Nicolae Ilinca, Tampa Mircea, Ene Corina Daniela, Mitran Cristina Iulia, Mitran Madalina Irina, Sarbu Maria Isabela, Matei Clara, Ene Cosmin, Georgescu Simona Roxana
Department of Dermatology, 'Victor Babes' Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania.
Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Exp Ther Med. 2019 Feb;17(2):1012-1019. doi: 10.3892/etm.2018.7053. Epub 2018 Dec 5.
Recent data suggest that severe psoriasis is an independent risk factor for chronic renal disease. In the present study, we investigated the role of related-purine derivatives as predictors of renal dysfunctions in patients with psoriasis. A prospective study was conducted on a group of 45 patients with psoriasis vulgaris and 45 control cases, monitored over a 5-year period. Alterations of renal function, albumin/creatinine ratio (ACR, mg/g) and UA/creatinine ratio (UACR, mg/mg) were determined in spontaneous urine samples. The status of related-purine derivatives was evaluated by quantification of uric acid (UA, mg/dl), adenosine deaminase (ADA, UI/mg protein), xanthine oxidase (XO, UI/mg protein) and 8-hydroxy-deoxy-guanosine levels (8-OHdG, ng/ml) in serum samples. Compared to the controls, in patients with psoriasis there was an increase in related-purine derivatives levels, which was demonstrated by the elevated serum levels of UA (5.1±0.4 vs. 5.4±1.0, P=0.066), ADA (0.14±0.08 vs. 0.29±0.12, P=0.052), XO (0.22±0.11 vs. 0.42±0.21, P=0.011) and 8-OHdG (3.1±0.05 vs. 8.3±4.7, P=0.002). The serum levels of related-purine derivatives were associated with the severity of psoriasis. In addition, there was a link between the serum levels of related-purine derivatives and markers of renal impairment. There were positive correlations between 8-OHdG and ACR (r=0.452, P=0.028) and between ADA, XO, UA, 8-OHdG and UACR (r=0.297 and P=0.032, r=0.301 and P=0.002, r=0.431 and P=0.027, r=0.508 and P=0.002) and negative correlations between UA, 8-OHdG and the estimated glomerular filtration rate (r=-0.301 and P=0.036, r=-0.384 and P=0.002). Thus, severe psoriasis is a risk factor for the development of renal disease.
近期数据表明，重度银屑病是慢性肾病的独立危险因素。在本研究中，我们调查了相关嘌呤衍生物作为银屑病患者肾功能障碍预测指标的作用。对一组45例寻常型银屑病患者和45例对照者进行了一项前瞻性研究，为期5年。在随机尿液样本中测定肾功能、白蛋白/肌酐比值（ACR，mg/g）和尿酸/肌酐比值（UACR，mg/mg）的变化。通过定量血清样本中的尿酸（UA，mg/dl）、腺苷脱氨酶（ADA，UI/mg蛋白）、黄嘌呤氧化酶（XO，UI/mg蛋白）和8-羟基脱氧鸟苷水平（8-OHdG，ng/ml）来评估相关嘌呤衍生物的状态。与对照组相比，银屑病患者的相关嘌呤衍生物水平升高，表现为血清UA水平升高（5.1±0.4 vs. 5.4±1.0，P=0.066）、ADA水平升高（0.14±0.08 vs. 0.29±0.12，P=0.052）、XO水平升高（0.22±0.11 vs. 0.42±0.21，P=0.011）和8-OHdG水平升高（3.1±0.05 vs. 8.3±4.7，P=0.002）。相关嘌呤衍生物的血清水平与银屑病的严重程度相关。此外，相关嘌呤衍生物的血清水平与肾功能损害标志物之间存在联系。8-OHdG与ACR之间存在正相关（r=0.452，P=0.028），ADA、XO、UA、8-OHdG与UACR之间存在正相关（r=0.297，P=0.032；r=0.301，P=0.002；r=0.431，P=0.027；r=0.508，P=0.002），UA、8-OHdG与估计肾小球滤过率之间存在负相关（r=-0.301，P=0.036；r=-0.384，P=0.002）。因此，重度银屑病是肾病发生的一个危险因素。
