Nassar Ahmed, Abd El Fattah Nermeen, Afify Ahmed, El-Khazragy Nashwa, El Sayed Mahira
Department of Dermatology, Andrology and Venereology, Ain Shams University, Cairo, EGY.
Department of Clinical Pathology-Hematology, Ain Shams Medical Research Institute (MASRI) Ain Shams University, Cairo, EGY.
Cureus. 2024 Aug 6;16(8):e66262. doi: 10.7759/cureus.66262. eCollection 2024 Aug.
Background Psoriasis is a relapsing dermatologic disease with a complex multifactorial etiology. Accumulating evidence has established the presence of cutaneous steroidogenesis with 11 β-hydroxysteroid dehydrogenase (11βHSD) enzyme being the most important final step of this pathway. This enzyme can control local levels of activated glucocorticoids (GCs) in the skin, which is the key to maintaining healthy skin. Methods This case-control study was conducted to evaluate 11βHSD1 level in psoriasis patients, in both lesional and non-lesional skin, compare it to controls, and correlate its activity with the Psoriasis Area and Severity Index (PASI) and the Perceived Stress Scale (PSS). Results A significant decrease of 11βHSD1 level in psoriasis patients compared to healthy controls was observed. In addition, decreased 11βHSD1 level was observed in lesional compared to non-lesional skin in psoriasis patients. There was no significant correlation between the enzyme levels and PASI score or PSS score in patients with psoriasis. However, the PSS score was negatively correlated with 11βHSD1 level in healthy controls. Further histopathological assessment revealed that lower enzyme levels were associated with greater epidermal acanthosis and inflammation. Conclusion This shows the role of 11βHSD1 in controlling psoriatic inflammation, including the degree of epidermal proliferation, which might reveal the complex symphony of psoriasis pathogenesis.
银屑病是一种具有复杂多因素病因的复发性皮肤病。越来越多的证据表明皮肤存在类固醇生成，其中11β-羟基类固醇脱氢酶（11βHSD）是该途径中最重要的最后一步。这种酶可以控制皮肤中活化糖皮质激素（GCs）的局部水平，这是维持健康皮肤的关键。方法：本病例对照研究旨在评估银屑病患者皮损和非皮损皮肤中的11βHSD1水平，将其与对照组进行比较，并将其活性与银屑病面积和严重程度指数（PASI）及感知压力量表（PSS）相关联。结果：观察到银屑病患者的11βHSD1水平与健康对照组相比显著降低。此外，银屑病患者皮损皮肤中的11βHSD1水平低于非皮损皮肤。银屑病患者的酶水平与PASI评分或PSS评分之间无显著相关性。然而，健康对照组的PSS评分与11βHSD1水平呈负相关。进一步的组织病理学评估显示，较低的酶水平与更大程度的表皮棘皮症和炎症相关。结论：这表明11βHSD1在控制银屑病炎症中发挥作用，包括表皮增殖程度，这可能揭示了银屑病发病机制的复杂过程。
