Circulating Cell-Free DNA as Inflammatory Marker in Egyptian Psoriasis Patients.

IF 5.2 Q1 DERMATOLOGY Psoriasis (Auckland, N.Z.) Pub Date : 2020-05-21 eCollection Date: 2020-01-01 DOI:10.2147/PTT.S241750
Haneya A A Anani, Amany M Tawfeik, Soheir S Maklad, Abeer M Kamel, Enas E El-Said, Asmaa S Farag
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引用次数: 3

Abstract

Background: Cell lesion and apoptosis with release of cell-free DNA (CFD) in circulation are associated with chronic inflammation of psoriasis.

Objective: 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.

Patients and methods: 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.

Results: 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.

Conclusion: 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.

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埃及银屑病患者循环Cell-Free DNA作为炎症标志物
背景:循环中cell-free DNA (CFD)释放引起的细胞病变和凋亡与psoriasis慢性炎症有关。目的:本研究的目的是to确定psoriasis患者血清中的CFD浓度,评估其与银屑病区域严重程度指数(PASI)和其他炎症生物标志物(c -反应蛋白(CRP)和erythrocyte sedimentation rate (ESR))水平定义的疾病严重程度的关系,并监测治疗效果。患者与方法:不同类型成人患者30例psoriasis(寻常型25例;轻度10例,中度15例,红皮病5例;在疾病加重期、开始治疗前(T0)和治疗12周后(T12),对轻度病例进行局部治疗,中度病例进行窄带紫外线B (NB-UVB)治疗,重度病例进行甲氨蝶呤治疗。20名健康对照者也参与了这项研究。采用人β-globin基因引物quantitative real time PCR (qPCR)检测治疗前后血清中CFD的浓度。结果:在T0时,所有患者的ESR (P=0.05)和CFD (P=0.001)水平均显著高于对照组。与轻度/中度疾病(寻常病)相比,在严重疾病(红皮病)中观察到所有参数的显著升高。甲氨蝶呤治疗显著降低了包括CFD在内的所有炎症标志物(P= 0.042),而局部和紫外线照射治疗没有效果。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)呈正相关。结论:循环CFD水平可用于监测psoriasis严重程度。然而,它的水平不能用于治疗,除非在用甲氨蝶呤成功治疗的严重红皮病患者。我们建议验证一个方便和准确的DNA分析直接应用于生物样品,不需要事先DNA提取和扩增。
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