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Cozma EC, Găman MA, Orzan O, Hamed KV, Voiculescu VM, Găman AM. Oxidative Stress and Inflammation Levels in a Population of Eastern European Naïve Versus Treated Psoriasis Patients. Cureus 2023; 15:e48177. [PMID: 38046733 PMCID: PMC10693351 DOI: 10.7759/cureus.48177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease, with a major impact on the patients' quality of life. Oxidative stress (OS) is represented by the imbalance between oxidant and antioxidant mechanisms of the organism, with increased levels being described in the majority of chronic diseases. We present the first prospective study in Romania to evaluate the redox balance changes (using a CR3000 analyzer) in patients with moderate-severe psoriasis based on treatment regimens: treatment-naïve (A), treatment with novel targeted agents (B) and methotrexate (C). The study group included 53 Caucasian patients divided into three groups (A- 27 patients, B - 15 patients, and C - 11 patients) for which OS, antioxidant status, standard blood count, and inflammatory status were evaluated. Our findings demonstrate that patients with psoriasis display high levels of OS, with elevated Free Oxygen Radical Test (FORT) (p-value for group A (pA)<0.0001, p-value for group B (pB)=0.0019 and p-value for group C (pC)=0.0063) and reduced Free Oxygen Radical Defense (FORD) (pB=0.018) values noted in our subjects. Higher erythrocyte sedimentation rate (ESR) values were detected in groups B (pB=0.00012) and C (pC<0.00001). Psoriasis treatments alleviate FORT and FORD levels, but their impact is not sufficient to restore the oxidative balance to normal ranges. Moreover, despite adequate treatment, patients with psoriasis display elevated inflammation levels. Future research should explore in more detail the interplay between OS and inflammation in psoriasis, namely the long-term impact on the redox balance of biotherapies.
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Affiliation(s)
| | - Mihnea-Alexandru Găman
- Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, ROU
- Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Olguța Orzan
- Dermatology, Elias Emergency University Hospital, Bucharest, ROU
| | | | - Vlad Mihai Voiculescu
- Dermatology, Elias Emergency University Hospital, Bucharest, ROU
- Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
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Paksoy T, Ustaoğlu G, Yaman D, Arıöz Ö, Demirci M, Ünlü Ö, Avcı E, Polat M. The link between total antioxidant status, total oxidant status, arylesterase activity, and subgingival microbiota in psoriasis patients. Int J Dermatol 2022; 61:1487-1496. [PMID: 35906956 DOI: 10.1111/ijd.16353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Studies focusing on the relationship between periodontitis and systemic diseases have suggested a possible association between these two chronic and inflammatory disorders. We aimed to comparatively investigate the salivary oxidative status, biomarker levels, clinical findings, and the microbial load on subgingival biofilm samples in psoriasis patients and controls. METHODS Forty participants were allocated into four groups as follows: (1) systemically and periodontally healthy (C group); (2) systemically healthy with periodontitis (P group); (3) psoriasis (Ps) and periodontally healthy (Ps-C group); and (4) Ps with periodontitis (Ps-P group). Subgingival biofilm samples were obtained to detect the periodontopathogenic agents by Real-time PCR (qPCR). The total antioxidant status (TAS) (mmol/l), total oxidant status (TOS) (μmol/l), and arylesterase (ARE) activity (U/L) were analyzed using saliva samples. RESULTS The level of TOS and oxidative stress index (OSI) were significantly higher in patients with Ps-P and P compared to controls (P = 0.001, and P ˂ 0.001, respectively). ARE levels were higher in controls compared to Ps and P (P ˂ 0.001). The prevalences of bacteria detected in subgingival biofilm samples were similar between all groups (P > 0.05). CONCLUSIONS This study reported that psoriasis may amplify TOS and OSI, and the co-existence of psoriasis and periodontitis may aggravate oxidative stress.
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Affiliation(s)
- Tuğçe Paksoy
- Istanbul Atlas University, Faculty of Dentistry, Department of Periodontology, Istanbul, Turkey
| | - Gülbahar Ustaoğlu
- Bolu Abant Izzet Baysal University, Faculty of Dentistry, Department of Periodontology, Bolu, Turkey
| | - Deniz Yaman
- Bolu Abant Izzet Baysal University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Bolu, Turkey
| | - Özkan Arıöz
- Bolu Abant Izzet Baysal University, Faculty of Dentistry, Department of Periodontology, Bolu, Turkey
| | - Mehmet Demirci
- Kırklareli University, Faculty of Medicine, Department of Medical Microbiology, Kırklareli, Turkey
| | - Özge Ünlü
- İstanbul Atlas University, Faculty of Medicine, Department of Medical Microbiology, İstanbul, Turkey
| | - Emre Avcı
- Health Sciences University, Gülhane Pharmacy Faculty, Basic Pharmaceutical Sciences Department, Department of Biochemistry, İstanbul, Turkey
| | - Mualla Polat
- Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Dermatology and Venerology, Bolu, Turkey
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Dobrică EC, Cozma MA, Găman MA, Voiculescu VM, Găman AM. The Involvement of Oxidative Stress in Psoriasis: A Systematic Review. Antioxidants (Basel) 2022; 11:antiox11020282. [PMID: 35204165 PMCID: PMC8868066 DOI: 10.3390/antiox11020282] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory dermatosis characterized by the appearance of erythematous plaques, covered by white scales, occasionally pruritogenic, and distributed mainly on the extensor areas. Oxidative stress is defined as an imbalance or a transient or chronic increase in the levels of free oxygen/nitrogen radicals, either as a result of the exaggerated elevation in their production or the decrease in their ability to be eliminated by antioxidant systems. Although the pathogenesis of psoriasis remains far from elucidated, there are studies that delineate an involvement of oxidative stress in this skin disorder. Thus, a systematic search was computed in PubMed/Medline, Web of Science and SCOPUS and, in total, 1293 potentially eligible articles exploring this research question were detected. Following the removal of duplicates and the exclusion of irrelevant manuscripts based on the screening of their titles and abstracts (n = 995), 298 original articles were selected for full-text review. Finally, after we applied the exclusion and inclusion criteria, 79 original articles were included in this systematic review. Overall, the data analyzed in this systematic review point out that oxidative stress markers are elevated in psoriasis and share an association with the duration and severity of the disease. The concentrations of these biomarkers are impacted on by anti-psoriasis therapy. In addition, the crosstalk between psoriasis and oxidative stress is influenced by several polymorphisms that arise in genes encoding markers or enzymes related to the redox balance. Although the involvement of oxidative stress in psoriasis remains undisputable, future research is needed to explore the utility of assessing circulating serum, plasma, urinary and/or skin biomarkers of oxidative stress and of studying polymorphisms in genes regulating the redox balance, as well as how can these findings be translated into the management of psoriasis, as well in understanding its pathogenesis and evolution.
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Affiliation(s)
- Elena-Codruța Dobrică
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Dermatology, “Elias” University Emergency Hospital, 011461 Bucharest, Romania
- Correspondence: or (E.-C.D.); (V.-M.V.)
| | - Matei-Alexandru Cozma
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.-A.C.); (M.-A.G.)
- Department of Gastroenterology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.-A.C.); (M.-A.G.)
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Vlad-Mihai Voiculescu
- Department of Dermatology, “Elias” University Emergency Hospital, 011461 Bucharest, Romania
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.-A.C.); (M.-A.G.)
- Correspondence: or (E.-C.D.); (V.-M.V.)
| | - Amelia Maria Găman
- Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; or
- Clinic of Hematology, Filantropia City Hospital, 200143 Craiova, Romania
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Albayrak L, Sogut O, Çakmak S, Gökdemir MT, Kaya H. Plasma oxidative-stress parameters and prolidase activity in patients with various causes of abdominal pain. Am J Emerg Med 2020; 38:99-104. [DOI: 10.1016/j.ajem.2019.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 10/27/2022] Open
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Zhang Y, Li Z, Ma Y, Mu Z. Association of total oxidant status, total antioxidant status, and malondialdehyde and catalase levels with psoriasis: a systematic review and meta-analysis. Clin Rheumatol 2019; 38:2659-2671. [DOI: 10.1007/s10067-019-04676-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/29/2019] [Accepted: 07/03/2019] [Indexed: 12/13/2022]
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Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis? Postepy Dermatol Alergol 2016; 33:340-344. [PMID: 27881939 PMCID: PMC5110623 DOI: 10.5114/ada.2016.62839] [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] [Received: 09/01/2015] [Accepted: 10/02/2015] [Indexed: 11/24/2022] Open
Abstract
Introduction Psoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury. Aim To examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers. Material and methods Forty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group. Results Statistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease. Conclusions As a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.
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The relationship between body mass index, waist circumference and psoriatic arthritis in the Turkish population. Postepy Dermatol Alergol 2016; 33:219-23. [PMID: 27512358 PMCID: PMC4969418 DOI: 10.5114/ada.2016.60615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 05/28/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Psoriasis is a chronic, immune-mediated inflammatory disease predominantly affecting the skin, with a complex aetiology. Recently it has been suggested that the chronic inflammation of psoriasis may cause metabolic and vascular disorders. The relationship between obesity and psoriatic arthritis (PsA) is not clear, and there are insufficient prospective studies addressing this subject. Aim To investigate the relationship between psoriatic arthritis, severity of psoriasis and obesity in the Turkish population. Material and methods Patient data from psoriasis outpatient clinics from February 2007 to July 2013 were reviewed retrospectively using the Psoriasis-Turkey (PSR-TR) registration system. Patients’ age, onset age, body mass index (BMI), waist circumference, psoriasis area and severity index (PASI), and arthritis information were reviewed. In the outpatient clinics, patients who had joint pain consulted rheumatology clinics. The CASPAR criteria were used for the diagnosis of arthritis. Results A total of 443 males and 495 females enrolled in this study. The mean age of females was 43.9 years (18–93 years) and the mean age of males was 44.6 years (18–89 years). A total of 231 (25%) patients had psoriatic arthritis. Investigation of the relationship between PASI, BMI, waist circumference (WC) and arthritis revealed a statistically significant relationship between each variable. Conclusions In this study we observed a relationship between PsA and high BMI, high WC and high PASI. Psoriatic arthritis is a chronic inflammatory disorder and a chronic inflammatory state induced by adiposity may lead to PsA.
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Peluso I, Cavaliere A, Palmery M. Plasma total antioxidant capacity and peroxidation biomarkers in psoriasis. J Biomed Sci 2016; 23:52. [PMID: 27377373 PMCID: PMC4932672 DOI: 10.1186/s12929-016-0268-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 06/28/2016] [Indexed: 01/05/2023] Open
Abstract
Systemic biomarkers of oxidative stress can be relevant for assessment of psoriasis severity, for prediction of the outcome of therapy and of the development of comorbidities. In this review we aimed to evaluate the relationship between plasma total antioxidant capacity (TAC) and peroxidation biomarkers, as well as their association with dyslipidemia and systemic inflammation in psoriasis. The review of 59 case–control comparisons (from 41 studies) and 17 interventions (from 13 studies) suggests that peroxidation markers are more sensitive than TAC in the evaluation of oxidative stress in psoriasis. Although few studies investigated the effect of treatment on oxidative stress, it seems that biological drugs could be the better choice in the treatment of psoriasis. However, considering the limitations of TAC and plasma peroxidation markers, this review suggests that new methods should be developed in order to evaluate systemic oxidative stress in psoriasis.
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Affiliation(s)
- Ilaria Peluso
- Center of Nutrition, Council for Agricultural Research and Economics (CREA-NUT), Via Ardeatina 546, Rome, 00178, Italy.
| | - Arturo Cavaliere
- Dermopathic Institute of the Immaculate IDI-IRCCS, Via dei Monti di Creta, 104, Rome, 00167, Italy
| | - Maura Palmery
- Department of Physiology and Pharmacology "V. Erspamer", "Sapienza" University of Rome, P.le Aldo Moro 5, Rome, 00185, Italy
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Abstract
The pathophysiology of psoriasis is complex and dynamic. Recently, the involvement of oxidative stress in the pathogenesis of psoriasis has been proposed. Oxidative stress is an imbalance between oxidants and antioxidants in favor of the oxidants, leading to a disruption of redox signaling and control and/or molecular damage. In this article, the published studies on the role of oxidative stress in psoriasis pathogenesis are reviewed, focusing on the impacts of oxidative stress on dendritic cells, T lymphocytes, and keratinocytes, on angiogenesis and on inflammatory signaling (mitogen-activated protein kinase, nuclear factor-κB, and Janus kinase/signal transducer and activator of transcription). As there is compelling evidence that oxidative stress is involved in the pathogenesis of psoriasis, the possibility of using this information to develop novel strategies for treatment of patients with psoriasis is of considerable interest. In this article, we also review the published studies on treating psoriasis with antioxidants and drugs with antioxidant activity.
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Affiliation(s)
- Xiran Lin
- a Department of Dermatology , The First Affiliated Hospital of Dalian Medical University , Dalian , China
| | - Tian Huang
- b Department of Dermatology , The Second Affiliated Hospital of Dalian Medical University , Dalian , China
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Lin X, Huang T. Impact of pregnancy and oestrogen on psoriasis and potential therapeutic use of selective oestrogen receptor modulators for psoriasis. J Eur Acad Dermatol Venereol 2016; 30:1085-91. [PMID: 27072912 DOI: 10.1111/jdv.13661] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
- X. Lin
- Department of Dermatology First Affiliated Hospital of Dalian Medical University Dalian China
| | - T. Huang
- Department of Dermatology Second Affiliated Hospital of Dalian Medical University Dalian China
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