Nowowiejska Julia, Baran Anna, Hermanowicz Justyna M, Sieklucka Beata, Pawlak Dariusz, Flisiak Iwona
Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St., 15-540, Bialystok, Poland.
Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C St., 15-089, Bialystok, Poland.
Dermatol Ther (Heidelb). 2023 Oct;13(10):2217-2227. doi: 10.1007/s13555-023-00992-2. Epub 2023 Aug 11.
Psoriasis, one of the most frequent dermatoses, strongly associated with metabolic disorders which increase patients' comorbidity and mortality. Hence, it is essential to look for markers of such complications. Our aim was to assess the clinical utility of urinary tumor necrosis factor alpha (TNFα), endothelin 1 (ET-1) and α1-acid glycoprotein (α1AGP) as well as their serum concentrations as markers of metabolic complications in psoriatics, and to examine the relations of these markers to clinical and demographic parameters.
The study involved 60 patients with plaque psoriasis and 30 volunteers without skin diseases (the control group). Serum and urinary concentrations of TNFα, ET-1 and α1AGP were measured by ELISA. Psoriasis severity was assessed using the psoriasis activity and severity index (PASI). Routine laboratory investigations were additionally performed.
All serum markers were significantly higher in the patients compared to the controls. TNFα was undetectable in the urine in half of the patients. The urinary ET-1/creatinine concentration ratio was significantly lower in the psoriatics than the controls, whereas the absolute urinary α1AGP was significantly higher and the α1AGP/creatinine ratio was insignificantly different. There was no correlation between serum or urinary markers and PASI. All serum markers were higher in patients with psoriasis lasting less than 15 years.
Serum TNFα, ET-1 and α1AGP seem to be useful biomarkers of metabolic syndrome in psoriatics. ET-1 could perhaps become a urinary marker of metabolic disorders in psoriatics, but further studies are required to confirm that a decreased ET-1 concentration in urine is a reliable predictive tool. Increased urinary α1AGP also requires more in-depth research as a potential marker. TNFα urine assessment does not seem to be useful for screening for metabolic disorders in psoriatics. Serum or urinary TNFα, ET-1 and α1AGP do not seem to be associated with psoriasis severity or duration.
银屑病是最常见的皮肤病之一，与代谢紊乱密切相关，这会增加患者的合并症和死亡率。因此，寻找此类并发症的标志物至关重要。我们的目的是评估尿肿瘤坏死因子α（TNFα）、内皮素1（ET-1）和α1-酸性糖蛋白（α1AGP）的临床效用及其血清浓度作为银屑病患者代谢并发症标志物的情况，并研究这些标志物与临床和人口统计学参数的关系。
该研究纳入了60例斑块状银屑病患者和30名无皮肤病的志愿者（对照组）。采用酶联免疫吸附测定法（ELISA）测量血清和尿液中TNFα、ET-1和α1AGP的浓度。使用银屑病活动和严重程度指数（PASI）评估银屑病的严重程度。另外还进行了常规实验室检查。
与对照组相比，患者的所有血清标志物均显著升高。一半患者的尿液中未检测到TNFα。银屑病患者尿液中ET-1/肌酐浓度比显著低于对照组，而尿液中α1AGP的绝对值显著更高，且α1AGP/肌酐比无显著差异。血清或尿液标志物与PASI之间无相关性。病程小于15年的银屑病患者所有血清标志物更高。
血清TNFα、ET-1和α1AGP似乎是银屑病患者代谢综合征的有用生物标志物。ET-1可能成为银屑病患者代谢紊乱的尿液标志物，但需要进一步研究以证实尿液中ET-1浓度降低是一种可靠的预测工具。尿液中α1AGP升高作为潜在标志物也需要更深入的研究。尿液TNFα评估似乎对银屑病患者代谢紊乱的筛查无用。血清或尿液中的TNFα、ET-1和α1AGP似乎与银屑病的严重程度或病程无关。
