Extracellular matrix alterations in the skin of patients affected by psoriasis

Background Psoriasis is a chronic inflammatory disease dependent upon a complex interaction between genetic predisposition and immunological factors. It is characterized by skin lesions throughout the body, causing great morbidity and affecting life quality. The present study aimed to evaluate the protein and mRNA expression of heparanase-1 (HPSE), heparanase-2 (HPSE2), syndecan-1 (SYND1), metalloproteinases (MMP2, MMP9), and tissue inhibitor metalloproteinases 2 (TIMP2) in skin samples. Methods From each psoriasis patient, two samples were collected, one sample from a psoriasis plaque (n = 23) and the other sample from non-affected skin (n = 23), as well as tissue collected by blepharoplasty from control individuals (n = 18). Protein expression was investigated by immunohistochemistry, followed by digital quantification. Quantitative RT-PCR obtained mRNA expression. Statistical analyses were done, and p values < 0.05 were considered significant. Results A significant increase in protein and mRNA expression was observed in both heparanases (HPSE and HPSE2), and higher protein levels of MMP9 and TIMP2 were observed in the psoriasis plaque compared to the non-affected skin. The data point to a probable activation of MMP2 by TIMP2. Moreover, there was a significant increase in HPSE2, SYND1, MMP9, and TIMP2 in non-affected skin samples from patients with psoriasis than in the control sample (tissue obtained by individuals who do not have psoriasis). Conclusions These results show a possible correlation between the characteristic inflammatory process and alterations in the expression of the extracellular matrix in psoriasis. The increased expression of HPSE2, SYND1, MMP9, and TIMP2, even in the absence of psoriatic plaque, indicates that these molecules may be involved with extracellular matrix changes in the initial alterations the psoriatic process and may be candidates for the development of target treatments.

Evaluation of Serum Level of Claudin‐ 3 and Its Association with Disease Severity in Patients with Psoriasis in Iraqi patients

Background Psoriasis is a prevalent inflammatory skin disease. Psoriasis is a complex illness in which environmental variables acting on individuals with unique genetic predisposition causing immunological dysregulation. Claudins are transmembrane proteins that help to generate tight junctions by binding to the actin cytoskeleton. Claudin 3 in the blood is thought to be a good indicator of intestinal permeability. Objective: The aim of this study was to detect of the alteration of claudin-3 in psoriasis patient and find the correlation between severity and concentration of the claudin-3. Patients and methods: forty psoriatic patients (25males and 15 females) and thirty normal healthy controls (19 men and 11 females) who were age and sex matched to the cases group were included in this study. They were chosen at random from Al Fallujah hospital Dermatology Department outpatient clinic. Result: When compared to the control group, the psoriasis group had substantially greater levels of claudin-3 (mean=2.18 ± 0.16 versus 1.27 ± 0.03; p0.0001). Furthermore, the amount of claudin-3 rose progressively as the severity grade increased (001). There were no significant correlations between claudin-3 levels and gender, dietary status, or family history in the psoriasis group (p>0.05 for each). Conclusion: Claudin-3 levels were considerably greater in psoriasis patients than in healthy controls. PASI levels were shown to be linked to claudin-3 levels.

Happiness and depression in psoriasis: a cross-sectional study in Germany

Purpose Prior research on the psychological consequences of skin diseases has focused on assessing mental comorbidities. The aim of this study was to investigate subjective well-being in a large sample of individuals affected by psoriasis, a chronic inflammatory skin disease, and to explore the associations with depression and disease-related parameters such as disease severity. Methods A cross-sectional online survey was conducted from March to June 2019. The link to the questionnaire was shared on websites and Facebook pages of psoriasis patient organizations and campaigns. Participants filled in validated scales measuring subjective well-being—operationalized as positive affect (PA), negative affect (NA) and satisfaction with life (SWL); and depression. Results The data of 722 participants were analyzed. Exploratory factor analysis supported the differentiation of PA, NA, SWL, and depression as four different constructs. The respondents reported lower levels of PA than healthy individuals and judged themselves to be less happy and were less satisfied with their lives than the general population (except age group 65 + years). 40.3% of respondents were screened positive for depression. More severe psoriasis was associated with lower affective well-being and a higher risk for depression. Conclusion The results of this study empirically supported the differentiation of subjective well-being and depression as different constructs in individuals with psoriasis, and underline the large mental burden of the disease which goes beyond a higher risk for depression. Measures of well-being should thus be incorporated in both research and clinical practice in patients with psoriasis in order to achieve a more comprehensive picture of the mental burden of this disease.

Immunotherapy Using HistobulinTM In Psoriasis: A Case Report

Background: There is no cure for psoriasis. Early treatment using biologics is recommended to improve skin manifestations and reduce systemic inflammation, which leads to comorbidities in various organs.Case Presentation: HistobulinTM therapy was performed on a psoriasis patient who developed the disorder due to allergic rhinitis. Psoriasis was confirmed pathologically by skin biopsy. The patient responded rapidly, and the skin manifestations began to improve after just the first injection. Although the patient showed some temporary aggravation after the third injection, the clinical symptoms and signs improved continuously thereafter and disappeared after the eighth injection. Remission was induced and was evident when the patient showed no symptoms and signs during the subsequent 4 weeks during which time the patient received 4 more injections; afterwards, HistobulinTM therapy was ceased. After treatment, psoriasis did not recur for more than 6 months.Conclusions: HistobulinTM is effective and induces remission in psoriasis patients. HistobulinTM is suggested for curative therapeutics in psoriasis patients, and further basic research and clinical evaluation are necessary.

Mycobacterium Kansasii infection in a psoriasis patient treated with adalimumab and switch to apremilast: first report and literature review

Patient under anti-TNF-alpha treatment have an increased risk of mycobacterial infections, particularly tuberculosis. Only four case reports of Mycobacterium kansasii infection under anti-TNF-α treatment (two with etanercept, two with infliximab) have been reported, but none under adalimumab. A 72-year-old man treated with adalimumab for psoriasis vulgaris and arthropathic psoriasis, complained on nocturnal cough, occasional hemoptysis and the new onset of ill-defined, reddish, asymptomatic persistent plaquesnodules covered by serum crusts on his back, on the dorsum of the right hand and right middle finger. Routine laboratory investigations, HIV and TB screening (QuantiFERONTB- Gold test) were all within normal limits. A skin biopsy was inconclusive and special stainings resulted negative for microorganisms. Only PCR identified M. kansasii. The patient stopped adalimumab and started anti-TB treatment with gradual improvement of the skin lesions. At 26 months follow-up visit no signs or symptoms of relapse of M. kansasii disease occurred.

Molecular Mechanisms of ZC3H12C/Reg-3 Biological Activity and Its Involvement in Psoriasis Pathology

The members of the ZC3H12/MCPIP/Regnase family of RNases have emerged as important regulators of inflammation. In contrast to Regnase-1, -2 and -4, a thorough characterization of Regnase-3 (Reg-3) has not yet been explored. Here we demonstrate that Reg-3 differs from other family members in terms of NYN/PIN domain features, cellular localization pattern and substrate specificity. Together with Reg-1, the most comprehensively characterized family member, Reg-3 shared IL-6, IER-3 and Reg-1 mRNAs, but not IL-1β mRNA, as substrates. In addition, Reg-3 was found to be the only family member which regulates transcript levels of TNF, a cytokine implicated in chronic inflammatory diseases including psoriasis. Previous meta-analysis of genome-wide association studies revealed Reg-3 to be among new psoriasis susceptibility loci. Here we demonstrate that Reg-3 transcript levels are increased in psoriasis patient skin tissue and in an experimental model of psoriasis, supporting the immunomodulatory role of Reg-3 in psoriasis, possibly through degradation of mRNA for TNF and other factors such as Reg-1. On the other hand, Reg-1 was found to destabilize Reg-3 transcripts, suggesting reciprocal regulation between Reg-3 and Reg-1 in the skin. We found that either Reg-1 or Reg-3 were expressed in human keratinocytes in vitro. However, in contrast to robustly upregulated Reg-1 mRNA levels, Reg-3 expression was not affected in the epidermis of psoriasis patients. Taken together, these data suggest that epidermal levels of Reg-3 are negatively regulated by Reg-1 in psoriasis, and that Reg-1 and Reg-3 are both involved in psoriasis pathophysiology through controlling, at least in part different transcripts.

The Use of Person-Centered Language in Medical Research Journals Focusing on Psoriasis: Cross-sectional Analysis

Background Person-centered language places a person’s identity before any disability or medical condition they may have. Using person-centered language reduces stigma and improves the patient-physician relationship, potentially optimizing health outcomes. Patients with psoriasis often feel stigmatized due to their chronic skin condition. Objective We seek to evaluate the use of person-centered language in psoriasis literature and to explore whether certain article characteristics were associated with non–person-centered language. Methods We performed a systematic search on PubMed for recently published articles in journals that regularly publish psoriasis studies. After article reduction procedures, randomization, and screening, we reached our target sample of 400 articles. The following non–person-centered language terms were extracted from each article: “Psoriasis Patient,” “Psoriasis subject,” “Affected with,” “Sufferer,” “Suffering from,” “Burdened with,” “Afflicted with,” and “Problems with.” Screening and data extraction occurred in a masked duplicate fashion. Results Of the 400 included articles, 272 (68%) were not adherent to person-centered language guidelines according to the American Medical Association Manual of Style. The most frequent non–person-centered language term was “Psoriasis Patient,” found in 174 (43.5%) articles. The stigmatizing language was associated with the type of article and funding status, with original investigations and funded studies having higher rates of stigmatizing language. Conclusions Articles about psoriasis commonly use non–person-centered language terms. It is important to shift away from using stigmatizing language about patients with psoriasis to avoid potential untoward influences. We recommend using “patients with psoriasis” or “patient living with psoriasis” to emphasize the importance of person-centered care.