What’s New in Psoriasis Research

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Stigmatization Among Patients With Plaque Psoriasis

A comprehensive study published in the Journal of Clinical Medicine examined the prevalence of stigmatization among patients with plaque psoriasis, shedding light on the emotional and psychological burdens they face. Psoriasis can have profound effects on the social and emotional well-being of those affected.

This study, which included 122 participants, aimed to analyze the level of stigmatization experienced by patients with plaque psoriasis, considering various demographic and clinical factors. The research utilized both a 6-item Stigmatization Scale and a 33-item Feelings of Stigmatization Questionnaire, providing detailed insights into the patients’ experiences.

The results revealed several significant factors influencing the levels of stigmatization experienced by individuals with plaque psoriasis. One notable determinant was gender, with female patients reporting a higher degree of stigmatization compared to male patients. Another influencing factor was the place of residence, indicating that individuals residing in rural areas faced a stronger sense of stigmatization than their urban counterparts. This observation could be linked to a lack of anonymity in smaller communities.

The location of psoriatic lesions on visible body parts, such as the face and scalp, was found to significantly impact the stigmatization experienced, particularly among women. In addition, patients with lesions spreading across their entire body demonstrated an increased level of stigmatization, particularly in the domain of positive attitudes.

Interestingly, patient age, age at diagnosis, duration of psoriasis, family history of psoriasis, and educational level did not show a significant association with the level of stigmatization experienced. These results suggest that stigmatization is a complex phenomenon influenced by a combination of societal, cultural, and individual factors.

“Women and respondents living in the countryside present higher levels of stigmatization due to psoriasis. The location of psoriatic lesions is important for the psychosocial functioning of the patient,” concluded the study authors.

Reference
Jankowiak B, Krajewska-Kułak E, Jakoniuk M, Khvorik DF. Stigmatization among patients with plaque psoriasis. J Clin. Med. 2023;12(19):6425. doi:10.3390/jcm12196425

Cathepsin B a Potential Novel Marker of Psoriatic Itch

According to a study published in Cells, cathepsin B could serve as a common indicator of the mast cell (MC)-dependent itch signature in psoriasis.

Researchers aimed to unravel the specific contributions of MCs to the cutaneous neuroinflammatory response in psoriasis. They examined MC density, distribution, their relationship with nerve fibers, disease severity, and molecular signatures by comparing MCs isolated from the skin of patients with psoriasis and healthy individuals using RNA-seq analysis.

In psoriatic skin, MCs were found to be closely associated with calcitonin gene-related peptide-positive nerve fibers, and both MC and nerve fiber density increased with disease severity. Gene expression analysis highlighted significant representation of neuron-related pathways in psoriatic skin, indicating the involvement of MCs in neuronal development and supporting evidence of their close interaction with nerve fibers. Furthermore, the study identified upregulated genes in MCs from psoriasis-involved skin, including CTSB, TLR4, and TACR1, all of which are associated with itch. CTSB emerged as a reliable indicator of psoriasis, as it was consistently elevated in both whole-skin datasets and isolated MCs. The density of cathepsin B+ cells, a marker for MCs, correlated with disease severity, strengthening the link between MCs and psoriasis-related itch.

“Our study provides evidence that cathepsin B could serve as a common indicator of the MC-dependent itch signature in psoriasis,” the authors concluded.

Reference
West PW, Tontini C, Atmoko H, et al. Human mast cells upregulate cathepsin B, a novel marker of itch in psoriasis. Cells. 2023;12(17):2177. doi:10.3390/cells-12172177doi:10.3389/fmed.2022.965423

Oxidized mtDNA Associated With Measures of Coronary Plaque Formation in Psoriasis

A recent study published in JID Innovations delved into the connection between psoriasis (PsO) and atherosclerosis, particularly examining immune and inflammatory biomarkers in patients with PsO. The study focused on oxidized mitochondrial DNA (ox-mtDNA), a byproduct of pyroptosis observed in various cells, including keratinocytes. Using enzyme-linked immunosorbent assay (ELISA), the researchers quantified ox-mtDNA levels in patients with PsO and individuals without PsO.

The findings revealed that patients with PsO exhibited significantly higher levels of ox-mtDNA compared to healthy subjects. Importantly, ox-mtDNA showed positive associations with IL-17a and low-density granulocytes, and a negative association with high-density lipoprotein cholesterol. Adjusting for traditional cardiovascular risk factors, the study established an association between ox-mtDNA and noncalcified coronary burden measured through coronary computed tomography angiography.

Furthermore, biologic-naïve patients with PsO treated with anti-IL-17a therapy demonstrated a notable 14% decrease in ox-mtDNA levels and a 10% reduction in noncalcified coronary artery burden over 1 year. This suggests a potential link between ox-mtDNA and early autoimmune-driven atherosclerotic features. The study implies that monitoring ox-mtDNA levels could serve as a valuable biomarker for assessing cardiovascular risk in patients with PsO. These findings not only contribute to our understanding of the intricate relationship between autoimmune diseases and cardiovascular health but also suggest the therapeutic potential of anti-IL-17a therapy in mitigating both PsO-related inflammation and atherosclerotic burden.

“In summary, levels of ox-mtDNA in PsO are associated with measures of coronary plaque formation, indicating that this biomarker may be an autoimmune-driven early atherosclerotic feature,” the authors concluded.

Reference
Lateef SS, Ward GA, Li H, et al. Circulating oxidized mtDNA is associated broadly with cardiovascular disease in a longitudinal cohort study of psoriasis. JID Innov. 2024;4(1):100243. doi:10.1016/j.xjidi.2023.100243

Red Blood Cell Distribution Width and Psoriasis Risk in Women

According to a study published in Frontiers in Medicine, red blood cell distribution width (RDW) levels were associated with an increased risk of psoriasis in women.

Researchers aimed to investigate the association between RDW and psoriasis among US adults using data from the National Health and Nutrition Examination Survey conducted between 2009 and 2014. The study included 14,089 participants, and psoriasis status was determined through self-reported questionnaires.

The results revealed a noteworthy association between higher RDW levels and an increased risk of psoriasis in female participants after adjusting for confounding variables (OR = 1.10 [95% CI, 1.01, 1.19]; P = 0.025). However, in male participants, no significant association was observed between RDW and the risk of psoriasis (OR = 0.99 [95% CI, 0.87, 1.15]; P = 0.992).

Furthermore, subgroup and interaction analyses indicated that the most robust positive association was predominantly observed in female participants with a body mass index (BMI) exceeding 29.9 kg/m² (OR = 1.20 [95% CI, 1.09, 1.32], P = 0.004). These findings suggest a gender-specific relationship between RDW and psoriasis, with a heightened risk in women, particularly those with a higher BMI.

“In conclusion, we found that increased RDW levels were associated with an increased risk of psoriasis in females, which could provide clinicians with auxiliary data for the early diagnosis of psoriasis,” the authors concluded.

Reference
Zhang Y, Lv Z, Peng P, Zhao T. Association between red blood cell distribution width and psoriasis among the US adults. Front Med (Lausanne). 2023;10:1290514. doi:10.3389/fmed.2023.1290514