Evaluation of Erythroid Disturbance and Thiol-Disulphide Homeostasis in Patients with Psoriasis

Abstract

This study aims to assess how mean corpuscular volume (MCV), red cell distribution width (RDW), and thiol-disulphide homeostasis are altered in psoriasis patients. This is a cross-sectional review of 76 healthy volunteers and 87 psoriasis patients who were consecutively admitted to the department of dermatology. Psoriasis patients and healthy controls were statistically similar with respect to age, sex, body mass index, blood pressures, and disease duration (p > 0.05 for all). When compared to healthy controls, psoriasis patients had significantly higher MCV, RDW, C-reactive protein (CRP), disulphide, disulphide/native thiol, and disulphide/total thiol (p < 0.001 for all). However, psoriasis patients had significantly lower native thiol and native thiol/total thiol (p = 0.009 and p < 0.001, respectively). When compared to healthy controls, the patients with Psoriasis Area Severity Index (PASI) ≤ 10 and patients with PASI > 10 had significantly higher MCV, disulphide, disulphide/native thiol, and disulphide/total thiol (p < 0.001 for all). The patients with PASI ≤ 10 and patients with PASI > 10 had significantly lower native thiol/native thiol than healthy controls (p < 0.001 for all). The psoriasis patients with PASI > 10 had significantly higher RDW and CRP than healthy controls and patients with PASI ≤ 10 (p < 0.001 for all). Disulphide, disulphide/native thiol, disulphide/total thiol, and native thiol/total thiol correlate significantly with both PASI scores and disease duration. Thiol-disulphide homeostasis is enhanced in psoriasis patients. Ongoing inflammation and increased oxidative stress in psoriasis patients also trigger the formation of prooxidants which are neutralized by antioxidants such as thiols. That is why plasma thiol levels are decreased in psoriasis patients.

Comparison of mean platelet volume (MPV) and red blood cell distribution width (RDW) between psoriasis patients and controls: A systematic review and meta-analysis

“…The major characteristics of 13 studies [14][15][16][17][18][19][20][21][22][23][24][25][26] enrolling 1331 psoriasis patients and 919 healthy controls were shown in Table 1. Twelve studies from Asia region, and one from Egypt, Africa were included.…”

Platelet Dysfunction and Its Role in the Pathogenesis of Psoriasis

“…A significant decrease in antioxidation ability was measured by reduced glutathione peroxidase, superoxide dismutase, and catalase levels in different groups of psoriasis patients when compared with a normal group [83, 85]. Lower levels of plasma thiols containing sulphydryl (–SH) groups were found and thereby indicated the insufficient antioxidant system to neutralize the effects of prooxidants in the patients [87]. Other free-radical-scavenging systems, such as lipophilic antioxidant paraoxonase 1 and vitamin E, were also significantly lower in psoriasis [88].…”

Increased red blood cell distribution width in patients with plaque psoriasis

“…RDW elevation in plaque psoriasis was first described by Kim et al (5) in 2015, who proposed this as a marker of psoriasis-associated systemic inflammation. Indeed, systemic inflammation leads to more significant oxidative stress, damage of circulating red blood cells, and inhibition of erythropoiesis with impaired erythrocyte maturation (9)(10)(11). Furthermore, proinflammatory cytokines were also shown to alter iron metabolism, which is a crucial factor for erythropoiesis.…”