Effect of cognitive behavioral therapy on anxiety and depression in patients with psoriasis

Guo

et al. 2023

Preprint

BACKGROUND: Abnormal neuroimmune regulation is involved in the occurrence and development of psoriasis. The elevated levels of neurotransmitters in the skin locally promote the activation of immune cells by binding to their corresponding receptors, leading to the inflammation of psoriasis lesions. As an important neurotransmitter receptor, Neurokinin-1 Receptors (NK-1R) can bind to a variety of ligands to intensify the activation of immune cells and maintain the inflammatory response in psoriasis. However, its specific role in psoriasis needs to be further elucidated. METHODS：Immunohistochemistry was used to detect the expression levels of Substance P (SP) and NK-1R in human skin lesions. Mice with imiquimod (IMQ)-induced psoriasis were treated with NK-1R agonist or inhibitor, and NK-1R knockout (KO) mice were treated with IMQ to establish a psoriatic lesion model. The severity of skin lesions was scored using the Psoriasis Area Severity Index (PASI). The epidermal thickness of the mice was measured by hematoxylin–eosin staining. The levels of SP and NK-1R in the skin lesions were detected by fluorescence immunohistochemistry. The expression of inflammatory factors in the skin lesions and peripheral blood was detected using Luminex assay. Western blotting was used to investigate the expression levels of Akt/PKB (Protein kinase B), p-Akt, Rho family GTPase 3 (RND3), and vascular endothelial growth factor (VEGF). Flow cytometry was used to detect the number of dendritic cells (DCs), macrophages, T lymphocytes, and so on. The expression of CD80, CD86, and (major histocompatibility complex II, MHC II) molecules on CD11c+ DCs in ears, skin lesions, and spleens were also examined by flow cytometry. Bone marrow–derived DCs were cultured from the bone marrow of wild-type (WT) and NK-1R KO mice. Luminex assay was used to detect the cytokines secreted by DCs. RESULTS: The expression levels of SP and NK-1R increased in human skin lesions. NK-1R agonist aggravated IMQ-induced psoriasis-like skin lesions in mice, while NK-1R inhibitor could alleviate skin lesions. NK-1R KO mice showed alleviated skin lesions, reduced epidermal thickness, decreased expression of proliferating cell nuclear antigen and CD3+, decreased levels of inflammatory cytokines in the skin and peripheral blood, decreased protein expression levels of SP, NK-1R, and p-Akt, RND3, and VEGF in the skin lesions. Further, the expression level of MHC II on CD11c+ DCs in ears decreased in the ears of NK-1R KO mice, the expression levels of CD80 and CD86 on CD11c+ DCs in the skin lesions decreased, and the expression levels of CD80 and MHC II on CD11c+ DCs were decreased in the spleen. The secretion of cytokines IL-1β, IL-12p70, IL-23, and tumor necrosis factor-α decreased in NK-1R KO mice when bone marrow–derived DCs were cultured in vitro. CONCLUSIONS: NK-1R deficiency alleviated psoriasis by reducing the inflammatory response of DCs, which was also associated with SP/NK-1R/Akt and RND3/VEGF pathways. The results also suggested that NK-1R might be a key molecular target of psoriasis.

Section: Discussionmentioning

confidence: 99%

NK-1R deficiency alleviates psoriasis by reducing the inflammatory response of dendritic cells

Guo

et al. 2023

Preprint

“…Even though all these coping mechanisms are beneficial and appreciated by the patient, psychological therapy remains the best treatment for a patient in distress and it may be good to be given in patients with psoriasis-related depression and anxiety in the form of cognitive behavioural therapy [ 34 ].…”

Section: A Proposal For Alternative Coping Mechanismsmentioning

confidence: 99%

The role of smoking in psoriasis

Laguardia,

Owczarczyk-Saczonek,

Maggi

2024

pdia

Psoriasis has a clear and strong connection with smoking in both its pathogenesis and clinical course. Smoking can cause a serious worsening of both the disease itself and the systemic complications such as cardiovascular events, psoriatic arthritis (PsA), cancer and depression. Smoking also seems to alter the gut microbiota and thus promote psoriasis itself. The aim of our article is to review all the most interesting discoveries on its role and thus provide a good picture of the current state of knowledge. Furthermore, we provide some alternative and healthier coping mechanisms for stress and depression related to the disease such as exercise, meditation, balneotherapy and acupuncture.

“…Several international studies have shown that CBT can reduce sadness, anxiety, and other negative emotions. However, this has not been proven through a comprehensive examination (Tan et al, 2021). The purpose of study are; (1) what are the other conditions related to psoriasis?, and…”

Section: Introductionmentioning

confidence: 99%

Cognitive Behavioral Therapy as an Adjunctive Treatment for Anxiety and Depression in Psoriasis Patients

Dewi,

Wijayanti,

Chen

et al. 2023

devotion

Psoriasis is a skin disease associated with the body's immune system. Mental health is one of the accompanying diseases of psoriasis. The clinical manifestations of psoriasis allow sufferers to experience anxiety and depression. There is a significant correlation between anxiety and depression to psoriasis, therefore, an adjunctive therapy is needed in addition to pharmacological therapy. One of these is Cognitive Behavioral Therapy (CBT), which aims to overcome anxiety and depression. This literature review summarizes recent findings regarding the application of CBT in psoriasis patients. The aim of this review is to summarize the latest findings about CBT as an alternative therapy in psoriasis patients. The literature review method was carried out by conducting literature reviews from various online databases, namely NCBI, Science Direct, Elsevier, and Mendeley using predetermined criteria. The results of the literature review showed that psoriasis causes severe psychological suffering, sadness, stigmatization, and decreased health-related quality of life. Result of this review is psychotherapy can lead to positive results in the development of a patient's condition. When performed regularly, CBT can effectively treat a variety of mental health conditions in individuals experiencing mild to moderate anxiety. CBT includes psychological training, self-monitoring, cognitive reconstruction, the prevention of exposure to negative stimuli, and rigorous training. The implications of writing this review are, CBT can be included in the treatment of psoriasis to obtain faster healing results through therapy methods for anxiety and depression in psoriasis patients.