Redaktion

Menschen mit Schuppenflechte oder Psoriasis-Arthritis fragen sich oft, ob Übergewicht die Wirkung ihrer Medikamente beeinflusst. Eine neue Studie hat das nun genauer untersucht. Forschende haben 228 Erwachsene mit verschiedenen chronisch-entzündlichen Krankheiten beobachtet, darunter auch Menschen mit Psoriasis oder Psoriasis-Arthritis. Nach rund 16 Wochen zeigte sich: Etwa die Hälfte sprach auf die biologische Therapie an, egal ob sie übergewichtig waren oder nicht. Der Unterschied zwischen den Gruppen war nicht groß[1]. Andere Studien zeigen aber: Trotz guter Hautergebnisse gibt es bei Übergewichtigen oft noch eine Rest-Entzündung im Körper. Vor allem das Bauchfett scheint dabei eine Rolle zu spielen. Deshalb empfehlen viele Experten, neben der Therapie auch auf das Gewicht zu achten, um Entzündungen im Körper möglichst gering zu halten[5]. Originaltitel: Impact of Obesity on Treatment Response in Patients With Chronic Inflammatory Disease Receiving Biologic Therapy: Secondary Analysis of the Prospective Multicentre BELIEVE Cohort Study Link zur Quelle

Menschen mit Psoriasis oder Psoriasis-Arthritis haben sehr häufig auch eine Lebererkrankung, die man MASLD nennt. MASLD steht für eine durch Stoffwechselprobleme verursachte Fettleber. Forschende nutzten MRT-Untersuchungen, um die Leber direkt sichtbar zu machen und nicht nur auf Blutwerte zu verlassen. Sie fanden heraus, dass etwa ein Fünftel der Betroffenen eine ernsthafte Leberentzündung hat. Das ist viel öfter als bei Menschen ohne Psoriasis[1][3]. Oft merken Betroffene davon nichts, denn die Leberwerte im Blut sehen meist normal aus. Das bedeutet: Selbst wenn die Blutuntersuchung in Ordnung ist, kann eine Fettleber vorliegen[1][2][3]. Gerade bei Menschen mit Übergewicht oder weiteren Stoffwechsel-Problemen sollte man die Leber deshalb öfter mit Bildgebung prüfen. Fazit: Menschen mit Psoriasis oder Psoriasis-Arthritis sollten wissen, dass ihre Leber öfter betroffen sein kann, auch wenn sie sich gesund fühlen[1][3][5]. Originaltitel: High prevalence of MASLD in psoriasis and psoriatic arthritis assessed with multiparametric magnetic resonance imaging Link zur Quelle

### Geschlechtsspezifische Unterschiede bei Psoriasisarthritis Psoriasisarthritis (PsA) ist eine chronische Entzündungskrankheit, die sowohl Gelenke als auch Haut betrifft. Studien zeigen, dass es geschlechtsspezifische Unterschiede gibt, die die Behandlung beeinflussen. **Klinische Merkmale:** - Frauen neigen dazu, periphere Arthritis sowie höhere Schmerzgrade zu erleben und haben oft stärkere funktionelle Einschränkungen. - Männer hingegen haben häufiger Beteiligung der Wirbelsäule, fortschreitende radiografische Veränderungen und schwerere Hauterkrankungen. **Behandlungsergebnisse:** Frauen reagieren oft weniger gut auf bestimmte Behandlungen wie TNF-Inhibitoren. Sie erreichen seltener niedrige Krankheitsaktivität und bleiben häufiger nicht bei der Therapie. **Komorbiditäten:** Depression und Fibromyalgie sind bei Frauen häufiger. Die Daten zu kardiovaskulären Risikofaktoren sind unklar. Erkennen und Ansprechen dieser Unterschiede ist wichtig, um auf die individuellen Bedürfnisse der Patienten eingehen zu können. Originaltitel: Unveiling Sex-Related Variability in Psoriatic Arthritis: A Call for Personalized Care Link zur Quelle

Wenn Menschen mit Psoriasis-Arthritis oder axialer Spondyloarthritis ihr erstes TNF-Hemmer-Medikament (TNFi) absetzen müssen, stehen Ärzte vor einer Wahl: Wechseln sie zu einem anderen TNFi (Zyklus-Strategie) oder probieren sie ein Medikament mit anderem Wirkprinzip, zum Beispiel einen IL-17-Hemmer (Swap-Strategie)? Studien zeigen, dass beide Methoden ähnlich gut wirken, was die Beibehaltung des Medikaments angeht[3][4]. Allerdings gibt es Hinweise, dass der Wechsel zu einer neuen Wirkstoffklasse, also ein Swap, oft etwas erfolgreicher ist, besonders was die Langzeitwirkung betrifft[5]. Für Männer mit Psoriasis-Arthritis kann ein Wechsel zu IL-17-Hemmern jedoch das Risiko für Therapieversagen leicht erhöhen[2]. Am Ende entscheiden häufig Begleiterkrankungen, wie stark die Gelenkentzündungen sind oder ob man andere Medikamente wie Kortison nimmt, darüber, welche Strategie am besten passt[4]. Kurz gesagt: Beide Wege sind möglich, oft ist aber der Wechsel zu einer neuen Medikamentenklasse einen Versuch wert. Originaltitel: Cycle versus swap strategy after TNFi discontinuation in psoriatic arthritis and axial spondyloarthritis: a quasi-experimental study Link zur Quelle

Frauen bekommen Psoriasis meist früher als Männer, im Schnitt mit 37 Jahren, Männer erst mit 40. Bei Menschen mit früher Psoriasis bekommen Männer öfter starke Medikamente wie Tabletten oder Biologika, Frauen seltener. Männer fangen damit auch schneller an. Bei Psoriasis, die erst später auftritt, sieht man diesen Unterschied zwischen Männern und Frauen nicht. Ganz egal ob Mann oder Frau: Wer die Krankheit früh bekommt, startet meist auch früher mit einer Lichttherapie. Die Forscher meinen, dass es wichtig ist, bei der Behandlung darauf zu achten, ob jemand jung oder älter ist, wenn die Schuppenflechte anfängt, und ob er männlich oder weiblich ist. So kann die Therapie besser angepasst werden[2]. Originaltitel: Exploring the Impact of Gender and Age of Onset on Psoriasis Treatment Management Link zur Quelle

Psoriasis ist nicht nur eine Hautsache. Die Erkrankung bringt oft Schlafprobleme mit sich, weil Juckreiz und Schmerzen das Ein- und Durchschlafen erschweren. Über 85 Prozent der Betroffenen berichten, dass sie schlecht schlafen können[1]. Das wiederum wirkt sich auch auf die Psyche aus: Wer schlechter schläft, hat ein erhöhtes Risiko für Ängste und Depressionen[1][3]. Die aktuelle Forschung zeigt, dass schlechter Schlaf und seelische Belastungen bei Menschen mit Psoriasis eng zusammenhängen und sich gegenseitig verstärken können[1][3]. Neben dem Juckreiz kann auch die Entzündung im Körper das Schlafzentrum beeinflussen. Die Studienmacher empfehlen deshalb, dass Ärzte und Patienten beim Thema Psoriasis auch immer den Schlaf im Blick haben sollten – und offen darüber sprechen[2][3]. So kann gemeinsam nach Lösungen gesucht werden, um die Lebensqualität zu verbessern. Originaltitel: The Impact of Psoriasis on Sleep Quality: Examining the Relationship Between Psoriasis, Sleep, and Mental Health Link zur Quelle

In dieser Studie wurde das Medikament si-544 bei Erwachsenen mit Psoriasis vulgaris (Schuppenflechte) oder Psoriasis-Arthritis untersucht. Ziel der Studie war es, die Sicherheit und Verträglichkeit von si-544 zu prüfen und erste Hinweise auf die Wirksamkeit zu erhalten. Die Teilnehmer erhielten entweder das Prüfmedikament oder ein Placebo, ohne zu wissen, welche Behandlung sie bekamen (doppelblind). Insgesamt nahmen 45 Erwachsene an verschiedenen Standorten in Europa teil. Die untersuchte Substanz si-544 ist ein neuartiges Medikament, das gezielt einen bestimmten Kaliumkanal (Kv1.3) auf Immunzellen blockiert. Dieser Kanal spielt eine wichtige Rolle bei Autoimmunerkrankungen wie Schuppenflechte und Psoriasis-Arthritis, weil er an der Aktivierung bestimmter T-Zellen beteiligt ist. Durch die Blockade dieses Kanals soll die übermäßige Entzündungsreaktion im Körper gebremst werden – ohne das gesamte Immunsystem lahmzulegen. Si-544 wird als Injektion unter die Haut verabreicht und zeigte in bisherigen Studien eine gute Verträglichkeit sowie keine schwerwiegenden Nebenwirkungen. Originaltitel: A multicenter, Phase 1b, double-blind, placebo-controlled study to evaluate the safety and tolerability, and the efficacy of si-544 in adults with psoriasis vulgaris or psoriatic arthritis Erkrankung: Psoriasis vulgaris (Schuppenflechte), Psoriasis-Arthritis Phase: 1b Firma: selectION Therapeutics GmbH Art der Verabreichung: Injektion (subkutan) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-507393-40-00

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

Psoriasis is an inflammatory skin disease, and current treatments have their own limitations, including moderate treatment effectiveness, poor compliance, and potential safety risks, etc. Therefore, the primary focus of this study is to explore novel molecular targets and improve the diagnosis and treatment of psoriasis patients. In this study, comprehensive bioinformatics analysis was performed on the expression profiles of tissue samples from patients with psoriasis in the clinical trial of TYK2/JAK1 inhibitor treatment (NCT02310750). Weighted gene co-expression network analysis (WGCNA) and least absolute shrinkage and selection operator (LASSO) regression were performed to identify characteristic genes and construct the diagnostic models. Gene set enrichment analysis (GSEA) was used to identify the biological processes of psoriasis characteristic gene sets. GO and KEGG pathway analysis were combined to elucidate the potential biological significance of differentially expressed genes (DEGs). The accuracy of biomarker identification was further validated using immune cell infiltration and receiver operating characteristic (ROC) curves based on external data (GSE6710\GSE30999\GSE14905). A total of 5 genes (DEFB103A, OAS3, OASL, SAMD9, STAT1) were co-identified as characteristic genes in psoriasis progression and treatment. The feature of the immune cell infiltration was highly consistent with association of characteristic biomarkers with immune cells. A total of 14 up-regulated genes and 5 down-regulated genes were identified in respective modules (AUC NL/LS = 0.9783; AUC pre/post = 0.9395; AUC external = 0.9469). In addition, 8 genes (DEFB103A, OASL, HERC6, ISG15, MKI67, MX1, MXD1, SCO2) were considered to have statistically significant differences in sensitivity of short-term treatment for psoriasis. The research findings provide an understanding of the role of novel biomarkers and offer a perspective for further in-depth investigation into the progression and treatment of psoriasis.Weiterlesen

Psoriasis is a chronic inflammatory skin disease whose main manifestation is scaly and erythematous plaques. The pathogenesis is complex, including genetic and environmental factors. In recent years, epigenetic modifications, which means changing in gene expression instead of altering the DNA sequence, have been gradually studied by scholars as an important mechanism in psoriasis pathogenesis. The clinical application of epigenetics in psoriasis is promising with its potential as diagnostic biomarkers, predictors of disease progression, and targets for treatment. This review reveals the role of epigenetics in the pathogenesis of psoriasis and its contribution to clinical treatment for patients with psoriasis.Weiterlesen

No abstract supplied.Weiterlesen

ObjectivePsoriatic arthritis (PsA) is a chronic inflammatory condition associated with psoriasis and characterised by heterogeneous clinical manifestations, including peripheral and axial arthritis, enthesitis and dactylitis. A subset of patients exhibits a 'difficult-to-treat' (D2T) phenotype, necessitating complex therapeutic strategies. Metabolic syndrome (MetS) is highly prevalent in PsA patients and has been implicated in increased disease activity.This study aimed to evaluate the impact of MetS on the development of D2T phenotype in PsA and its potential implications for disease management.MethodsA cross-sectional study was conducted on PsA patients recruited from the Rheumatology Clinic at Fondazione Policlinico Campus Bio-Medico of Rome. Patients fulfilling the Classification Criteria for Psoriatic Arthritis criteria were assessed for disease activity and the presence of MetS according to National Cholesterol Education Programme Adult Treatment Panel III criteria. D2T PsA was defined based on the Rheumatoid Arthritis European Alliance of Associations for Rheumatolog criteria revised for PsA by Perrotta et al. Statistical analyses, including logistic regression and path analysis, were performed to explore associations between MetS and D2T PsA.ResultsAmong 182 PsA patients, 42.94% met MetS criteria. The D2T subset (n=66) demonstrated a significantly higher prevalence of MetS (81.82% vs 29.37%, p<0.0001). Logistic regression revealed a strong association between MetS and D2T PsA (OR 7.56, 95% CI 2.53 to 22.56, p<0.0001), and path analysis confirmed MetS as an independent predictor of D2T phenotype.ConclusionsMetS is strongly associated with a D2T phenotype in PsA, suggesting that metabolic comorbidities contribute to disease severity and treatment resistance. Addressing metabolic dysfunction may be crucial in optimising therapeutic outcomes in PsA management.Weiterlesen

Background/objectivesThe mechanism of action of treatment drugs for psoriasis is based on anti-inflammation and the inhibition of epidermal proliferation, and retinoids and vitamin D3 derivatives are first-line therapy drugs for psoriasis. This meta-analysis aimed to comprehensively evaluate the efficacy and safety of calcipotriol-acitretin combination therapy for psoriasis and investigate its effect on serum inflammatory factors.MethodsA systematic search of PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese biomedical literature service system (SinoMed), and Chinese Biomedical Journal Database (VIP), from the earliest record until Dec.13, 2024, was conducted. The outcomes were overall effective rate, Psoriasis Area and Severity Index (PASI) scores, inflammatory factor level and side effects.ResultsA total of 13 studies with 1196 patients were included in this meta-analysis. The results of this study show that the calcipotriol-acitretin combination therapy could improve the total effective rate when compared with acitretin [RR = 1.25, 95% CI (1.18, 1.33)] or calcipotriol [RR = 1.36, 95% CI (1.20, 1.56)] monotherapy. The combined therapy could decrease the PASI score observably when compared with acitretin monotherapy [SMD =  - 2.26, 95% CI (-3.24, -1.28)] or calcipotriol monotherapy [SMD =  - 3.79, 95% CI (-5.78, -1.79)]. Calcipotriol-acitretin combination therapy remarkably reduced the levels of TNF-α, IL-23, IL-17, INF-γ and IL-6 in serum, while increasing the levels of IL-4 and IL-10 within the serum, compared to acitretin monotherapy. This combination therapy did not increase the risk of skin irritation & burning pain, dry skin and perioral dermatitis. Notably, the incidence of perioral dermatitis was lower in combination therapy than acitretin monotherapy [P = 0.04, RR = 0.24, 95% CI (0.06, 0.93)].ConclusionsThe calcipotriol-acitretin combination therapy could be a safe and effective therapeutic strategy in the treatment of psoriasis. However, the lack of PROSPERO registration and the high heterogeneity in this study limited the conclusion, and more high-quality RCTs were needed for further evaluation.Weiterlesen

Psoriasis, a chronic skin autoimmune disease characterized by abnormal immune responses, is influenced by genetic and environmental factors. Recent microbiota research has revealed that short-chain fatty acids (SCFAs), metabolites produced by gut microbiota, play a pivotal role in regulating immune function and inflammation. This review examines the current literature on the relationship between gut dysbiosis, SCFA production, and immune modulation in psoriasis, focusing on emerging evidence from microbiota and immunological studies. SCFAs have been shown to influence key immune pathways, including T-cell activation and cytokine production, which are critical in psoriasis pathogenesis. Reduced SCFA levels have been observed in psoriasis, highlighting the role of gut dysbiosis in disease progression. Understanding the gut-skin axis and the role of SCFAs offers novel insights into developing effective, safe, and accessible treatments for psoriasis. Restoring microbial balance and SCFA production may serve as a promising therapeutic approach for managing psoriasis.Weiterlesen

BackgroundPsoriasis is a chronic inflammatory skin disorder characterized by elevated levels of proinflammatory cytokines. Mesenchymal stem cells (MSCs) have demonstrated therapeutic potential, yet the specific mechanisms involved are not fully understood.ObjectiveTo investigated the effectiveness of extracellular vesicles (EVs) derived from MSCs that were genetically modified to overexpress miR-146a, in a mouse model of psoriasis.MethodsTo enhance miR-146a expression, MSCs were transfected, and their EVs were subsequently purified. Thirty mice were randomly assigned to three groups and induced with imiquimod cream to develop psoriasis-like skin lesions. The treatment groups included: (1) a control group administered PBS, (2) a group treated with EVs containing a control miRNA (miR-control EVs), and (3) a group receiving EVs enriched with miR-146a (miR-146a-EVs). EVs were administered intravenously and lesions were evaluated. Following intravenous administration of EVs, the severity of skin lesions was assessed. Concentrations of key cytokines, including IFN-γ, IL-17, TNF-α, IL-23, IL-6, IL-1β, TGF-β, IL-10, and IL-4, were quantified in both spleen and skin tissue lysates using ELISA and qRT-PCR techniques.ResultsThe experimental findings demonstrated that the administration of miR-146a-enriched EVs led to a significant improvement in clinical symptoms. There were substantial reductions observed in combined erythema, scaling, and skin thickness measurements compared to untreated controls. Additionally, levels of proinflammatory cytokines IFN-γ, IL-17, TNF-α, IL-23, IL-6, and IL-1β were significantly downregulated in the miR-146a-EV group, while anti-inflammatory TGF-β, IL-10 and IL-4 were upregulated. The same results were obtained in the spleens of mice.ConclusionEVs derived from miR-146a-modified MSCs effectively reduced psoriasis-like inflammation by modulating cytokine expression. This novel cell-free therapy holds promise for the treatment of psoriasis.Weiterlesen

IntroductionPsoriatic arthritis (PsA) is an immune-inflammatory disease involving skin and synovial-entheseal compartments. The understanding of IL-17 biological function has revolutionized the understanding of PsA pathogenesis and, consequently, its therapeutic approach.Areas coveredIn this review article, we have outlined the primary evidence regarding the biological functions of IL-17A in PsA, and summarized data from randomized controlled trials (RCTs) on PsA and psoriasis approved secukinumab, ixekizumab, bimekizumab, brodalumab, and emerging IL-17 inhibitors.Expert opinionThe biologic disease-modifying antirheumatic drugs (bDMARDs), secukinumab, and ixekizumab target interleukin-17A (IL-17A), and bimekizumab, which simultaneously neutralizes IL-17A and IL-17F, have demonstrated efficacy in treating both peripheral and axial articular manifestations of PsA, as well in improving skin involvement, enthesitis and dactylitis. Brodalumab, which inhibits the IL-17 receptor A (IL-17RA), represent an efficacious strategy for psoriasis.Continued research into the role of IL-17s in PsA pathogenesis is crucial for improving our understanding of the disease and developing more effective therapeutic strategies. Further research and advancements in biologic therapies will refine IL-17 inhibitory strategies, potentially improving outcomes for PsA patients, and other immune-mediated diseases.Weiterlesen

Background: Psoriasis is a chronic autoimmune condition characterized by recurrent episodes of skin inflammation. Despite progress in treatment, managing flare-ups of psoriasis remains a significant hurdle once the therapy is halted. This review aims to unravel the enigma of relapse by examining the interactions between epigenetics, metabolic reprogramming, and inflammatory memory.Methods and Results: Skin-resident memory T cells and keratinocytes with a history of inflammation play crucial roles in the metabolic and epigenetic alterations observed during relapse. This review explores epigenetic factors involved in the recurrence of psoriasis, such as histone alterations, chromatin restructuring, and non-coding RNAs. Furthermore, we explored environmental influences, metabolic reprogramming, and genetic predispositions that influence the persistence and recurrence of psoriasis. We also outline the function of the gut-brain-skin axis in this scenario. Finally, we discuss pharmacological strategies for managing psoriasis relapse, including targeted biologics.Conclusion: This review provides a comprehensive summary on the intricate epigenetic, molecular, metabolic and environmental cues that exacerbate or facilitate psoriasis relapse. In summary, it also provides an enticing update on the therapeutics currently employed to treat psoriasis relapse.Weiterlesen

Bei einem Patienten mit Asthma entwickelte sich nach einer Behandlung mit den Medikamenten Dupilumab und Tezepelumab eine sogenannte generalisierte pustulöse Psoriasis. Das ist eine Form von Schuppenflechte, bei der viele kleine Eiterbläschen auf der Haut entstehen. Dupilumab wird eigentlich häufig gegen Neurodermitis und Asthma eingesetzt, doch es gibt Berichte, dass manche Menschen dadurch eine pustulöse Psoriasis entwickeln können[1][3][4][5]. Diese Hautreaktion ist selten, aber möglich und zeigt, dass neue Medikamente manchmal unerwartete Nebenwirkungen haben können. Wer Veränderungen auf der Haut bemerkt, sollte das seinem Arzt melden. Originaltitel: Generalized pustular psoriasis in a patient with asthma following dupilumab and tezepelumab therapy. Link zur Quelle

No abstract supplied.Weiterlesen

Introduction Paediatric psoriasis is often misdiagnosed, and the overlap condition of psoriasis and atopic dermatitis (AD), known as psoriasis-dermatitis, further complicates accurate identification. Research has shown that interleukin-36 gamma (IL-36γ) measurement via tape stripping can help diagnose complex cases of psoriasis in adults. However, there are no published studies evaluating the applicability of this method in children, especially for distinguishing psoriasis from AD and the overlap condition. We aimed to assess the utility of IL-36γ measurement via tape stripping for distinguishing psoriasis from AD and for predicting the evolution of psoriasis-dermatitis in children and adolescents. Methods We conducted a cross-sectional diagnostic accuracy study in consecutive cases of psoriasis, AD, and psoriasis-dermatitis, and in healthy controls. IL-36γ concentration was measured using tape stripping and enzyme-linked immunosorbent assay (ELISA). Expert paediatric dermatologists independently confirmed the clinical diagnoses (reference standard). Results We included 11 children with psoriasis, 11 with AD, 11 with psoriasis-dermatitis, and 10 healthy controls (mean age 8.7 years, 57% female). Mean IL-36γ levels in psoriasis lesions were significantly higher than in AD lesions (144 pg/mL versus 14.4 pg/mL, P = 0.033) and in healthy controls (144 pg/mL versus 10.4 pg/mL, P = 0.037). The IL-36γ tape stripping method demonstrated a sensitivity of 91% and specificity of 91% for distinguishing psoriasis from AD, with an area under the receiver operating characteristic (ROC) curve of 0.959. The IL-36γ concentrations in participants with psoriasis-dermatitis predicted the evolution to psoriasis or dermatitis in most cases (5 out of 6, 83.3%). Conclusion IL-36γ measurement via tape stripping offers a promising method for distinguishing psoriasis from AD in children. This non-invasive approach is practical for routine clinical application and demonstrates good sensitivity and specificity, which suggests it could improve early diagnosis and patient outcomes.Weiterlesen

IntroductionPsoriasis is a chronic immune-mediated skin disease with known physical and mental health comorbidities, such as cardiovascular disease, depression, and anxiety. Psoriasis also has a significant impact on quality of life and sleep due to factors like itch and pain. This study aims to assess the relationship between sleep quality, mental health, and psoriasis, and specifically investigate the impact of poor sleep quality on mental health outcomes within participants with psoriasis.MethodsIn this cross-sectional study, we enrolled 556 participants into two cohorts: 487 participants were enrolled into the psoriasis cohort, and 69 were enrolled into the healthy control cohort. The demographics, disease severity, family history, sleep quality (PROMIS 8a, PROMIS 8b, and Insomnia Severity Index), and mental health (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7) of participants were assessed. Descriptive analysis and logistic regression models were employed to examine sleep and mental health, adjusting for potential confounders like demographics and comorbidities.ResultsA comparison of patients with psoriasis and healthy controls revealed worsened sleep and mental health outcomes in patients with psoriasis. Among participants with psoriasis, greater sleep impairment (Patient-Reported Outcomes Measurement Information System (PROMIS) 8a), sleep disturbance (PROMIS 8b), and insomnia were significantly associated with anxiety (ORa 1.22; 95% confidence interval (CI) 1.16, 1.30; ORa 1.26; 95% CI 1.16, 1.80; ORa 5.13; 95% CI 2.91, 9.33; respectively) and depression (ORa 1.42; 95% CI 1.32, 1.56; ORa 1.16; 95% CI 1.08, 1.26; ORa 7.04; 95% CI 4.01, 12.77; respectively).ConclusionThese findings underscore the importance of recognizing how psoriasis can impact mental health and sleep. Building a collaborative relationship between patients with psoriasis and their providers is essential to improve overall sleep and life quality.Weiterlesen

BackgroundThe impact of traditional systemic drugs to treat psoriasis (ciclosporin, methotrexate, and acitretin) in a subsequent response to biologics has not been adequately addressed in the literature. In clinical practice, it is increasingly necessary to initiate, due to concomitant comorbidities, biologics in patients with psoriasis or psoriatic arthritis (PsA) who have not undergone prior treatment with systemics, i.e. full-naive.Objectives and methodsThis study analyzed the possible impact of non-biological systemic therapies on the effectiveness and drug survival of first-line biologic drug up to 12 months in bio-naive psoriatic and PsA patients consecutively enrolled from January 2017 to March 2021.ResultsNinety-five patients with severe psoriasis (13.5%) were full-naive. Being full-naive and having or not having undergone methotrexate or cyclosporine therapy did not impact response to subsequent years of biologic therapy. Only acitretin promotes faster response to subsequent biologic drugs with 59.6% and 74.2% of patients achieving Psoriasis Area Severity Index (PASI) 90 at 16 and 28 week, respectively, vs. 50.5% and 65% (p = 0.034 and 0.026). In multivariate analysis, the advantage given by acitretin was lost.ConclusionPrevious systemic therapy in bio-naive patients does not appear to result in a differential response to biologics during the first year of treatment.Weiterlesen

BackgroundPsoriasis is a chronic skin disease affected by genetic and autoimmunity. The traditional Chinese medicine, Compound Qingdai Capsule (CQC), has shown potential benefits in treating psoriasis in clinical settings. Despite its efficacy, the molecular mechanisms underpinning its therapeutic action remain unclear.PurposeThis study aimed to unravel the molecular mechanism of Compound Qingdai Capsule for psoriasis based on the psoriasis pathogenic pathway network, integrating multi-omics analysis, systems pharmacology, machine learning modeling, and animal experimentation.MethodsPsoriasis pathogenic pathway network was constructed through employing bioinformatics analysis and psoriasis-related multi-omics data mining. The ingredients of CQC were detected by UPLC-MS/MS, and target prediction was performed by systems pharmacology. Machine learning, including Lasso regression, Random Forest, and Support Vector Machine (SVM), were utilized to screen core targets of psoriasis. Molecular docking was employed to evaluate the binding affinity between ingredients and core targets. The expression levels of core targets were determined using qRT-PCR and ELISA.ResultsPsoriasis-related datasets GSE201827 and GSE174763 were comprehensively analyzed to obtain 635 psoriasis-related genes. These genes were further enriched to elucidate signaling pathways involved, leading to the construction of psoriasis pathogenic pathway network. Utilizing UPLC-MS/MS, 29 main ingredients of CQC were characterized. CQC ingredients-targets network was constructed using these ingredients and their targets. Screening of CQC anti-psoriasis core targets using machine learning algorithm. Molecular docking confirmed good binding affinity between these targets and ingredients. Imiquimod (IMQ) induced psoriasis-like rat validated the anti-psoriasis effect of CQC by alleviating symptoms, reducing spleen and thymus index, and modulating the expressions of core targets at mRNA and protein levels.ConclusionCQC effectively modulates the expression levels of AURKB, CCNB1, CCNB2, CCNE1, CDK1, and JAK3 through various ingredients, such as astilbin, salvianolic acid A, and engeletin, via multiple pathways, thereby alleviating psoriasis-like symptoms.Weiterlesen