical-record review, and by capturing the attitudes and treatment approaches of dermatology specialists. Results Data from 409 patients with beyond-mild psoriasis treated with Cal/BD foam were provided by 120 dermatology specialists from Germany, Spain, and the UK. Cal/BD foam was prescribed as monotherapy for most (58%) patients and was considered to be effective. Cal/BD foam was infrequently used in combination with biologics (7%) in this segment; 26% of patients received Cal/BD foam in combination with a non-biologic systemic treatment. Cal/BD foam prescribers generally use topical agents to bridge the waiting time to non-biologic/biologic systemic treatment, and as an add-on to systemic treatment for residual lesions. Conclusions In patients with beyond-mild psoriasis, the most commonly prescribed topical medication was Cal/BD foam, which was regarded as an effective treatment. Further research is needed to determine optimal use of Cal/BD foam in these patients. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00501-3.
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Affiliation(s)
- Roland Aschoff
- Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Antonio Martorell
- Dermatology and Venereology Service, Hospital de Manises, Valencia, Spain.
| | | | | | - Anthony Bewley
- Dermatology Department, Barts Health NHS Trust and Queen Mary University, London, UK
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14
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Kahremany S, Hofmann L, Harari M, Gruzman A, Cohen G. Pruritus in psoriasis and atopic dermatitis: current treatments and new perspectives. Pharmacol Rep 2021; 73:443-453. [PMID: 33460006 DOI: 10.1007/s43440-020-00206-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/11/2020] [Accepted: 11/29/2020] [Indexed: 02/06/2023]
Abstract
Psoriasis and atopic dermatitis (AD) are two common chronic inflammatory skin diseases. Although showing different etiology and clinical manifestations, patients with either disease suffer from low health-related quality of life due to pruritus (dermal itch). Recent studies have revealed that more than 85% of psoriasis patients suffer from pruritus, and it is also the dominating symptom of AD. However, as this is a non-life treating symptom, it was partly neglected for years. In this review, we focus on current findings as well as the impact and potential treatments of pruritus in these two skin diseases. We first distinguish the type of itch based on involved mediators and modulators. This clear delineation between the types of pruritus based on involved receptors and pathways allows for precise treatment. In addition, insights into recent clinical trials aimed to alleviate pruritus by targeting these receptors are presented. We also report about novel advances in combinatorial treatments, dedicated to the type of pruritus linked to a causal disease. Altogether, we suggest that only a focused treatment tailored to the primary disease and the underlying molecular signals will provide fast and sustained relief of pruritus associated with psoriasis or AD.
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Affiliation(s)
- Shirin Kahremany
- Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel. .,The Skin Research Institute, The Dead Sea and Arava Science Center, 86910, Masada, Israel.
| | - Lukas Hofmann
- Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Marco Harari
- Medical Climatotherapy Unit, The Dead Sea and Arava Science Center, 86910, Masada, Israel
| | - Arie Gruzman
- Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Guy Cohen
- The Skin Research Institute, The Dead Sea and Arava Science Center, 86910, Masada, Israel.,Ben Gurion University of the Negev, Eilat Campus, 8855630, Eilat, Israel
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15
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Fereig SA, El-Zaafarany GM, Arafa MG, Abdel-Mottaleb MMA. Tackling the various classes of nano-therapeutics employed in topical therapy of psoriasis. Drug Deliv 2020; 27:662-680. [PMID: 32393082 PMCID: PMC7269080 DOI: 10.1080/10717544.2020.1754527] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
Psoriasis is a dermatological chronic skin condition with underlying autoimmune etiology. It deeply affects patients' quality of life. Therefore, it was an interesting target for researchers throughout the past years. Conventionally, the treatment options include anti-inflammatory agents, immune suppressants, biologic treatment, and phototherapy. Nanotechnology offers promising characteristics that allow for tailoring a drug carrier to achieve dermal targeting, improved efficacy and minimize undesirable effects. Being the safest route, the first line of treatment and a targeted approach, we solely discussed the use of the topical route, combined with advanced drug delivery systems for the management of psoriasis in this article. Advanced systems include polymeric, metallic, lipidic and hybrid nanocarriers incorporating different active agents. All formerly mentioned types of drug delivery systems were investigated through the past decades for the purpose of topical application on psoriatic plaques. Scientists' efforts are promising to reach an optimized formula with a convenient dosage form to improve efficacy, safety, and compliance for the treatment of psoriasis. Accordingly, it will offer a better quality of life for patients.
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Affiliation(s)
- Salma A. Fereig
- Faculty of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, The British University in Egypt (BUE), El Sherouk City, Egypt
| | - Ghada M. El-Zaafarany
- Faculty of Pharmacy, Department of pharmaceutics and Industrial Pharmacy, Ain Shams University, Cairo, Egypt
| | - Mona G. Arafa
- Faculty of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, The British University in Egypt (BUE), El Sherouk City, Egypt
- Chemotherapeutic Unit, Mansoura University Hospitals, Mansoura, Egypt
| | - Mona M. A. Abdel-Mottaleb
- Faculty of Pharmacy, Department of pharmaceutics and Industrial Pharmacy, Ain Shams University, Cairo, Egypt
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16
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Shin SH, Kim HY, Yoon HS, Park WJ, Adams DR, Pyne NJ, Pyne S, Park JW. A Novel Selective Sphingosine Kinase 2 Inhibitor, HWG-35D, Ameliorates the Severity of Imiquimod-Induced Psoriasis Model by Blocking Th17 Differentiation of Naïve CD4 T Lymphocytes. Int J Mol Sci 2020; 21:ijms21218371. [PMID: 33171607 PMCID: PMC7664669 DOI: 10.3390/ijms21218371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023] Open
Abstract
Sphingosine kinases (SK) catalyze the phosphorylation of sphingosine to generate sphingosine-1-phosphate. Two isoforms of SK (SK1 and SK2) exist in mammals. Previously, we showed the beneficial effects of SK2 inhibition, using ABC294640, in a psoriasis mouse model. However, ABC294640 also induces the degradation of SK1 and dihydroceramide desaturase 1 (DES1). Considering these additional effects of ABC294640, we re-examined the efficacy of SK2 inhibition in an IMQ-induced psoriasis mouse model using a novel SK2 inhibitor, HWG-35D, which exhibits nM potency and 100-fold selectivity for SK2 over SK1. Topical application of HWG-35D ameliorated IMQ-induced skin lesions and normalized the serum interleukin-17A levels elevated by IMQ. Application of HWG-35D also decreased skin mRNA levels of interleukin-17A, K6 and K16 genes induced by IMQ. Consistent with the previous data using ABC294640, HWG-35D also blocked T helper type 17 differentiation of naïve CD4+ T cells with concomitant reduction of SOCS1. Importantly, HWG-35D did not affect SK1 or DES1 expression levels. These results reaffirm an important role of SK2 in the T helper type 17 response and suggest that highly selective and potent SK2 inhibitors such as HWG-35D might be of therapeutic use for the treatment of psoriasis.
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Affiliation(s)
- Sun-Hye Shin
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (S.-H.S.); (H.-Y.K.); (H.-S.Y.)
| | - Hee-Yeon Kim
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (S.-H.S.); (H.-Y.K.); (H.-S.Y.)
| | - Hee-Soo Yoon
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (S.-H.S.); (H.-Y.K.); (H.-S.Y.)
| | - Woo-Jae Park
- Department of Biochemistry, College of Medicine, Gachon University, Incheon 21999, Korea;
| | - David R. Adams
- School of Engineering & Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK;
| | - Nigel J. Pyne
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (N.J.P.); (S.P.)
| | - Susan Pyne
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK; (N.J.P.); (S.P.)
| | - Joo-Won Park
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (S.-H.S.); (H.-Y.K.); (H.-S.Y.)
- Correspondence: e-mail (J.W.P.); Tel.: +82-2-6986-6201
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17
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Uppala R, Tsoi LC, Harms PW, Wang B, Billi AC, Maverakis E, Michelle Kahlenberg J, Ward NL, Gudjonsson JE. "Autoinflammatory psoriasis"-genetics and biology of pustular psoriasis. Cell Mol Immunol 2020; 18:307-317. [PMID: 32814870 DOI: 10.1038/s41423-020-0519-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition that has a fairly wide range of clinical presentations. Plaque psoriasis, which is the most common manifestation of psoriasis, is located on one end of the spectrum, dominated by adaptive immune responses, whereas the rarer pustular psoriasis lies on the opposite end, dominated by innate and autoinflammatory immune responses. In recent years, genetic studies have identified six genetic variants that predispose to pustular psoriasis, and these have highlighted the role of IL-36 cytokines as central to pustular psoriasis pathogenesis. In this review, we discuss the presentation and clinical subtypes of pustular psoriasis, contribution of genetic predisposing variants, critical role of the IL-36 family of cytokines in disease pathophysiology, and treatment perspectives for pustular psoriasis. We further outline the application of appropriate mouse models for the study of pustular psoriasis and address the outstanding questions and issues related to our understanding of the mechanisms involved in pustular psoriasis.
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Affiliation(s)
- Ranjitha Uppala
- Graduate Program in Immunology, University of Michigan, Ann Arbor, MI, USA.,Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA. .,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA.
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18
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Association of Pathogenic Th17 Cells with the Disease Severity and Its Potential Implication for Biological Treatment Selection in Psoriasis Patients. Mediators Inflamm 2020; 2020:8065147. [PMID: 32801996 PMCID: PMC7415124 DOI: 10.1155/2020/8065147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/03/2020] [Indexed: 12/22/2022] Open
Abstract
Psoriasis is an inflammatory autoimmune disease characterized by cutaneous lesions in plaques. It has been proposed that the immune response has a key role in the disease progression. Particularly, the Th17 cells through IL-17 can contribute to maintain the inflammatory process. The pathogenic Th17 phenotype has been described in human diseases and associated with high severity in inflammatory experimental models. However, it is not clear if the pathogenic phenotype could be present in the skin and peripheral blood as well as its possible association to severity in psoriasis. In the lesional skin, we found high infiltration of Th17 cells and the pathogenic phenotype, finding a correlation between the frequency of Th17 cells and the Psoriasis Area and Severity Index (PASI) score. In peripheral blood, we observed a pool of Th17 lymphocytes with potential to acquire pathogenic features. Interestingly, the percentage of pathogenic Th17 cells (CD4+ RORγt+ IFN-γ+) correlates with disease severity. Moreover, we distinguished three groups of patients based on their IL-17/IFN-γ production by Th17 lymphocytes, which seems to be related with a dynamic or stable potential to express these cytokines. Remarkably, we evaluated the cytokine production by Th17 cells as an immunological marker for the adequate selection of biologic therapy. We found that patients analyzed by this immunological approach and treated with antibodies against IL-17 and TNFα showed great improvement depicted by reduction in PASI and Dermatology Life Quality Index (DLQI) score as well as the percentage of Body Surface Area (BSA). Altogether, our results highlight the importance of the assessment of the pathogenic phenotype in Th17 cells as an immune personalized analysis with the potential to support the therapy choice in the clinical practice.
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19
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Carrascosa JM, Theng C, Thaçi D. Spotlight on Topical Long-Term Management of Plaque Psoriasis. Clin Cosmet Investig Dermatol 2020; 13:495-498. [PMID: 32801825 PMCID: PMC7397561 DOI: 10.2147/ccid.s254114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/07/2020] [Indexed: 12/17/2022]
Abstract
During the 28th Congress of the European Academy of Dermatology and Venereology (EADV) held in Madrid in October 2019, an industry hub was dedicated to the long-term management of psoriasis. Psoriasis is a systemic inflammatory disease primarily involving the skin that affects up to 4% of the European population, the majority of whom present with chronic plaque psoriasis. Topical therapies are well established in the first-line treatment of psoriatic plaque flares. Nevertheless, as psoriasis is a chronic disease, long-term control should be considered. The aim of the session was to provide expert opinion on the benefit of long-term maintenance therapy in chronic plaque psoriasis and introduce the concept of pro-active management to decrease the number of relapses and improve patient quality of life. The current guidelines and recommendations were reviewed, as well as the available data on published clinical trials. There is still an important role for topical therapy in psoriasis and current recommendations suggest a maintenance regimen for psoriasis. Adherence optimization and proactive management of relapse can be key factors for obtaining clinical outcomes in topical long-term therapy. Calcipotriol/betamethasone dipropionate foam is the only topical formulation with long-term data as a twice-weekly proactive treatment approach for up to 52 weeks for chronic plaque psoriasis.
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Affiliation(s)
| | - Colin Theng
- The Skin Specialists & Laser Clinic, Singapore
| | - Diamant Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
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20
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Xing J, Zhao X, Li X, Wang Y, Li J, Hou R, Niu X, Yin G, Li X, Zhang K. Variation at ACOT12 and CT62 locus represents susceptibility to psoriasis in Han population. Mol Genet Genomic Med 2019; 8:e1098. [PMID: 31858748 PMCID: PMC7005626 DOI: 10.1002/mgg3.1098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 02/06/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory disorder of the skin, and genetic factors are reported to be involved in the disease pathogenesis. Many studies have named psoriasis candidate genes. Objective In this study, we determined the mutation frequency of 7 variable genes in 1,027 psoriatic patients and investigated its possible mechanism associated with psoriasis. Method A total of 7 variable genes from 1,027 psoriatic patients were amplified and sequenced using the Sanger method. The mutation frequency was compared to that of non‐psoriatic individuals in Asia using information from databases. Results Among the 7 investigated genes, the mutation frequency of ACOT12 (c.80A>G, 9.98% vs. 5.85%, p < .05) and CT62 (c.476C>T,15.8% vs. 9.93%, p < .05) was found to be significantly higher than among non‐psoriatic Asian individuals. The mutation frequencies of CASZ1(c.599T>G), SPRED1(c.155A>G), and ACOT12 (c.80A>G) differed significantly between the groups organized by medical history, PASI, and family history. SPRED1 gene variants (17.25% vs. 7.78%, p < .01) showed a stronger association with the family history group at the onset of psoriasis than with the no family history group. Conclusions Our results provide a comprehensive correlation analysis of susceptibility genes in psoriasis patients. Clinical characteristics of patients play important roles in the development of psoriatic skin.
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Affiliation(s)
- Jianxiao Xing
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xincheng Zhao
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaofang Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ying Wang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Junqin Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ruixia Hou
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xuping Niu
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Guohua Yin
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xinhua Li
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Kaiming Zhang
- Shanxi Key Laboratory of Stem Cells for Immunological Dermatosis, Institute of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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21
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Sharma J, Larkin J. Therapeutic Implication of SOCS1 Modulation in the Treatment of Autoimmunity and Cancer. Front Pharmacol 2019; 10:324. [PMID: 31105556 PMCID: PMC6499178 DOI: 10.3389/fphar.2019.00324] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/18/2019] [Indexed: 12/14/2022] Open
Abstract
The suppressor of cytokine signaling (SOCS) family of intracellular proteins has a vital role in the regulation of the immune system and resolution of inflammatory cascades. SOCS1, also called STAT-induced STAT inhibitor (SSI) or JAK-binding protein (JAB), is a member of the SOCS family with actions ranging from immune modulation to cell cycle regulation. Knockout of SOCS1 leads to perinatal lethality in mice and increased vulnerability to cancer, while several SNPs associated with the SOCS1 gene have been implicated in human inflammation-mediated diseases. In this review, we describe the mechanism of action of SOCS1 and its potential therapeutic role in the prevention and treatment of autoimmunity and cancer. We also provide a brief outline of the other JAK inhibitors, both FDA-approved and under investigation.
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Affiliation(s)
- Jatin Sharma
- Department of Microbiology and Cell Science, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Joseph Larkin
- Department of Microbiology and Cell Science, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
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22
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Fan X, Wang H, Sun L, Zheng X, Yin X, Zuo X, Peng Q, Standish KA, Cheng H, Zhang Y, Wang Z, Xiao F, Yang S, Zhang X, Schork NJ. Fine mapping and subphenotyping implicates ADRA1B gene variants in psoriasis susceptibility in a Chinese population. Epigenomics 2019; 11:455-467. [PMID: 30785334 DOI: 10.2217/epi-2018-0131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AIM A genomic region on 5q33.3 lies between and encompasses the IL12B and PTTG1 genes, and contains many potential psoriasis causal variants. We aimed to further examine the influence of variants in and around this region. MATERIALS & METHODS We used least absolute shrinkage and selection operator (LASSO)-based regression analysis to assess independent contributions of 2171 variants to psoriasis susceptibility and tested them for association with different clinical psoriasis subtypes. RESULTS We found that ADRA1B gene variants contribute to psoriasis in Chinese population. ADRA1B gene variants have a stronger association with moderate-to-severe disease group and an earlier age at onset of psoriasis than IL-12B and PTTG1 variants. CONCLUSION The association of variants in the ADRA1B gene with psoriasis could explain why variants in the IL-12B, ADRA1B and PTTG1 gene regions are associated with psoriasis.
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Affiliation(s)
- Xing Fan
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Hongyan Wang
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Liangdan Sun
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Xiaodong Zheng
- Instituteof Dermatology, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei City, Anhui, 230032, PR China
| | - Xianyong Yin
- Instituteof Dermatology, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei City, Anhui, 230032, PR China
| | - Xianbo Zuo
- Instituteof Dermatology, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei City, Anhui, 230032, PR China
| | - Qian Peng
- Molecular& Cellular Neuroscience, The Scripps Research Institute, 10550 North TorreyPines Road, La Jolla, CA 92037, USA
| | - Kristopher A Standish
- Genomics, Bioinformatics, J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA92037, USA
| | - Hui Cheng
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Yaohua Zhang
- Instituteof Dermatology, Department of Dermatology, Huashan Hospital, Fudan University, No.12, Middle Urumqi Road, Shanghai, 200040, PR China
| | - Zaixing Wang
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Fengli Xiao
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Sen Yang
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Xuejun Zhang
- Departmentof Dermatology, Anhui Medical University, The First Affiliated Hospital ofAnhui Medical University, 218 Jixi Road, Shushan District, Hefei City, Anhui, 230022, PR China
| | - Nicholas J Schork
- HumanBiology, J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA 92037, USA
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Abstract
Childhood exposure to traumatic events, termed early life stress (ELS), is now widely recognized for causing long-term negative health effects that may not manifest until adulthood. Allostatic load (AL) describes the cumulative "wear-and-tear" effects of chronic stress on the body that may adversely affect human health by accelerating other disease processes. Recent epidemiological studies have reported higher stress levels in industrialized countries and trends of increasing prevalence in autoimmune diseases during recent decades. To elucidate mechanisms of stress-related immune dysregulation, most animal studies up to now have focused on AL and stress-triggered events occurring in adults but have not explored ELS in the context of autoimmune disorders. We have identified a current gap in understanding the impact of ELS on immune system ontogeny and its potential for priming genetically susceptible individuals who are at increased risk for autoimmune diseases later in life, through mechanisms involving neuroendocrine-immune cross talk. In this review, we highlight the intersection between stress and immune function, with a focus on ELS as consequential for increased autoimmune disorder risks later in life.
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Affiliation(s)
- Jamie Y. Choe
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Maya Nair
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Riyaz Basha
- Department of Pediatrics and Women’s Health, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Byung-Jin Kim
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Harlan P. Jones
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
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24
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Surcel M, Huică RI, Munteanu AN, Isvoranu G, Pîrvu IR, Ciotaru D, Constantin C, Bratu O, Căruntu C, Neagu M, Ursaciuc C. Phenotypic changes of lymphocyte populations in psoriasiform dermatitis animal model. Exp Ther Med 2018; 17:1030-1038. [PMID: 30679970 PMCID: PMC6327675 DOI: 10.3892/etm.2018.6978] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/24/2018] [Indexed: 12/19/2022] Open
Abstract
Psoriasis is a T cell mediated, chronic inflammatory autoimmune skin disease that affects up to 2-3% of the global population and leads to a decrease in quality of life. Experimental data accumulated in recent years highlighted the important role played by the immune system in the pathogenesis of this disease. Non-human psoriasis models are an important research tool that attempts to reproduce the clinical features of the disease in order to explain the pathogenesis of psoriasis and to identify possible therapeutic targets. Imiquimod-based murine model of psoriatic dermatitis is an alternative to traditional models of experimental psoriasis in mice and the induced dermatitis closely mimics the pathologic changes in human psoriasis. In order to emphasize changes in immune cell populations involved in lesion pathogenesis, we performed a murine model of psoriasiform dermatitis model by topical IMQ application. The progress and the severity of IMQ-induced skin inflammation were clinically (PASI score) and histopathologically evaluated. The immunological changes induced by IMQ treatment in lymphocyte populations from peripheral blood and spleen were evaluated by flow cytometry. The main changes observed in peripheral blood were the significantly increased T-CD8a+ lymphocyte and NK1.1+ cell percentages and the decreased T-CD4+ and B lymphocyte percentages in IMQ-treated mice. In spleen samples, lymphocytes showed the same tendency of variation as in peripheral blood, but without statistical significance. A significant decrease of B cells percentages was observed in spleen suspensions. Data obtained in skin samples may suggest the involvement of CD3ε+, CD4+ and CD8a+ cells in the lesional process. This murine model was analyzed by performing a basic cellular profile at three levels: peripheral blood, spleen and skin. The evaluation aimed to establish the immune framework of this experimental model that could further be used for etipathogenic mechanism identification and/or for studies regarding targeted therapies.
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Affiliation(s)
- Mihaela Surcel
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania.,Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Radu-Ionuț Huică
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania.,Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adriana Narcisa Munteanu
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania
| | - Gheorghița Isvoranu
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania
| | - Ioana Ruxandra Pîrvu
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania
| | - Dan Ciotaru
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania
| | - Carolina Constantin
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania.,Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
| | - Ovidiu Bratu
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Constantin Căruntu
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Monica Neagu
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania.,Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania.,Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
| | - Cornel Ursaciuc
- Immunobiology Laboratory, 'Victor Babeș' National Institute of Pathology, 050096 Bucharest, Romania
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25
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Increased risk of keratopathy after psoriasis: A nationwide population-based study. PLoS One 2018; 13:e0201285. [PMID: 30044880 PMCID: PMC6059472 DOI: 10.1371/journal.pone.0201285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background To evaluate whether the presence of psoriasis increases the risk of keratopathy incidence by using Taiwan’s National Health Insurance Research Database (NHIRD). Methodology/Principal findings This retrospective cohort study used data from the NHIRD for the 2009 to 2012 period. A total of 3,648 patients diagnosed with psoriasis were enrolled in the study group while another 14,592 individuals were selected as the control group. The study group was propensity score-matched with a group of controls who had not received a diagnosis of psoriasis. Multivariate Cox regression analysis was performed to estimate the adjusted hazard ratio (aHR) of keratopathy. For the events of keratopathy, 71 patients in the study group and 208 patients in the control group developed keratopathy with a attributable risk of 23.43 per 100,000 person-months (incidence rate ratio = 1.40; P = 0.01) which correlated to the elevated cumulative probability (P = 0.03). The multivariate analysis revealed that the risk of keratopathy was higher in patients who had psoriasis (aHR = 1.31, P = 0.04). In addition, age older than 60 years (aHR = 2.10, P<0.01) and dry eye disease (aHR = 2.79, P<0.01) would also increase the risk of developing keratopathy. Conclusions Psoriasis was associated with an increased risk of keratopathy in patients without preexisting prominent corneal disease. Moreover, the risk of incident keratopathy increases with exposure to psoriasis.
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26
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Ghasemi Basir HR, Alirezaei P, Hamian Z, Khanlarzadeh E. Are quantitative histopathologic criteria capable of differentiating psoriasis from chronic dermatitis? Clin Cosmet Investig Dermatol 2018; 11:239-244. [PMID: 29785133 PMCID: PMC5955025 DOI: 10.2147/ccid.s160697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background There are overlapping features in histopathologic characteristics of psoriasis and chronic dermatitis, which sometimes make the correct diagnosis difficult. Objective The aim of this study was to compare the histopathologic diagnostic features of psoriasis with chronic dermatitis quantitatively. Patients and methods In this study, 30 patients with psoriasis and 30 patients with chronic dermatitis were included. Diagnosis of psoriasis or chronic dermatitis was based on clinicopathologic correlation. Photos of histopathologic slides were provided by LABOMED Digital Camera and LABOMED Microscope. Width and length of rete ridges, minimal thickness of suprapapillary plates, thickness of epidermis, thickness of hyperkeratotic layer, and minimal thickness of granular layer were determined using Pixel Pro software on micrometer scale. Results Suprapapillary plates and granular layer were significantly thicker in patients with chronic dermatitis compared with patients with psoriasis. The rete ridges were longer and wider, the epidermis was thicker, and the parakeratotic layer was also thicker in patients with psoriasis compared with patients with chronic dermatitis, and the difference between these corresponding parameters in the two groups was statistically significant except for thickness of parakeratotic layer. Moreover, the mean ratio of minimal suprapapillary plate’s thickness to epidermal thickness and the mean ratio of minimal granular layer’s thickness to parakeratotic layer’s thickness were significantly higher in patients with chronic dermatitis compared with those with psoriasis. Conclusion Despite overlapping histopathologic features in psoriasis and chronic dermatitis, quantitative histopathologic criteria might be valuable for differentiation of these two conditions. Ratios of minimal suprapapillary plate’s thickness to epidermal thickness and minimal granular layer’s thickness to parakeratotic layer’s thickness can be particularly helpful in this regard.
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Affiliation(s)
- Hamid Reza Ghasemi Basir
- Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Pedram Alirezaei
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Hamian
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elham Khanlarzadeh
- Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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27
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Fowler JF, Del Rosso JQ, Pakunlu RI, Sidgiddi S. Treatment Satisfaction, Product Perception, and Quality of Life in Plaque Psoriasis Patients Using Betamethasone Dipropionate Spray 0.05. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2017; 10:13-18. [PMID: 29399255 PMCID: PMC5774905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To assess patient-reported satisfaction, efficacy, and tolerability associated with the use of betamethasone dipropionate spray 0.05% when applied twice daily in subjects with moderate plaque psoriasis. Design: This was an open-label, multicenter study involving 45 patients with moderate plaque psoriasis, with the aim of evaluating patient-reported outcomes with betamethasone dipropionate spray 0.05%. Patients treated all affected areas twice daily with betamethasone dipropionate (BD) spray 0.05% for 28 days per label instructions. Measurements: Outcome measures included the Treatment Satisfaction Questionnaire for Medication (TSQM), Dermatology Life Quality Index (DLQI), Investigators Global Assessment (IGA), and Total Sign Score (TSS). In addition, the lesions were photographed at baseline (Day 1) and on Day 8, Day 14, and Day 29. Results: The results indicated that BD spray 0.05% treatment is associated with improved quality of life. BD spray 0.05% also led to improved IGA and TSS values and a reduction in the percentage of body surface area affected. Conclusion: In subjects with moderate plaque psoriasis, BD spray 0.05% demonstrated good levels of patient satisfaction and quality of life measures, in combination with improvements in the global assessment of disease and the level of itching experienced by subjects.
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Affiliation(s)
- Joseph F Fowler
- Dr. Fowler is Co-Founder of Dermatology Specialists Research in Louisville, Kentucky, and Clinical Professor of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky
- Dr. Del Rosso is Research Director at JDR Dermatology Research in Las Vegas, Nevada; Adjunct Clinical Professor of Dermatology at Touro University Nevada, Las Vegas; and with Dermatology and Cutaneous Surgery at Thomas Dermatology in Las Vegas, Nevada
- Dr. Pakunlu is Associate Director of Chemistry, Manufacturing, and Controls
- Dr. Sidgiddi is Director of Clinical Development at Promius Pharma, a subsidiary of Dr. Reddy's Laboratories, in Princeton, New Jersey
| | - James Q Del Rosso
- Dr. Fowler is Co-Founder of Dermatology Specialists Research in Louisville, Kentucky, and Clinical Professor of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky
- Dr. Del Rosso is Research Director at JDR Dermatology Research in Las Vegas, Nevada; Adjunct Clinical Professor of Dermatology at Touro University Nevada, Las Vegas; and with Dermatology and Cutaneous Surgery at Thomas Dermatology in Las Vegas, Nevada
- Dr. Pakunlu is Associate Director of Chemistry, Manufacturing, and Controls
- Dr. Sidgiddi is Director of Clinical Development at Promius Pharma, a subsidiary of Dr. Reddy's Laboratories, in Princeton, New Jersey
| | - Refika I Pakunlu
- Dr. Fowler is Co-Founder of Dermatology Specialists Research in Louisville, Kentucky, and Clinical Professor of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky
- Dr. Del Rosso is Research Director at JDR Dermatology Research in Las Vegas, Nevada; Adjunct Clinical Professor of Dermatology at Touro University Nevada, Las Vegas; and with Dermatology and Cutaneous Surgery at Thomas Dermatology in Las Vegas, Nevada
- Dr. Pakunlu is Associate Director of Chemistry, Manufacturing, and Controls
- Dr. Sidgiddi is Director of Clinical Development at Promius Pharma, a subsidiary of Dr. Reddy's Laboratories, in Princeton, New Jersey
| | - Srinivas Sidgiddi
- Dr. Fowler is Co-Founder of Dermatology Specialists Research in Louisville, Kentucky, and Clinical Professor of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky
- Dr. Del Rosso is Research Director at JDR Dermatology Research in Las Vegas, Nevada; Adjunct Clinical Professor of Dermatology at Touro University Nevada, Las Vegas; and with Dermatology and Cutaneous Surgery at Thomas Dermatology in Las Vegas, Nevada
- Dr. Pakunlu is Associate Director of Chemistry, Manufacturing, and Controls
- Dr. Sidgiddi is Director of Clinical Development at Promius Pharma, a subsidiary of Dr. Reddy's Laboratories, in Princeton, New Jersey
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Talaee R, Hajheydari Z, Moghaddam AY, Moraveji SA, Ravandi BF. Prevalence of Oral Mucosal Lesions and Their Association with Severity of Psoriasis among Psoriatic Patients Referred To Dermatology Clinic: A Cross-Sectional Study in Kashan/Iran. Open Access Maced J Med Sci 2017; 5:978-982. [PMID: 29362631 PMCID: PMC5771307 DOI: 10.3889/oamjms.2017.189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/20/2017] [Accepted: 09/23/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND: Psoriasis is a common inflammatory papulosquamous disease of the skin with unknown aetiology that may be associated with the abnormal T-cell function. AIM: This study was aimed to determine the prevalence of oral mucosal lesions and their associations with severity of psoriasis in psoriatic patients attending the dermatologic clinic of Shahid Beheshti Teaching Hospital at Kashan, Iran. METHODS: In this cross-sectional descriptive analytic study, all consecutive patients with psoriasis who referred to the dermatologic clinic at the Shahid Beheshti Hospital of Kashan University of Medical Sciences in Kashan City/ Iran were enrolled. All patients were examined for the presence of oral lesions, and the clinical and epidemiological features of the disease were recorded in a questionnaire for each patient. A biopsy was taken from atypical suspected patients with oral lesions by an expert dermatologist. Data were analysed using the Statistical Package for Social Science (Version 18). Descriptive statistics tests; Cross tabulation and Chi-square with Fisher’s exact test were used. RESULTS: Of total 177 psoriatic patients, 62 cases (35%) of patients were male, and 115 cases (65%) were female. Mean age of patients was 31.71 years. The oral lesion was seen in 83 cases (46.9%). Fissure tongue (28.2%) and geographic tongue (4.5%) were the most common oral lesions. The prevalence of oral lesions in patients with psoriasis significantly was associated with age, history of oral lesions, and with the onset of the oral lesions (P < 0.05). The most common form of psoriasis was chronic plaque form (Psoriasis Vulgaris) observed in 147 cases (83.1). The majority of patients (67.2%) were suffering from a mild form of the disease. Psoriasis Area and Severity Index (PASI) score of most patients was mild. CONCLUSIONS: The prevalence of oral lesions such as Fissure tongue and geographic tongue is higher in psoriatic patients suggests further studies for approving the clinical importance of these apparently nonspecific lesions as possible predictors or markers of the severity of the cases suspected to Psoriasis disease.
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Affiliation(s)
- Rezvan Talaee
- Department of Dermatology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Zohreh Hajheydari
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Yeganeh Moghaddam
- Department of Otolaryngology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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