Meta-analysis Of The Relationship Between SICAM-1 And Psoriasis

Objectives: Psoriasis is a common chronic inflammatory proliferative skin disease. Psoriasis has a long course and difficult to cure. It is easy to recrudesce. Psoriasis caused great negative impact on the quality of life. The precise pathomechanisms of this disease are still unknown. It is now accepted psoriasis as a T-cell-mediated immune-disease. The main mechanism of the immune pathogenesis of psoriasis can be summarized as follow. Exogenous antigen-induced and endogenous self-antigen resulted in Langerhans cells, dendritic cells and other antigen-presenting cells capture antigens and then presented at the cell surface. Mature antigen-presenting cells which through the blood vessels into the lymph nodes of skin, was handed to the natural T-cell antigen. Natural T cells become pathogenic effector memory T cells by activation, differentiation and proliferation. Memory T cells migrate to the skin and the lesion. A variety of inflammatory factors and cytokines, which are induced by memory T cells, leading to a series of pathological changes of psoriasis in lesion. At present, more generally accepted is that memory T lymphocytes in the lesion and cytokines play a key step in pathogenesis of psoriasis. sICAM-1 (soluble intercellular adhesion molecule-1) is one important cytokine in the pathogenesis. In recent years, many studaies on sICAM-1 of psoriasis patients. However, some studies sample size small and some results are not consistent. Meta analysis is a synthesis and evaluation method about existing data.It can carry out comprehensive statistical analysis and evaluation about number of independent research findings which have the same purpose. Meta analysis can improve and enhance the statistical power because of small sample size. It can make more objective judgments and reliable conclusions about inconsistent results. It can answer questions which has not yet answered or can not be answered in a separate study. This study in order to assess the relationship between serum sICAM-1 and Psoriasis by the mean of Meta-analysis and provide objective reference for clinical study and target treatment for psoriasis.Methods: Search terms: Psoriasis, Soluble intercellular adhesion molecule-1, sICAM-1. Searchable database: Cochrane Library, PubMed, Chinese academic literature, the total library web publishing (including Master's thesis and doctoral dissertation) (CNKI New), Chinese Journal of Documentation Services System (sinomed). This study adopt considering case-control researches of the relationship between s-ICAM-1 and Psoriasis. Two authors collected data independently and evaluated quality and results. The researches are analysed by RevMan4.2.8.Result: 21 articles are adopted. There are 788 cases of psoriasis patients compared with 624 cases of normal controls. All the studies detect serum sICAM-1 by ELISA. Some of studies mention sensitivity, specificity and reproducibility of the method. The results of Meta-analysis: sICAM-1 in serum was markedly elevated in patients of not sub-type and not phased versus normal Z = 4.70 (P < 0.00001),WMD147.68,95%CI(86.05, 209.31); Vulgaris versus Normal Z = 6.14 (P < 0.00001),WMD152.95,95%CI(104.09, 201.81); Progressive versus Normal Z = 4.85 (P < 0.00001),WMD176.04,95%CI(104.94, 247.14); Quiescent versus Normal Z = 3.14 (P = 0.002),WMD89.69,95%CI(33.64, 145.74); Regression versus Normal Z = 1.44 (P = 0.15),WMD81.49,95%CI(-29.75, 192.73); Progressive versus Quiescent Z = 4.25 (P < 0.0001),WMD83.06,95%CI(44.76, 121.37); Progressive versus Regression Z = 10.84 (P < 0.00001),WMD125.12,95%CI(102.50, 147.74); Quiescent versus Regression Z = 1.09 (P = 0.28),WMD36.69,95%CI(-29.39, 102.76). There is a positive correlation between serum level of ICAM-1 with PASI score.Conclusion: The results showed that serum sICAM-1 level of psoriasis patients, which not sub-type, not phased and vulgaris, higher than those in normal controls. This shows that the pathogenesis of psoriasis associated with increased sICAM-1. Serum sICAM-1 level of progressive and quiescent psoriasis patients higher than those in normal controls. This shows that active or maintenance of the disease caused by high level of serum sICAM-1. There is no difference between regression versus normal control. This shows that serum level of sICAM-1 dropped to near normal levels when the diease got better to regression phase. This only reinforces the serum sICAM-1 levels and the activity of disease. Serum sICAM-1 level of progressive psoriasis patients higher than those in quiescent and regression patients. Serum sICAM-1 levels were significantly decreased during the diease condition from the active to maintain or dissipated. This phenomenon also shows that the serum sICAM-1 levels and disease activity. There is no difference between quiescent regression. Serum sICAM-1 levels were not significantly decreased during the diease condition from maintain to dissipated. There are 8 articles metion the relationship between serum level of ICAM-1 with PASI score. All of the results have statistically significant positive correlation. This shows that the serum sICAM-1 levels and the severity of illness were positively correlated.This study showed that serum sICAM-1 level is are related with the degree of psoriasis activity and severity. There are some limitations in the study and the included literature. In the future, We look forword high-quality literature will be included in this study. That will further verify the results of this study.