IntroductionPsoriasis and psoriatic arthritis (PSA) are chronic, inflammatory, systemic diseases characterized by metabolic abnormalities, including an increased cardiovascular risk and an oxidative imbalance. This study assessed blood parameters of lipid metabolism and markers of oxidative stress in patients with psoriasis and PSA.Material and methodsThe study included 93 patients with psoriasis (31 patients with PSA and psoriasis, 62 patients with psoriasis vulgaris), and 60 healthy, age-matched controls. Serum concentrations of the glucose and the following lipid metabolism parameters were measured: triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL), very low-density lipoproteins (VLDL), high-density lipoproteins (HDL), and apolipoproteins A and B (ApoA, ApoB). Oxidative status was determined as serum concentrations of ox-LDL/MDA Adduct. The Psoriasis Area and Severity Index (PASI) was used to determine disease severity.ResultsAmong the three studied groups, controls had the highest HDL concentration (p < 0.001), patients with PSA had the highest ApoB concentration (p < 0.05), ApoA : ApoB ratio (p < 0.05), ox-LDL/MDA adduct concentration (p < 0.001), and TC: HDL and LDL : HDL ratios (accordingly p < 0.05, p < 0.01). In patients with psoriasis or PSA, oxidative status correlated positively with TC and ApoB concentrations.ConclusionsIn line with previous research, among patients with psoriasis and PSA, we found lipid metabolism abnormalities and an oxidative imbalance, which might be due to chronic inflammation in these conditions. Effective treatment of patients with psoriasis or PSA could reduce the risk of cardiovascular diseases.

Introduction: Patients with psoriasis and psoriatic arthritis (PsA) have metabolic disturbances, which may be due to chronic inflammation. Aim: Because interleukin-6 (IL-6) regulates both metabolic and inflammatory processes, we evaluated IL-6 as a potential marker of inflammation and metabolic disturbances in psoriasis. Material and methods: This study involved 93 patients with psoriasis, including 31 patients with concurrent PsA. We investigated whether serum markers of lipid metabolism and inflammation, including IL-6, were related to each other and to disease activity. Results: We found that concurrent PsA was associated with higher serum concentrations of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and IL-6. In patients with psoriasis alone, the IL-6 serum concentration correlated positively with the concentrations of TC and LDL-c and with erythrocyte sedimentation rates (ESRs). Moreover, IL-6 concentrations tended to correlate positively with the percentage of the body area affected by psoriatic lesions. Among all patients, those with normal blood lipids had lower ESRs and IL-6 concentrations than patients with abnormal blood lipids. A logistic regression model showed that PsA, Psoriasis Area Severity Index (PASI), and ESR were significant predictors of the serum IL-6 concentration. Conclusions: Interleukin-6 may be an indicator of inflammatory activity in psoriasis. Moreover, IL-6 may be related to lipid abnormalities in patients with this disease.

Decreased levels of HDL cholesterol and increased concentrations of fasting glucose may represent very early stages of MetS in children with psoriasis. However, a large population-based study is needed to establish the relationship between psoriasis and MetS in children, including the environmental, genetic and immunological factors leading to their co-occurrence.

From 5% to 40% patients with psoriatic skin lesions develop psoriatic arthritis, but 15% to 30% of patients with psoriasis suffer from undiagnosed psoriatic arthritis. The key role in development of psoriasis is played by T-lymphocytes and release of proinflammatory cytokines, interferon and adhesive proteins. Infection may exert an influence on psoriasis vulgaris and psoriatic arthritis development. The presence of antibodies against the antigens of Yersinia spp., Campylobacter spp. and Chlamydia trachomatis was more frequently observed in the serum of patients with psoriatic arthritis. Diagnosis of psoriatic arthritis may be based on CASPAR criteria. Diagnostic imaging (CT, MRI, USG) are routine diagnostic procedures in psoriatic arthritis. Several sub-types of psoriatic arthritis have been identified. Questionnaires to identify early stages of the disease have been constructed. Genetic factors, cigarette smoking, alcohol abuse, infections, stress and environmental factors may affect clinical course and results of treatment of psoriasis vulgaris and psoriatic arthritis. In severe cases, the disease may lead to disability. streszCzenie U 5-40% pacjentów z łuszczycą skóry występuje łuszczycowe zapalenie stawów, natomiast ok. 15-30% pacjentów z łuszczycą skóry ma nierozpoznane łuszczycowe zapalenie stawów. Kluczową rolę w patogenezie łuszczycowego zapalenia stawów odgrywają limfocyty T oraz wydzielane przez nie prozapalne cytokiny (interleukiny, interferony) i białka adhezyjne. Zarówno w łuszczycy, jak i w łuszczycowym zapaleniu stawów ważna jest też rola czynnika infekcyjnego. W surowicy pacjentów z łuszczycowym zapaleniem stawów znacznie częściej obserwowano obecność przeciwciał przeciwko antygenom Yersinia spp., Campylobacter spp. oraz Chlamydia trachomatis. Rozpoznanie łuszczycowego zapalenia stawów może być oparte na kryteriach CASPAR. Badania obrazowe (TK, MRI, USG) stanowią rutynową diagnostykę w tej chorobie. Wyróżniono kilka podtypów łuszczycowego zapalenia stawów i wprowadzono kwestionariusze umożliwiające identyfikację ich wczesnych postaci. Na przebieg kliniczny oraz wyniki leczenia łuszczycowego zapalenia stawów istotny wpływ mogą mieć czynniki gene

Aim. The aim of the study was a potential impact of prednisone on the early immune response in HIV-negative young adults with active pulmonary tuberculosis, during the first four weeks of treatment.Material and methods. The study included 38 adults, aged 18-39 years, with active pulmonary tuberculosis. The first group of patients received only anti-tuberculosis chemotherapy whereas the second group of patients was administered antituberculosis chemotherapy and 20 mg prednisone, once daily. Serum levels of tumor necrosis factor-alpha, interferon-gamma and interleukin 1-beta were measured using ELISA kits before treatment initiation as well after two and four weeks of treatment, in both study groups.Results. The highest serum levels of evaluated cytokines were observed before treatment initiation. Serum levels of cytokines were significantly decreased in patients who received anti-tuberculosis drugs and prednisone, compare to those not treated with prednisone (p<0.001), in all study periods.Conclusions. Adjunctive therapy, like 20 mg prednisone daily, remarkably inhibited the secretion of inflammatory cytokines during the early stage of active pulmonary tuberculosis in HIV-negative young adults, which is likely to be beneficial for this group of patients.