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Psoriasis is a chronic immune-mediated inflammatory dermatosis. Recently, ozone therapy has been applicated to psoriasis treatment; however, the mechanism by which ozone therapy improves psoriasis remains unclear. The excessive proliferation and the differentiation of basal keratinocytes have been considered critical issues during pathological psoriasis process, in which keratin 6 (KRT6) and KRT10 might be involved. In the present study, KRT6, IL-17 and IL-22 protein within psoriasis lesions was decreased, while KRT10 and Tp63 protein in psoriasis lesions was increased by ozone treatment in both patient and IMQ mice psoriatic tissues. In the meantime, ozone treatment down-regulated KRT6 mRNA and protein expression while up-regulated KRT10 mRNA and protein expression within IL-22 treated primary KCs; the cell viability of KCs was suppressed by ozone treatment. Moreover, Tp63 bound to KRT10 promoter region to activate its transcription in basal keratinocytes; the promotive effects of ozone on Tp63 and KRT10 were significantly reversed by Tp63 silence. Both TP63 and KRT10 mRNA expression were significantly increased by ozone treatment in psoriasis lesions; there was a positive correlation between Tp63 and KRT10 expression within tissue samples, suggesting that ozone induces the expression of Tp63 to enhance the expression of KRT10 and the differentiation of keratinocytes, therefore improving the psoriasis. In conclusion, the application of ozonated oil could be an efficient and safe treatment for psoriasis; ozone promotes the differentiation of keratinocytes via increasing Tp63-mediated transcription of KRT10, therefore improving psoriasis.

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Background: Psoriasis is widely accepted as a metabolic syndrome with significantly abnormal lipid metabolism and high blood lipids keep patients in a persistent low level of inflammatory condition. Hyperlipidemia and associated inflammatory reaction are believed to be the major risk factors contributing to the onset and recurrence of psoriasis. Peroxisome proliferator activated receptor-gamma (PPAR-γ) can effectively control the blood lipid level and inhibit inflammatory reaction. Methods: Ozone autohemotherapy (OAHT) was applied to treat psoriatic patients. The psoriasis area and severity index (PASI) score and blood lipid level were used to evaluate the efficacy. PPAR-γ expression level and correlation analysis were used to determine the OAHT target involving psoriasis. Results: We found that OAHT significantly decreased patients’ PASI scores and lipid blood level. Furthermore, we found that PPAR-γ expression in CD4+ T cells from patients with psoriasis was significantly lower than healthy controls, furtherly, we detected PPAR-γ expression upregulated after treatment compared with before treatment. There, we performed the correlation analysis on PPAR-γ level and patients’ PASI scores or lipid blood level. These results suggested OAHT might obviously improve patients’ PASI scores and decrease lipid blood level by regulating PPAR-γ expression. Conclusions: We found that OAHT can attenuate the condition of psoriatic patients and lower blood lipid by inducing PPAR-γ expression, suggesting that OAHT is effective in treating psoriasis and is worthy of further evaluations for its clinical applications.