The Relationship Of Cytokine Profiles And Disease Activity In Patients With Psoriasis Vulgaris

BackgroundPsoriasis is an immune-mediated chronic inflammatory skin disease,mainly characterized by abnormal activation of immune cells,infiltration and excessive proliferation of skin keratinocytes.The abnormal production and secretion of inflammatory cytokines is the pathophysiological basis of the occurrence and development of psoriasis,and it is also the main therapeutic target of psoriasis.At present,the detection of cytokine levels in serum of patients with psoriasis mostly focuses on a single or a few cytokines,and there are few research reports on the combined detection of multiple cytokines.ObjectiveThe aim of the study was to compare the levels of cytokines in the serum between patients with psoriasis and healthy controls.In addition,further analyze the differences of serum cytokines levels in psoriatic patients at different stages and their correlation with PASI score.Which to further understand the significance of these serum cytokines in the observation of psoriasis disease activity and treatment.In this study,flow cytometry was used to detect multiple cytokines in the serum of patients with psoriasis,to compare the differences in the expression levels of cytokines in the serum between patients with psoriasis and healthy controls,and further analyze the differences of serum cytokines levels in psoriatic patients at different stages and their correlation with PASI score,which to provide a basis for the clinical diagnosis of psoriasis and evaluation of therapeutic efficacy.MethodsThirty-nine patients with clinically confirmed psoriasis were enrolled from the Department of Dermatology and Venereal diseases in the First Affiliated Hospital of Xinxiang Medical University from October 2019 to July 2020.Thirty healthy volunteers were selected during the same period.The enrollees’age,gender,family history,allergy history,BMI,stages,and other clinical characteristics were detaileed recorded.Individuals with other skin diseases,infection,abnormal blood coagulation,blood history,tumors,inflammatory bowel disease,AIDS or other immunosuppressive diseases were excluded.3.5 m L of blood was collected from selected people in a sodium heparin anticoagulation tube,and the supernatants were collected and saved at-80°C for testing.The expression of 13 cytokines（IFN-α,IFN-γ,TNF-α,MCP-1,IL-1β,IL-6,IL-8,IL-10,IL-12,IL-18,IL-17A,IL-23 and IL-33）in the serum of the participants was determined by flow cytometry.Mann-Whitney test was used for differences between two groups,Kruskal Wallis test was used for differences between multiple groups,and Spearman was used for correlation analysis.Results1.A total of 39 psoriatic patients,20 males（51.3%）and 19 females（48.7%）were enrolled in the study.The mean age and BMI of the recorded psoriatic patients were28.01±19.61 years and 22.82±4.23.5（12.82%）patients with family history and 8（20.51%）patients with allergies history were collected.The psoriatic patients were divided into three stages based on the Clinical Dermatology by Bian Zhao:22（56.41%）active stage,6（15.38%）stationary stage and 11（28.21%）retrograde stage.The control volunteers comprised 30 subjects（16 male,14 female,age 40.20±14.94 years,BMI24.59±3.69）.There were no significant differences in gender（x~2=0.029,P=0.866）,age（t=-2.829,P=0.380）,and BMI（t=-1.828,P=0.854）between the two groups.2.Compared with healthy controls,the levels of 9 cytokines（IFN-γ,TNF-α,IL-1β,IL-6,IL-10,IL-12P40,IL-18,IL-17A and IL-23）were significantly increased,While the level of MCP-1 decreased in psoriatic patients.3.The levels of IFN-γ,TNF-α,IL-1β,IL-6,IL-18,IL-17A and IL-23 in serum of psoriatic patients were positively correlated with PASI score.Among them,serum IL-17A and IL-23 had the most significant correlation with PASI score.4.There were more higher serum lever of IFN-γ,TNF-α,IL-1β,IL-6,IL-17A,IL-18and IL-23 in active psoriasis than healthy controls and retrograde psoriasis.5.The serum level of IL-18 in male patients and adult patients（18≤age≤40）were notably increased comparing with female and juveniles（age<18）.ConclusionIncreased serum levels of IFN-γ,TNF-α,IL-1β,IL-6,IL-17A,IL-18,and IL-23 in psoriatic patients were associated with PASI and the stage of disease,suggesting that these cytokines are closely related to disease activity in psoriasis.Therefore,the combined detection of multiple cytokines in the clinic can better accurately diagnose the disease activity of psoriasis and observe the therapeutic efficacy,so as to further optimize the treatment strategy.