Correlation of newer hematological parameters and IL-17A with severity of psoriasis in obese and non-obese patients
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20262841Keywords:
BMI, ESR, Hematological indices, IL-17A, Inflammation, Obesity, PASI, PsoriasisAbstract
Background: Psoriasis is a chronic immune-mediated inflammatory disorder associated with obesity and metabolic dysfunction. Interleukin-17A (IL-17A) and newer haematological indices are emerging as markers of systemic inflammation.
Methods: This analytical cross-sectional study included 46 psoriasis patients categorized into obese and non-obese groups based on BMI. Hematological parameters, NLR, PLR, and reticulocyte indices were analyzed, and serum IL-17A levels were measured using ELISA. Disease severity was assessed using PASI and CPSS. Statistical analysis was performed using Welch’s t-test and Pearson’s correlation.
Results: Obese patients showed higher PASI, CPSS, IL-17A, and ESR levels, though differences were not statistically significant. IL-17A showed a strong positive correlation with PASI in obese patients (r=0.791, p<0.001) and a significant correlation with ESR (r=0.341, p=0.02). ESR showed significant negative correlations with RBC indices. In non-obese patients, IL-17A correlated negatively with reticulocyte indices.
Conclusions: IL-17A and hematological inflammatory markers are significantly associated with psoriasis severity. IL-17A may serve as a useful adjunctive biomarker for assessing systemic inflammation in psoriasis.
References
Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ. 2020;369:m1590. DOI: https://doi.org/10.1136/bmj.m1590
Iskandar IYK, Parisi R, Griffiths CEM, Ashcroft DM. Systematic review examining changes over time and variation in the incidence and prevalence of psoriasis by age and gender. Br J Dermatol. 2021;184(2):243-58. DOI: https://doi.org/10.1111/bjd.19169
Jensen P, Skov L. Psoriasis and obesity. Dermatology. 2017;232(6):633-9. DOI: https://doi.org/10.1159/000455840
Hawkes JE, Chan TC, Krueger JG. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allerg Clin Immunol. 2017;140(3):645-53. DOI: https://doi.org/10.1016/j.jaci.2017.07.004
Furue M, Furue K, Tsuji G, Nakahara T. Interleukin-17A and keratinocytes in psoriasis. Int J Mol Sci. 2020;21(4):1275. DOI: https://doi.org/10.3390/ijms21041275
Nograles KE, Zaba LC, Guttman‐Yassky E, Fuentes‐Duculan J, Suárez‐Fariñas M, Cardinale I, et al. Th17 cytokines interleukin (IL)‐17 and IL‐22 modulate distinct inflammatory and keratinocyte‐response pathways. Br J Dermatol. 2008 Nov 1;159(5):1092-102. DOI: https://doi.org/10.1111/j.1365-2133.2008.08769.x
Lynde CW, Poulin Y, Vender R, Bourcier M, Khalil S. Interleukin 17A: toward a new understanding of psoriasis pathogenesis. J Am Acad Dermatol. 2014;71(1):141-50. DOI: https://doi.org/10.1016/j.jaad.2013.12.036
Michalak-Stoma A, Bartosińska J, Kowal M, Raczkiewicz D, Krasowska D, Chodorowska G. IL‐17A in the psoriatic patients’ serum and plaque scales as potential marker of the diseases severity and obesity. Mediat Inflamm. 2020;2020(1):7420823. DOI: https://doi.org/10.1155/2020/7420823
Bai F, Li GG, Liu Q, Niu X, Li R, Ma H. Short‐term efficacy and safety of IL‐17, IL‐12/23, and IL‐23 inhibitors brodalumab, secukinumab, ixekizumab, ustekinumab, guselkumab, tildrakizumab, and risankizumab for the treatment of moderate to severe plaque psoriasis: a systematic review and network meta‐analysis of randomized controlled trials. J Immunol Res. 2019;2019(1):2546161. DOI: https://doi.org/10.1155/2019/2546161
Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2012;2:e54. DOI: https://doi.org/10.1038/nutd.2012.26
Xu C, Ji J, Su T, Wang HW, Su ZL. The association of psoriasis and obesity: focusing on IL-17A-related immunological mechanisms. Int J Dermatol Venereol. 2021;4(2):116-21. DOI: https://doi.org/10.1097/JD9.0000000000000155
Setty AR, Curhan G, Choi HK. Obesity, waist circumference, weight change and the risk of psoriasis in women: Nurses’ Health Study II. Arch Intern Med 2007;167(15):1670-5. DOI: https://doi.org/10.1001/archinte.167.15.1670
Gisondi P, Del Giglio M, Di Francesco V, Zamboni M, Girolomoni G. Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: a randomized, controlled, investigator-blinded clinical trial. Am J Clin Nutr. 2008;88(5):1242-7. DOI: https://doi.org/10.3945/ajcn.2008.26427
Naldi L, Conti A, Cazzaniga S, Patrizi A, Pazzaglia M, Lanzoni A, et al. Diet and physical exercise in psoriasis: a randomized controlled trial. Br J Dermatol. 2014;170(3):634-42. DOI: https://doi.org/10.1111/bjd.12735
Wang WM, Wu C, Gao YM, Li F, Yu XL, Jin HZ. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and other haematological parameters in psoriasis patients. BMC Immunol. 2021;22(1):64. DOI: https://doi.org/10.1186/s12865-021-00454-4
Yi P, Jiang J, Wang Z, Wang X, Zhao M, Wu H, et al. Comparison of mean platelet volume (MPV) and red blood cell distribution width (RDW) between psoriasis patients and controls: a systematic review and meta-analysis. PLoS One. 2022;17(2):e0264504. DOI: https://doi.org/10.1371/journal.pone.0264504
Remaeus K, Stephansson O, Johansson K, Granath F, Hellgren K. Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study. BJOG. 2019;126(10):1213-22. DOI: https://doi.org/10.1111/1471-0528.15836
Czarnecka A, Zabłotna M, Purzycka-Bohdan D, Nowicki RJ, Szczerkowska-Dobosz A. An observational study of 147 psoriasis patients: overweightness and obesity as a significant clinical factors correlated with psoriasis. Medicina. 2023;59(11):2006. DOI: https://doi.org/10.3390/medicina59112006
Jacobi A, Langenbruch A, Purwins S, Augustin M, Radtke MA. Prevalence of obesity in patients with psoriasis: results of the national study PsoHealth3. Dermatology. 2015;231(3):231-8. DOI: https://doi.org/10.1159/000433528