The rise of staphylococcal super antigens in psoriatic patients: a case-control study

MRSA and Skin Infections in Psoriatic Patients: Therapeutic Options and New Perspectives

Psoriatic patients present various infectious risk factors, but there are few studies in the literature evaluating the actual impact of psoriasis in severe staphylococcal skin infections. Our narrative review of the literature suggests that psoriatic patients are at increased risk of both colonization and severe infection, during hospitalization, by S. aureus. The latter also appears to play a role in the pathogenesis of psoriasis through the production of exotoxins. Hospitalized psoriatic patients are also at increased risk of MRSA skin infections. For this reason, new molecules are needed that could both overcome bacterial resistance and inhibit exotoxin production. In our opinion, in the near future, topical quorum sensing inhibitors in combination with current anti-MRSA therapies will be able to overcome the increasing resistance and block exotoxin production. Supplementation with Vitamin E (VE) or derivatives could also enhance the effect of anti-MRSA antibiotics, considering that psoriatic patients with metabolic comorbidities show a low intake of VE and low serum levels, making VE supplementation an interesting new perspective.

Role of Superantigens In Various Childhood Inflamatory Diseases

----:: Super antigens (Sags) are some part of virus or bacteria proteins which stimulate T cells and antigen-presenting cells leading to systemic immune repose and inflammation. ---SAgs might have possible role in in various inflammatory childhood diseases (eg Kawasaki disease, atopic dermatitis, and chronic rhinosinusitis). ----Worldwide studies had done to determine the role of staphylococcal SAgs (TSST-1 ) in various inflammatory diseases. The SAgs (TSST-1) not only induce sepsis and septic shock (even in negative blood culture for S.aureus) ,but also might have significant role in various childhood inflammatory diseases ( eg KD, OMS, Polyp, dermatitis, psoriasis ) . In proven SAgs induced inflammatory diseases, inhibition the cell-destructive process by SAgs suppressants might be helpful. ----In toxic shock or sepsis like presentation even in cases with negative blood cultures immediate use pf anti staphylococcal drugs is required. ---Occasionaly, clinical presentation of some human viruses (eg coronavirus and adenovirus) mimic KD. ----- In addition ,coinfection with adenovirus, coronavirus, and para-influenza virus type 3 were observed with KD. -- Bacterial Sags induced increasement of acute-phase reactants and number of white blood cell, and neutrophil counts In developed KD. ----Multisystem inflammatory syndrome in children (MISC) and KS observed during the recent COVID-19 pandemia. This study summarized the relation between viral and bacterial SAgs and childhood inflammatory diseases.

The impact of external factors on psoriasis

Psoriasis is one of the most common chronic inflammatory skin diseases, constituting a significant health and socioeconomic problem. Despite numerous therapeutic options, the results of treatment very often remain insufficient. It is extremely important to remember that many external factors impact the effectiveness of therapy. This article discusses the importance of emollients in therapy and the influence of infectious agents and injuries on the course of psoriasis. Understanding the above-mentioned factors in the treatment of psoriasis is critical to achieve satisfactory therapeutic effects.

Increased risk of psoriasis in patients with chronic rhinosinusitis without nasal polyps: a longitudinal follow-up study using Korean national sample cohort

PURPOSE

Focal chronic inflammation or infection is thought to be one of the causes of psoriasis. Few reports on the association between chronic rhinosinusitis (CRS) and psoriasis exist, thus it is poorly defined. This study seeks to investigate the incidence of psoriasis in patients with CRS with reference to a matched control group.

METHODS

This national cohort study relies on data from Korean Health Insurance Review and Assessment Service-National Sample Cohort (HIRA-NSC), which were entered from 2002 to 2013. A total of 34,219 patients with CRS without nasal polyps was matched with 136,976 controls. The Cox proportional hazard model was used to analyze the crude (simple) and adjusted hazard ratios (HRs) of psoriasis. For subgroup analysis, participants were grouped by age and sex.

RESULTS

The risk of psoriasis was higher in the CRS group than in the control group (adjusted HR 1.28, 95% CI 1.12-1.47, P < 0.001). Children, adolescents below 19 years regardless of sex, and old adult men above 60 years are at significantly higher risk for subsequent psoriasis after CRS diagnosis.

CONCLUSION

CRS may increase the risk of psoriasis.

Effect of Substance P in Staphylococcus aureus and Staphylococcus epidermidis Virulence: Implication for Skin Homeostasis

Staphylococcus aureus and Staphylococcus epidermidis are two major skin associated bacteria, and Substance P (SP) is a major skin neuropeptide. Since bacteria are known to sense and response to many human hormones, we investigated the effects of SP on Staphylococci virulence in reconstructed human epidermis model and HaCaT keratinocytes. We show that SP is stimulating the virulence of S. aureus and S. epidermidis in a reconstructed human epidermis model. qRT-PCR array analysis of 64 genes expressed by keratinocytes in the response to bacterial infection revealed a potential link between the action of SP on Staphylococci and skin physiopathology. qRT-PCR and direct assay of cathelicidin and human β-defensin 2 secretion also provided that demonstration that the action of SP on bacteria is independent of antimicrobial peptide expression by keratinocytes. Considering an effect of SP on S. aureus and S. epidermidis, we observed that SP increases the adhesion potential of both bacteria on keratinocytes. However, SP modulates the virulence of S. aureus and S. epidermidis through different mechanisms. The response of S. aureus is associated with an increase in Staphylococcal Enterotoxin C2 (SEC2) production and a reduction of exolipase processing whereas in S. epidermidis the effect of SP appears mediated by a rise in biofilm formation activity. The Thermo unstable ribosomal Elongation factor Ef-Tu was identified as the SP-interacting protein in S. aureus and S. epidermidis. SP appears as an inter-kingdom communication factor involved in the regulation of bacterial virulence and essential for skin microflora homeostasis.