Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Department of Biostatistics, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Acta Dermatovenerol Alp Pannonica Adriat. 2023 Sep;32(3):93-97.
Psoriasis vulgaris is an immune-mediated inflammatory disease influenced by genetic and immunologic factors, including micronutrient deficiencies. The HLA-Cw6 gene and zinc level have been separately studied in psoriasis patients, yielding inconsistent findings. A descriptive study regarding HLA-Cw6 allele expression, zinc levels, and their direct correlation in Indonesia is lacking.
This prospective case-control study involved 33 psoriasis patients and 33 age- and sex-matched control patients at the dermatology clinic affiliated with Hasanuddin University in South Sulawesi in 2021. Cases were classified into mild, moderate, and severe psoriasis according to Psoriasis Area and Severity Index (PASI) score. An EDTA tube was used to take a 5 ml blood sample, followed by analysis for PCR of the HLA-Cw6 allele and a colorimetric assay to measure zinc level. Statistical analysis was performed to determine the association between HLA-Cw6 and zinc level and psoriasis disease severity.
Among the 33 psoriatic patients enrolled in this study, three (9.1%) of the cases were classified as mild psoriasis, 10 (30.3%) were classified as moderate psoriasis, and 20 (60.6%) were classified as severe psoriasis. The HLA-Cw6 allele was detected in 93.9% of psoriasis cases and in 3% of control patients (p < 0.001). The HLA-Cw6 allele was detected consecutively in 66.7%, 90.0%, and 100% of mild, moderate, and severe psoriasis patients, respectively. Zinc levels were lower in psoriasis patients compared to controls (16.85 ± 3.55 vs. 13.74 ± 3.78 μmol/l). Severe psoriasis patients exhibited the lowest average zinc level (14.76 ± 1.40 μmol/l, 15.48 ± 4.20 μmol/l, and 12.72 ± 3.56 μmol/l in mild, moderate, and severe patients, respectively). The mean zinc level in HLA-Cw6-positive patients was 13.68 μmol/l, and 14.6 μmol/l in HLA-Cw6-negative patients (p = 0.495).
The study revealed the presence of HLA-Cw6 allele expression and decreased serum zinc levels in psoriasis patients compared to controls. Both factors demonstrated associations with psoriasis disease severity.
寻常型银屑病是一种受遗传和免疫因素影响的免疫介导性炎症性疾病，包括微量元素缺乏。HLA-Cw6 基因和锌水平已分别在银屑病患者中进行了研究，但结果不一致。在印度尼西亚，缺乏关于 HLA-Cw6 等位基因表达、锌水平及其直接相关性的描述性研究。
本前瞻性病例对照研究于 2021 年在南苏拉威西省哈桑努丁大学附属医院皮肤科纳入 33 例银屑病患者和 33 例年龄和性别匹配的对照患者。根据银屑病面积和严重程度指数（PASI）评分，将病例分为轻度、中度和重度银屑病。使用 EDTA 管采集 5ml 血样，随后进行 HLA-Cw6 等位基因的 PCR 分析和比色法测定锌水平。统计分析用于确定 HLA-Cw6 与锌水平和银屑病疾病严重程度之间的关联。
本研究纳入的 33 例银屑病患者中，3 例（9.1%）为轻度银屑病，10 例（30.3%）为中度银屑病，20 例（60.6%）为重度银屑病。HLA-Cw6 等位基因在 93.9%的银屑病患者和 3%的对照患者中被检测到（p<0.001）。HLA-Cw6 等位基因在轻度、中度和重度银屑病患者中分别连续检测到 66.7%、90.0%和 100%。与对照组相比，银屑病患者的锌水平较低（16.85±3.55 与 13.74±3.78μmol/l）。重度银屑病患者的平均锌水平最低（轻度、中度和重度患者分别为 14.76±1.40μmol/l、15.48±4.20μmol/l 和 12.72±3.56μmol/l）。HLA-Cw6 阳性患者的平均锌水平为 13.68μmol/l，HLA-Cw6 阴性患者为 14.6μmol/l（p=0.495）。
与对照组相比，本研究显示银屑病患者存在 HLA-Cw6 等位基因表达和血清锌水平降低，这两个因素均与银屑病疾病严重程度相关。
