Background: Psoriasis is one of the most common chronic, life-long dermatologic diseases, which has considerable negative effects on quality of life. Psoriasis is considered as a systemic inflammatory disease, thus acute phase proteins such as C-reactive protein (CRP) and orosomucoid (ORM) have been shown to play a role in its pathophysiology. This study was aimed to compare CRP, serum ORM (se-ORM) and urinary ORM (u-ORM) levels of psoriatic patients to healthy individuals.Methods: 87 psoriatic patients and 41 healthy individuals were enrolled. Simultaneously obtained venous blood and spot urine samples were analysed. High sensitivity CRP and se-ORM levels were determined by routine procedures on automated analyzers. Urinary ORM was measured by a novel automated turbidimetric assay. U-ORM was referred to urinary creatinine (u-ORM/u-CREAT, mg/mmol).Results: Significantly higher hsCRP (p<0.001) and u-ORM/u-CREAT (p=0.001) levels were found among psoriatic patients compared to controls. No significant differences were found between the groups regarding se-ORM levels. HsCRP, se-ORM and u-ORM/u-CREAT levels were significantly higher in patients with severe psoriasis than in mild and moderate cases (p<0.05).Conclusion: As a highly sensitive, easily available biomarker u-ORM shows itself capable of becoming a new inflammatory marker in psoriasis providing clinically useful information on disease severity.

A jelen tudományos közleményt a szerzők a Pécsi Tudományegyetem alapításának 650. évfordulója emlékének szentelik.A psoriasis hazánkban és világviszonylatban is a leggyakrabban előforduló bőrbetegségek egyike. Jelentőségét hangsú-lyozza a gyakran élethossziglan fennálló plakkok okozta fájdalom, mozgáskorlátozottság és a pszichés terhelés életmi-nőségre gyakorolt hatása. Szövődményeit tekintve a nemegyszer maradandó károsodásokat okozó arthritis psoriaticán túl, a psoriasisos betegek esetében nagyobb cardiovascularis kockázattal kell számolni, gyakrabban alakulnak ki gyulladásos bélbetegségek és bizonyos daganatok. Az exogén és endogén tényezők okozta oxidatív stressz és a genetikai prediszpozíció hozzájárulhat a keratinocyták hiperproliferációjához és abnormális differenciálódásához, ezáltal a psoriasis kialakulásához, illetve fenntartásához. A nagyfokú oxidatív stressz felelős lehet továbbá a psoriasis szövődménye-inek megjelenéséért. Jelen közleményben, rövid patofiziológiai áttekintés után, néhány jól ismert biomarker (aszimmetrikus dimetilarginin, malonilaldehid, szuperoxid dizmutáz, kataláz) segítségével a szerzők bemutatják az oxidatív stressz szerepét a psoriasis és szövődményeinek kialakulásában. Orv. Hetil., 2016, 157(45), 1781-1785. Kulcsszavak: psoriasis, biomarker, oxidatív stressz Psoriasis and oxidative stressPsoriasis is among the most common dermatological diseases worldwide. Its significance is emphasized by adverse effects on quality of life, caused by chronic pain, physical and psychical disability due to psoriatic plaques. Besides the development of psoriatic arthritis, which often causes permanent joint damage, former studies revealed an increased risk of inflammatory bowel disease, cardiovascular disease and certain types of cancer. Genetic predisposition and oxidative stress caused by exogenous and endogenous factors can contribute to abnormal differentiation and hyperproliferation of keratinocytes, accordingly the development and maintenance of psoriasis. Moreover, excessive oxidative stress can be responsible for the onset of psoriasis complications. After a brief pathophysiological summary the authors discuss the role of oxidative stress in the development of psoriasis and its complications through several well studied biomarkers (asymmetric dimethylarginine, malondialdehyde, superoxide dismutase, catalase). Keywords ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések ADMA = aszimmetrikus dimetilarginin; BB = béta-blokkoló; BMI = body mass index; CARD-14 = caspase recruitment domain family member 14, CAT = catalase; CV = cardiovascularis; DLQI = Dermatology Life Quality Index, IF = interferon; IL12B = interleukin 12B; MDA = malonilaldehid; MHC = major histocompatibility complex; Li = lítium; MI = myocardialis infarctus; NFκB = nuclear factor kappa BVZ; NSAID = nem szteroid gyulladáscsökkentő; PASI = Psoriasis Area Severity Index; PSORS = psoriasis-susceptibility; PsA = arthritis psoriatica; SOD = szuperoxid dizmutáz; TNF = tumor necrosis factor A psoriasis a leggyakrabban előforduló bőrbetegségek egyike...

Purpose Psoriasis is one of the most common lifelong lasting dermatologic diseases. According to the latest studies, psoriatic patients have a higher risk of developing cardiovascular diseases. Psoriasis is considered as a systemic inflammatory disease. Several oxidative stress markers have been shown to be elevated in psoriasis. However, a panel of biomarkers has not been used yet. This study was aimed at exploring the connection between a panel of biomarkers (C-reactive protein, asymmetric dimethylarginine, uric acid, total antioxidant capacity, malondialdehyde, and orosomucoid [ORM]) and cardiovascular risk in psoriatic patients. Patients and methods The inclusion criterion was the onset of psoriasis with skin lesions. Exclusion criteria were impaired renal function (eGFR<60 mL/min/1.73 m 2 ), acute inflammations (urinary, respiratory, skin inflammation, etc), autoimmune disorders (rheumatoid arthritis, systemic lupus erythematosus, or inflammatory bowel disease), and any kind of biological antipsoriatic treatment. Patients with a medical history of myocardial infarction, coronary heart disease, stroke, transient ischemic attack, and carotid artery stenosis were also excluded. Biomarkers were measured by routine procedures, ELISA and HPLC. QRISK®2-2017 was used to assess 10-year risk of cardiovascular disease development. Psoriasis severity was measured by the Psoriasis Area and Severity Index. Results One hundred and fourteen psoriatic patients were enrolled. Only urinary orosomucoid and urinary orosomucoid/urinary creatinine (u-ORM/u-CREAT) ratio showed significant correlation with QRISK score (u-ORM, r=0.245; u-ORM/u-CREAT, r=0.309). When comparing mild psoriatic patients to moderate psoriatic patients, significant differences could only be found in u-ORM and u-ORM/u-CREAT ratio. Conclusion There seems to be a connection between urinary ORM and cardiovascular risk. U-ORM and u-ORM/u-CREAT ratio could be used as an indicator of low-grade inflammation in mild and moderate psoriasis. However, it is the 10-year follow-up of cardiovascular events that will determine the usefulness of this biomarker panel.

Aim: We aimed to investigate the effects of a single carbon dioxide (CO 2) treatment on arterial stiffness by monitoring the changes of aortic pulse-wave velocity (PWV) and aortic augmentation index (AIXao), which are indicators of arterial stiffness. Patients and Methods: PWV and AIXao were measured by an invasively validated oscillometric device. The measurements of stiffness parameters were performed before the CO 2 treatment, and at 1, 4 and 8 h after the first treatment. Results: Thirty-one patients were included. No significant changes were found in PWV. AIXao decreased significantly 1 h and 4 h after CO 2 treatment compared to baseline values (p=0.034 and p<0.001). AIXao increased 8 h after the CO 2 treatment, but remained significantly lower than baseline AIXao values (p=0.016). Conclusion: CO 2 treatment is capable of reducing peripheral vascular resistance. We hypothesize that CO 2 is not only a temporal vasodilator but is also capable of activating vasodilation pathways.

The short- and long-term decrease of ADMA levels suggests that CO is not only a vasodilator, but also has a beneficial effect on the NO pathway. ACE inhibition seems to enhance the effect of CO treatment.