Department of Dermatology, Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
Arch Dermatol Res. 2012 Mar;304(2):127-32. doi: 10.1007/s00403-012-1218-4. Epub 2012 Feb 15.
Stress is a well-known triggering factor along with genetic predisposition on the onset and during the course of psoriasis by altering the cellular constituents of the immune system. In the skin, there is a local hypothalamic-pituitary-adrenal (HPA) axis which is the equivalent of the central HPA axis. Corticotropin-releasing hormone (CRH) is a major regulator of the HPA axis in response to stress. This study was planned to show the role of CRH receptor type 1 (CRH-R1) in pathogenesis of psoriasis, the relation with the severity of psoriasis, and interpersonal variance in skin biopsy specimens of the psoriasis patient. Study involved 46 patients with psoriasis and 20 healthy control subjects who were older than 18 years. The clinical sign and PASI scores of psoriasis patients were recorded. Immunohistochemically, expression of CRH-R1 was investigated in psoriatic lesions and control group skin. A statistically significant increase of the expression of CRH-R1 was found in the skin biopsies of psoriasis patients compared with the control group patients. In patients with psoriasis, there was a positive correlation between the expressions of CRH-R1 and PASI scores (p = 0.001, r = +0.572). In addition, a statistically significant increase of PASI scores was found in the intense-stained CRH-R1 group compared with the weakly stained CRH-R1 patient group. The present study has demonstrated that CRH-R1 could have a role in pathogenesis of the psoriasis and stress may increase the intensity of psoriasis.
压力是银屑病发病和病程中的已知诱发因素之一，它通过改变免疫系统的细胞成分起作用。在皮肤中，存在局部下丘脑-垂体-肾上腺 (HPA) 轴，其相当于中枢 HPA 轴。促肾上腺皮质释放激素 (CRH) 是 HPA 轴对压力反应的主要调节剂。本研究旨在展示 CRH 受体 1 型 (CRH-R1) 在银屑病发病机制中的作用、与银屑病严重程度的关系以及银屑病患者皮肤活检标本中的人际差异。研究纳入了 46 例银屑病患者和 20 例年龄大于 18 岁的健康对照者。记录了银屑病患者的临床体征和 PASI 评分。免疫组化研究了 CRH-R1 在银屑病皮损和对照组皮肤中的表达。与对照组患者相比，银屑病患者皮肤活检标本中 CRH-R1 的表达显著增加。在银屑病患者中，CRH-R1 的表达与 PASI 评分之间存在正相关关系（p = 0.001，r = +0.572）。此外，与 CRH-R1 弱染色患者组相比，CRH-R1 强染色组的 PASI 评分显著增加。本研究表明，CRH-R1 可能在银屑病发病机制中起作用，压力可能会增加银屑病的严重程度。
