Association between serum periostin levels and the severity of arsenic-induced skin lesions

Abstract

Arsenic is a potent environmental toxicant and human carcinogen. Skin lesions are the most common manifestations of chronic exposure to arsenic. Advanced-stage skin lesions, particularly hyperkeratosis have been recognized as precancerous diseases. However, the underlying mechanism of arsenic-induced skin lesions remains unknown. Periostin, a matricellular protein, is implicated in the pathogenesis of many forms of skin lesions. The objective of this study was to examine whether periostin is associated with arsenic-induced skin lesions. A total of 442 individuals from low- (n = 123) and high-arsenic exposure areas (n = 319) in rural Bangladesh were evaluated for the presence of arsenic-induced skin lesions (Yes/No). Participants with skin lesions were further categorized into two groups: early-stage skin lesions (melanosis and keratosis) and advanced-stage skin lesions (hyperkeratosis). Drinking water, hair, and nail arsenic concentrations were considered as the participants’ exposure levels. The higher levels of arsenic and serum periostin were significantly associated with skin lesions. Causal mediation analysis revealed the significant effect of arsenic on skin lesions through the mediator, periostin, suggesting that periostin contributes to the development of skin lesions. When skin lesion was used as a three-category outcome (none, early-stage, and advanced-stage skin lesions), higher serum periostin levels were significantly associated with both early-stage and advanced-stage skin lesions. Median (IQR) periostin levels were progressively increased with the increasing severity of skin lesions. Furthermore, there were general trends in increasing serum type 2 cytokines (IL-4, IL-5, IL-13, and eotaxin) and immunoglobulin E (IgE) levels with the progression of the disease. The median (IQR) of IL-4, IL-5, IL-13, eotaxin, and IgE levels were significantly higher in the early-and advanced-stage skin lesions compared to the group of participants without skin lesions. The results of this study suggest that periostin is implicated in the pathogenesis and progression of arsenic-induced skin lesions through the dysregulation of type 2 immune response.

The Unknown Role of Periostin in Psoriatic Epidermal Hyperplasia

“…In systemic sclerosis, POSTN promotes and intensifies skin fibrosis. In AD, POSTN exacerbates tissue remodeling, leading to the development of hyperkeratotic skin lesions with distorted architecture [3,7,8]. AD and psoriasis are dermatoses characterized by epidermal hyperplasia, but the immune response in each of these diseases occurs differently.…”

Arsenic Exposure-Related Hypertension in Bangladesh and Reduced Circulating Nitric Oxide Bioavailability

“…The participants were from high-arsenic exposure villages in the region that included Marua in the Jessore district; Dutpatila, Jajri, Vultie, and Kestopur in the Chuadanga district; Khemirdia (Bheramara) in the Kushtia district; and Kazirpara in the Rajshahi district. During our visit to these villages, we found many residents with arsenical skin lesions (melanosis, leucomelanosis, keratosis, and hyperkeratosis), 39 the hallmark features of prolonged exposure to high concentrations of arsenic. The prevalence of arsenical skin lesions suggested that the residents living in those regions were exposed to high levels of arsenic.…”

Association of Methionine Synthase rs1805087 Polymorphism With Arsenic-Related Skin Pigmentary Changes: A Population-Based Case-Control Study

“…Pigmentary changes are considered the earliest dermatological manifestations and may act as an early marker of carcinogenicity. 18 The public should pay close attention to arsenic-induced pigmentary changes and explore the risk factors for susceptibility.…”