Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece.
Clin Exp Dermatol. 2011 Dec;36(8):845-50. doi: 10.1111/j.1365-2230.2011.04131.x. Epub 2011 Jul 25.
Psoriasis is a chronic, systemic, inflammatory disease. Inflammatory markers are used in clinical practice to detect acute inflammation, and as markers of treatment response. Etanercept blocks tumour necrosis factor (TNF)-α, which plays a central role in the psoriatic inflammation process.
To reveal any possible association between disease severity [measured by Psoriasis Area and Severity Index (PASI)] and the inflammatory burden (measured by a group of inflammatory markers), before and after etanercept treatment.
In total, 41 patients with psoriasis vulgaris, eligible for biological treatment with etanercept, were enrolled in the study. A set of inflammatory markers was measured, including levels of white blood cells and neutrophils, fibrinogen, ferritin, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), haptoglobin, ceruloplasmin and α1-antitrypsin, before and after 12 weeks of etanercept 50 mg twice weekly.
All markers were reduced after treatment (P < 0.001). PASI correlated with fibrinogen and hs-CRP. Of the 41 patients, 19 (46.3%) achieved reduction of 75% in PASI (PASI75). An increase in hs-CRP and ESR difference (values before minus values after treatment) was related to higher likelihood of achieving PASI75.
Inflammatory markers, particularly hs-CRP and to a lesser extent, fibrinogen and ESR, can be used to assist in assessing disease severity and response to treatment in patients with psoriasis. A combination of selected inflammatory factors (which we term the Index of Psoriasis Inflammation) in combination with PASI might reflect inflammatory status in psoriasis more accurately than each one separately.
银屑病是一种慢性、全身性、炎症性疾病。炎症标志物在临床实践中用于检测急性炎症，并作为治疗反应的标志物。依那西普阻断肿瘤坏死因子（TNF）-α，它在银屑病炎症过程中起核心作用。
揭示疾病严重程度（用银屑病面积和严重程度指数（PASI）衡量）与炎症负担（用一组炎症标志物衡量）之间的任何可能关联，在依那西普治疗前后。
共有 41 例符合依那西普生物治疗条件的寻常型银屑病患者纳入研究。在接受依那西普治疗 12 周前和治疗后，测量了一组炎症标志物，包括白细胞和中性粒细胞、纤维蛋白原、铁蛋白、高敏 C 反应蛋白（hs-CRP）、红细胞沉降率（ESR）、触珠蛋白、铜蓝蛋白和α1-抗胰蛋白酶的水平。
所有标志物在治疗后均降低（P < 0.001）。PASI 与纤维蛋白原和 hs-CRP 相关。在 41 例患者中，19 例（46.3%）达到 PASI 降低 75%（PASI75）。hs-CRP 和 ESR 差值（治疗前值减去治疗后值）的增加与更有可能达到 PASI75 相关。
炎症标志物，特别是 hs-CRP，在较小程度上还有纤维蛋白原和 ESR，可用于协助评估银屑病患者的疾病严重程度和治疗反应。与单独使用每个标志物相比，选择的炎症因子（我们称之为银屑病炎症指数）的组合与 PASI 结合可能更能准确反映银屑病的炎症状态。
