Interleukin 17 Expression in Psoriatic Skin Lesions before and after Treatment with Platelet Rich Plasma (PrP)

Abstract

Background: Psoriasis is a chronic immune-mediated inflammatory disorder with epidermal hyperplasia. There is some evidence that the Interleukin (IL) 17 has a role in the pathogenesis of psoriasis. Platelet Rich Plasma (PrP) is autologous concentration of platelets may improve the condition because of its anti-inflammatory nature. Aim of Work: This study has been conducted in an attempt to assess the effect of PrP as a new modality for treatment of chronic localized plaque psoriasis on IL17 expression in psoriatic skin lesions. Patients and Methods: This study is a randomized controlled clinical trial study in which 24 psoriasis patients attending Dermatology and Andrology Outpatient Clinics in Suez Canal University Hospitals between January 2016 to January 2017 were enrolled. Two symmetrical plaques were injected weekly intradermally with PrP and saline as placebo and skin biopsy was taken from each plaque before and after treatment. Skin biopsies were assessed for IL17 expression. Results: All the clinical parameters used for assessment of clinical response (size, erythema, thickness and scaling) significantly decreased after PrP injection by (27.39 ±29.33, 28.47±51.89, 25.35 ±66.23, and 24.31 ± 44.36%) respectively, while plaques injected with saline showed significant decrease of scaling only. Moreover 6 plaques out of the 9 plaques that were positive for IL17 converted to negative after treatment with PrP, while all them remained positive for IL17 expression after injection with saline as placebo. Conclusions: Although psoriatic plaques treated with PrP showed variable clinical and immunological improvement compared to lesions injected with saline as placebo, PrP treatment alone can't be considered as a therapeutic modality for treatment of localized plaque psoriasis.

Platelet-Rich Plasma for the Treatment of Plaque Psoriasis: A Systematic Review

“…While several clinical studies have demonstrated the effectiveness of PRP therapy in treating plaque psoriasis, their smaller sample sizes have limited the overall understanding of the treatment's impact and the generalization of the results. Although the existing research has shown promising results, the general consensus among medical researchers is that larger, more extensive studies are required [26][27][28][29][30]34]. By increasing the sample size, researchers can establish more substantial evidence of the effectiveness of PRP therapy for plaque psoriasis and further assess the potential benefits and risks associated with the treatment.…”

“…One plaque received the intradermal administration of PRP, while the other received normal saline as a placebo. They performed biopsies before and after treatment to investigate the role of IL-17 expression in psoriasis pathogenesis and PRP’s mechanism [ 34 ].…”

“…In comparison, saline treatment did not reduce plaque thickness (p = 0.073). PRP treatment and saline significantly reduced scaling (p = 0.007 and p = 0.013, respectively) [ 34 ].…”

“…The researchers demonstrated the effectiveness of PRP in treating plaque psoriasis and highlighted that PRP achieved this by reducing IL-17 expression in patients with plaque psoriasis. However, further research is needed to explore the relationship between PRP, IL-17 expression, and other inflammatory mediators in plaque psoriasis [ 34 ]. See Table 2 for the key studies and their findings reviewed in this paper.…”