Serum homocysteine, asymmetric dimethyl arginine (ADMA) and other arginine–NO pathway metabolite levels in patients with psoriasis

Abstract

Hyperhomocysteinemia, a well-known and independent risk factor for cardiovascular disease, has been related in several studies with psoriasis patients. It has been suggested that homocysteine leads to endothelial dysfunction by causing an accumulation of asymmetrical dimethyl arginine (ADMA), a potent endogenous nitric oxide (NO) synthase inhibitor of the L-arginine-NO pathway. However, limited data is available regarding the psoriasis and ADMA relationship. In this study, we aimed to investigate the serum levels of homocysteine, ADMA and other metabolites from the L-arginine-NO pathway in psoriasis patients. Forty-two patients with chronic plaque psoriasis and 48 controls were enrolled in the study. Serum homocysteine, ADMA, L-monomethyl-L-arginine (L-NMMA), symmetric dimethylarginine (SDMA) and L-arginine levels, and L-arginine/ADMA ratios of psoriasis patients and the control group were measured. The severity of psoriasis was assessed by the psoriasis area and severity index (PASI). The mean ADMA and homocysteine values were significantly higher, and citrulline and L-arginine/ADMA values were significantly lower in psoriasis patients compared to control subjects. However, there were no significant differences among the patient and control groups with respect to mean SDMA, L-NMMA and L-arginine values. PASI scores strongly correlated with the ADMA level and moderately correlated with L-arginine/ADMA ratio. This study suggests that the L-arginine-NO pathway metabolites, especially ADMA, may play an important role in the pathogenesis of psoriasis. Additionally, serum ADMA levels of psoriasis patients may be an indicator of the disease severity.

Asymmetric dimethylarginine but not osteoprotegerin correlates with disease severity in patients with moderate‐to‐severe psoriasis undergoing anti‐tumor necrosis factor‐α therapy

“…Our findings are in keeping with a recent study on 42 patients with chronic plaque psoriasis in which PASI score strongly correlated with the ADMA level . This study along with our present data highlight the potential role of ADMA in the pathogenesis of psoriasis.…”

Blood homocysteine, folic acid, vitamin B12 and vitamin B6 levels in psoriasis patients

“…However, unlike these results, patients with psoriasis were found to have high blood homocysteine in other five studies again in our country and five in Italy and one each in Ireland and Norway [20][21][22][23][24][25][26][27][28][29][30][31] . In the literature, studies showing psoriasis being accompanied by high blood homocysteine seem to be predominant (Table 3).…”

“…After the studies made in 1990s where high levels of homocysteine were found in plasma samples of subjects who had or would likely to have a history of myocardial infarction, ischemic stroke or peripheral vascular disease and the association of homocysteine with atherosclerosis and hypercoagulability had been shown [6][7][8][9][10][11][12] , along with increased attention to the comorbidities of psoriasis, as far as we know, 19 studies have been conducted to explore homocysteine levels in these patients. Homocysteine level was found to be high in 12 and normal in 7 of these studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] . Since this sulfur-containing amino acid is not taken through diet and not producing protein, homocysteine is formed via methionine catabolism 8,11,27 .…”

Hydrogel Micropatch and Mass Spectrometry–Assisted Screening for Psoriasis-Related Skin Metabolites

“…Metabolic profiling of unconventional specimens obtained in a noninvasive manner is particularly challenging (sampling, sample storage, sample treatment, chemical analysis, and data processing) and has not been extensively addressed. Thus, it is not surprising that more attention has been paid to the alterations in the blood metabolite composition in psoriasis (7,8), and studies focused on the skin are rare (6,9,10).…”