Imbalance between serum interleukin-36 and interleukin-38 is associated with metabolic syndrome in psoriasis vulgaris

Abstract

Background In psoriasis, interleukin (IL)-36 is considered a pathogenic driver, whereas IL-38 was downregulated. Little is known about their role in metabolic syndrome (Ms) in psoriasis. Objective To evaluate a possible relation between serum IL-36 and IL-38 and Ms in psoriasis vulgaris. Patients and methods This study was designed as a case–control study. It included 80 participants, who were divided into four groups: group A included 20 psoriasis patients with Ms, group B included 20 psoriasis patients without Ms, group C included 20 controls with Ms, and group D included 20 healthy controls. Written informed consents were signed by all participants. Clinical examination and psoriasis area and severity index (PASI) evaluation were done. BMI, waist circumference, arterial blood pressure, fasting blood glucose, and lipid profile were measured. Blood samples were withdrawn, and serum IL-36 and IL-38 levels were measured using enzyme-linked immunosorbent assay. Results Serum IL-36 levels were significantly higher in group A (mean±SD=187.84±32.84 pg/ml) compared with group B (mean±SD=156.5±24.09 pg/ml) (P<0.001), or group C (mean±SD=115.18±14.69 pg/ml) (P<0.001) or group D (mean±SD=38.06±10.18 pg/ml) (P<0.001). Serum IL-38 levels were significantly lower in group A (mean±SD 57.34±19.91 pg/ml) compared with group B (mean±SD=73.9±16.13 pg/ml) (P<0.006) or group C (mean±SD=74.67±12.89 pg/ml) (P=0.002), or group D (mean±SD=212.36±17.55 pg/ml) (P<0.001). In group A, IL-36 had a 75% sensitivity and 70% specificity with a cutoff value of 166.2, whereas IL-38 had an 80% sensitivity and 65% specificity with a cutoff value of 74. There was a significant negative correlation between IL36 and IL-38 levels (r=−0.637, P<0.001). Conclusion Patients with psoriasis with Ms had significantly higher IL-36 and lower IL-38. Imbalance between IL-36 and IL-38 may be associated with underlying metabolic disturbance seen in psoriasis.