Anani Haneya A A, Tawfeik Amany M, Maklad Soheir S, Kamel Abeer M, El-Said Enas E, Farag Asmaa S
Departments of Microbiology and Immunology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Dermatology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Psoriasis (Auckl). 2020 May 21;10:13-21. doi: 10.2147/PTT.S241750. eCollection 2020.
Cell lesion and apoptosis with release of cell-free DNA (CFD) in circulation are associated with chronic inflammation of psoriasis.
The objective of this study was to determine the CFD concentrations in sera of patients with psoriasis, to assess its relationship with disease severity as defined by Psoriasis Area Severity Index (PASI) and other inflammatory biomarkers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) levels, and to monitor the efficacy of treatment.
Thirty adult patients with different types of psoriasis (25 vulgaris; 10 mild, 15 moderate and 5 erythroderma; severe) were evaluated during the exacerbation phase of the disease, before starting (T0) and after 12 weeks (T12) of treatment with topical therapy for mild cases, narrowband-ultraviolet light B (NB-UVB) for moderate cases and methotrexate for severe cases. Twenty healthy controls were also involved in the study. The concentrations of CFD in sera were measured before and after treatment by quantitative real time PCR (qPCR) using primers of the human β-globin gene.
At T0, all patients presented significant higher levels of ESR (P=0.05) and CFD (P=0.001) compared with controls. Highly significant elevations of all parameters were observed in severe disease (erythroderma) compared to mild/moderate disease (vulgaris). Methotrexate treatment induced highly significant reductions in all inflammatory markers including CFD (P= 0.042) while topical and UV irradiation therapies had no effects. CFD concentrations showed positive correlations with both PASI (r=0.422, P=0.020) and ESR (r=0.321, P=0.023) only before the start of treatment.
The level of circulating CFD could be used to monitor psoriasis severity. However, its level cannot be stated for the treatment, except in severe erythrodermic patients upon successful treatment with methotrexate. We recommend validation of a convenient and accurate DNA assay applied directly to biological samples which does not require prior DNA extraction and amplification.
细胞损伤和凋亡以及循环中游离DNA（CFD）的释放与银屑病的慢性炎症相关。
本研究的目的是测定银屑病患者血清中的CFD浓度，评估其与银屑病面积严重程度指数（PASI）定义的疾病严重程度以及其他炎症生物标志物（C反应蛋白（CRP）和红细胞沉降率（ESR））水平的关系，并监测治疗效果。
30例不同类型银屑病的成年患者（25例寻常型；10例轻度、15例中度和5例红皮病型；重度）在疾病加重期进行评估，轻度病例在开始局部治疗前（T0）和治疗12周后（T12），中度病例采用窄谱中波紫外线B（NB-UVB）治疗，重度病例采用甲氨蝶呤治疗。20名健康对照者也参与了研究。使用人β-珠蛋白基因引物通过定量实时PCR（qPCR）在治疗前后测量血清中CFD的浓度。
在T0时，与对照组相比，所有患者的ESR（P=0.05）和CFD（P=0.001）水平均显著升高。与轻度/中度疾病（寻常型）相比，重度疾病（红皮病型）中所有参数均有高度显著升高。甲氨蝶呤治疗导致包括CFD在内的所有炎症标志物高度显著降低（P=0.042），而局部治疗和紫外线照射治疗无效。仅在治疗开始前，CFD浓度与PASI（r=0.422，P=0.020）和ESR（r=0.321，P=0.023）均呈正相关。
循环CFD水平可用于监测银屑病严重程度。然而，除重度红皮病患者甲氨蝶呤治疗成功外，其水平不能用于评估治疗效果。我们建议验证一种直接应用于生物样本的便捷、准确的DNA检测方法，该方法无需事先进行DNA提取和扩增。
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