Inflammatory marker alteration in response to systemic therapies in psoriasis

Abstract

Substantial research has focused on the presence of biomarkers involved in both the pathogenesis of psoriasis and its comorbidities. The identification of these biomarkers has a crucial role in establishing the diagnosis and prognosis, in understanding the physiopathological mechanism and in determining the therapeutic response. The aim of this study was to emphasize the alteration in inflammatory markers in response to systemic therapies in psoriasis. Evolution of inflammatory marker alteration was studied in 194 patients with psoriasis, aged between 7 and 87 years. Two groups were set up: the first comprised of patients treated with methotrexate (n=51), while the second comprised patients treated with biological therapy (n=143). Each group was evaluated for blood values of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fibrinogen before and after treatment, the fluctuation of these values according to the treatment, the interrelation between inflammatory markers and inflammatory activity of the disease and the evolution of the disease after treatment. In group I, 46 out of 51 patients had elevated levels of acute phase reactants before treatment. After treatment with methotrexate 7.5 mg/week, 12 out of 46 patients had elevated blood levels of ESR and 18 out of 46 patients of CRP and fibrinogen. Before treatment with biological therapy, 138 patients out of 143 presented abnormal high range for acute phase reactants. After treatment with biological therapy, 18 patients out of 138 had elevated blood levels of ESR and 37 patients out of 138 had elevated CRP and fibrinogen. A favorable evolution was noted in 98 patients out of 138. It was concluded that the systemic treatment with both methotrexate and biological therapy showed a marked decline in the patients with abnormal values of CRP, ESR and fibrinogen, indirectly showing a decline in the inflammatory activity of psoriasis.

High serum level of interleukin‑6 is linked with dyslipidemia in oral lichen planus

“…Recent research regarding cardiovascular risk in psoriasis suggests that chronic inflammation may be considered a component of the metabolic syndrome in which activation of type 1 T helper cells is present. The upregulation of type 1 T helper cells was observed in metabolic syndrome in correlation with several cytokines such as IL-6 and TNFα (29)(30)(31). IL-6 is a pleiotropic cytokine with a critical defense role in acute inflammatory response during infections and posttraumatic tissue injuries, promoting the synthesis of acute phase proteins including reactive C protein, amyloid A and fibrinogen.…”

Therapeutic implications of narrow band ultraviolet B on psoriasis severity and serum levels of acute phase reactants

“…A biological treatment for psoriasis (Etanercept) was shown to decrease the previously increased CRP serum levels in patients suffering from moderate and severe psoriasis 15 . A recent study reported that treating psoriasis with both methotrexate and biological therapy showed a significant decrease in the patients serum levels of CRP, ESR and fibrinogen 16 …”

“…15 A recent study reported that treating psoriasis with both methotrexate and biological therapy showed a significant decrease in the patients serum levels of CRP, ESR and fibrinogen. 16 Psoriasis severity and its correlation with inflammatory markers in response to treatment was evaluated by Kanelleas et al who found F I G U R E 2 Abdomen and forearm of a male patient before, A, and after, B, 36 sessions of NB-UVB showing moderate decrease in infiltration and scaling, and mild decrease in erythema that CRP serum levels diminished posttreatment (P < .001) and identified a relationship between PASI scores and CRP. 17 Another study reported a direct correlation between psoriasis severity and CRP serum levels that were decreased significantly following phototherapy sessions.…”

Cardiovascular comorbidities in psoriasis (Review)

“…Regarding biological therapy, based on the mechanism of action, it is divided into: T lymphocyte modulating agents (alefacept, efalizumab), TNF-α inhibitors (infliximab, adalimumab, etanercept), IL-12/IL-23 inhibitors (ustekinumab, briakinumab, guselkumab, risankizumab), and IL-17A inhibitors (ixekizumab, secukinumab) (1). The use of biological therapy significantly reduces inflammatory activity in psoriasis, this being demonstrated in various studies by measuring inflammation markers CRP, ESR and fibrinogen (28). It has recently been shown that biologic therapy prevents the formation and even reduces the growth of atheroma plaque (23,29,30).…”