Chandrashekar Laxmisha, Rajappa Medha, Revathy G, Sundar Indhumathi, Munisamy Malathi, Ananthanarayanan P H, Thappa Devinder Mohan, Basu Debdatta
Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Clin Chim Acta. 2015 Jun 15;446:181-5. doi: 10.1016/j.cca.2015.04.023. Epub 2015 Apr 25.
Psoriasis is an immune mediated inflammatory skin disease associated with systemic inflammation resulting in increased risk for associated cardiovascular co-morbidities. The role of platelet activation in the pathophysiology of this condition has not been clearly studied. We undertook to study the platelet activation markers in psoriasis, as compared to controls and to identify its association with disease severity in psoriasis.
Sixty-two patients with psoriasis and 62 age and gender matched healthy controls were enrolled in this cross-sectional study. The severity of the disease was assessed using the psoriasis area severity index (PASI) scoring. The platelet indices [mean platelet volume (MPV) and platelet distribution width (PDW)] were estimated by an automated haematological laser optical analyzer. Plasma soluble P-selectin and platelet derived microparticle (PDMP) concentrations, serum high sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6 concentrations were estimated in all study participants. Platelet aggregation was assessed using adenosine diphosphate (ADP) as aggregating agent.
We observed that there was significantly higher platelet indices (MPV and PDW) in patients with psoriasis, when compared to controls. Plasma soluble P-selectin concentrations, PDMP and platelet aggregation were significantly elevated in patients with psoriasis, as compared to controls. We also found significantly higher concentrations of hs-CRP and IL-6 in patients with psoriasis, as compared to controls. Platelet activation and systemic inflammation markers correlated positively with PASI, except PDW. We also observed significant positive correlation between platelet activation and systemic inflammation in psoriasis.
Significant platelet activation and systemic inflammation were observed in patients with psoriasis, especially when associated with severe disease. The increased platelet activation might be the missing link between the persistent inflammation and the development of atherosclerotic plaque leading onto cardiovascular co-morbidities seen associated with psoriasis.
银屑病是一种免疫介导的炎症性皮肤病，与全身炎症相关，会增加患相关心血管合并症的风险。血小板活化在这种疾病病理生理学中的作用尚未得到明确研究。我们旨在研究银屑病患者的血小板活化标志物，并与对照组进行比较，以确定其与银屑病疾病严重程度的关联。
本横断面研究纳入了62例银屑病患者以及62名年龄和性别匹配的健康对照者。使用银屑病面积严重程度指数（PASI）评分评估疾病严重程度。通过自动血液学激光光学分析仪估算血小板指标[平均血小板体积（MPV）和血小板分布宽度（PDW）]。对所有研究参与者测定血浆可溶性P-选择素和血小板衍生微粒（PDMP）浓度、血清高敏C反应蛋白（hs-CRP）和白细胞介素（IL）-6浓度。使用二磷酸腺苷（ADP）作为聚集剂评估血小板聚集情况。
我们观察到，与对照组相比，银屑病患者的血小板指标（MPV和PDW）显著更高。与对照组相比，银屑病患者的血浆可溶性P-选择素浓度、PDMP和血小板聚集显著升高。我们还发现，与对照组相比，银屑病患者的hs-CRP和IL-6浓度显著更高。除PDW外，血小板活化和全身炎症标志物与PASI呈正相关。我们还观察到银屑病患者的血小板活化与全身炎症之间存在显著正相关。
银屑病患者存在显著的血小板活化和全身炎症，尤其是在伴有严重疾病时。血小板活化增加可能是持续炎症与动脉粥样硬化斑块形成之间缺失的环节，而动脉粥样硬化斑块会导致银屑病相关的心血管合并症。
