Blood Cytokines in Psoriasis: Association with Clinical Scores of the Disease Severity and Psoriatic Arthritis

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Abstract

Introduction. Dysregulation of the immune system and inflammationis associated with the pathogenesis of psoriasis andmanifestedas significant changes in cytokine profile. This fact can be used to monitor the course of the disease and its treatment. However, the results of these studies are insufficient, sometimes contradictory and require a more in-depth analysis.

Aim — to identify matches between cytokine profile, clinical scoresof psoriasis severity and the presence of psoriatic arthritis (PsA).

Methods. Standardized clinical scores (PASI, BSA, and sPGA) were used to assess the severity of psoriasis. It was defined as moderate if 10 ≤ PASI < 20 and sPGA was 2–3, and as severe if PASI ≥ 20 and sPGA was 4–5. Determination of the cytokine levelsin plasma was carried out by the multiplex immunological analysis using xMAP technology. Statistical analysis and visualization of the obtained data was carried out using RStudio for MacOS and the R programming language.

Results. The total 113 patients with psoriasis vulgaris of moderate and severe severity were enrolled in the present study. On the basis of PASI score, moderate psoriasis was diagnosed in 55 (48.7%) patients and severe in 58 (51.3%) patients. PsA was diagnosed in 41 (36.3%) patients. Depends on disease severity the differences in the levels of IL-12, IL-20 and IL-22 were revealed. Significant difference in IL-6 level between patients with PsA and without it were shown. We have identified two independent cytokine networks, represented by a cluster of cytokines associated with psoriasis severity scores (IL1β–TNFα–IL-17A, IL-22, and IL-20), and a cluster which was not associated with severity (IL-21, IL-23, IL-25, IL-17F, IL-31, IL-33, IL-4, and IL-10).

Conclusion. The results of the study for the first time describe the cytokine networks associated with the systemic inflammation in psoriasis; characterize the main effector cytokines determined the severity of the inflammatory response in skin and the development of PsA.

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About the authors

Arfenya E. Karamova

State Research Centre of Dermatovenerology and Cosmetology

Author for correspondence.
Email: karamova@cnikvi.ru
ORCID iD: 0000-0003-3805-8489
SPIN-code: 3604-6491

MD, PhD, Assistant Professor

Russian Federation, 3 bld. 6 Korolenko str., 107076, Moscow

Anastasiia A. Vorontsova

State Research Centre of Dermatovenerology and Cosmetology

Email: vorontsova@cnikvi.ru
ORCID iD: 0000-0002-3129-0050
SPIN-code: 8334-2890

junior research associate

Russian Federation, 3 bld. 6 Korolenko str., 107076, Moscow

Olga A. Obraztsova

State Research Centre of Dermatovenerology and Cosmetology

Email: valeeva19@gmail.com
ORCID iD: 0000-0002-5728-2139
SPIN-code: 6355-4699

PhD in Biology

Russian Federation, 3 bld. 6 Korolenko str., 107076, Moscow

Eugenia R. Nikonorova

All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR)

Email: gatiatulinaer@gmail.com
ORCID iD: 0000-0002-6360-2194
SPIN-code: 5392-5170

MD, PhD

Russian Federation, Moscow

Alexandr A. Nikonorov

State Research Centre of Dermatovenerology and Cosmetology

Email: nikonorov_all@mail.ru
ORCID iD: 0000-0001-7214-8176
SPIN-code: 3859-7081

MD, PhD, Professor

Russian Federation, 3 bld. 6 Korolenko str., 107076, Moscow

Dmitry G. Deryabin

State Research Centre of Dermatovenerology and Cosmetology

Email: dgderyabin@yandex.ru
ORCID iD: 0000-0002-2495-6694
SPIN-code: 8243-2537

MD, PhD, Professor

Russian Federation, 3 bld. 6 Korolenko str., 107076, Moscow

Alexey A. Kubanov

State Research Centre of Dermatovenerology and Cosmetology

Email: kubanov@list.ru
ORCID iD: 0000-0002-7625-0503
SPIN-code: 8771-4990

MD, PhD, Professor, Academician of the RAS

Russian Federation, 3 bld. 6 Korolenko str., 107076, Moscow

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2. Fig.1. Study Design to Find Correlations Between Cytokine Profiles, Clinical Indexes of Psoriasis Severity, and the Presence of Psoriatic Arthritis

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3. Fig.2. Differences in clinical indexes of psoriasis severity depending on the presence of psoriatic arthritis: A - BSA index; B — PASI index; B - sPGA index

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4. Fig.3. Differences in the levels of IL-20 (A), IL-22 (B) and IL-12 (C) in the blood plasma of patients with moderate and severe psoriasis (according to the PASI index)

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5. Fig.4. Differences in IL-6 levels depending on the presence of psoriatic arthritis

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6. Fig.5. Correlation galaxies reflecting the structure of cytokine networks in psoriasis: A - having a connection with the severity of the disease, assessed by a complex of clinical indices (PASI, BSA and sPGA); B - not related to the severity of the disease, assessed by a complex of clinical indices (PASI, BSA and sPGA)

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