Dermal Distribution of Hyaluronan in Psoriatic Arthritis; Coexistence of CD44, MMP3 and 9

Abstract

Psoriatic arthritis is a chronic systemic disease in which patients develop persistent inflammation of the skin and joints, leading to disability and joint damage. The extracellular component hyaluronan (HA) plays an important role in regulatory processes such as inflammation, wound healing and tumour progression. At any site of inflammation HA can be depolymerized to low-molecular weight fragments, which, in turn, induce an array of inflammatory mediators that can lead to chronic inflammation. This study describes the serum concentration and dermal distribution of HA, its receptor CD44 and the metalloproteinases 3 and 9 in skin biopsies from patients with different types of psoriatic arthritis. Fifty-one patients with psoriatic arthritis were included in the study and classified as oligo- or poly-arthritic PsA with and without treatment. Biopsies were obtained from both involved and non-involved skin and compared with biopsies from healthy individuals. Serum HA was analysed for estimation of the total turnover of HA. The main findings were an overall redistribution of HA in both involved and non-involved psoriatic skin and an epidermal imbalance between HA and CD44. The structurally and functionally important basement membrane zone was found to be disintegrated and devoid of HA irrespective of the type of articular involvement, treatment or skin affection.

Hyaluronic acid in psoriasis

“…We have previously reported the interest of measuring levamisole and cocaine in hair samples in a patient presenting an atypical panniculitis with some features of vasculitis and positive ANCA testing. 3 Herein, we report additional data that reinforce the link between levamisole exposure and development of systemic vasculitis. In May 2011, a 39-year-old female cocaine addict (previously reported 3 ) consulted for recurrent (six stereotypic episodes per year) painful panniculitis with erythematous…”

“…Additionally, recent studies have also suggested that serum hyaluronic acid did not correlate with joint inflammation in psoriatic arthritis. 3 Recent progress has demonstrated that hyaluronan is an important immune regulator in various diseases. In particular, low molecular weight hyaluronan is a ligand for toll-like receptors (TLRs), and induces inflammatory cytokine gene expression.…”

Hyaluronan concentration and molecular mass in psoriatic arthritis: biomarkers of disease severity, resistance to treatment, and outcome

“…However, some earlier studies have failed to show the inflammatory properties of LMHA (12,13). In our earlier study of PsA, inflammation in skin of differing classification groups revealed a redistribution of HA in involved and non-involved psoriatic skin with epidermal imbalance between HA and its receptor CD44 in untreated patients with polyarticular disease (4).…”

“…Patients with PsA usually exhibit low-grade skin inflammation (3). However, in a previous study, we showed that patients with PsA can exhibit inflammatory changes in both lesional and non-lesional skin (4). Moreover, in psoriatic patients with neither joint complaints nor disease, about half have shown entheseal inflammation at the Achilles tendon insertion.…”

Application of vacuum sealing drainage to the treatment of seawater‐immersed blast‐injury wounds

“…In Laugier's study , immunohistochemistry of the skin showed that HA was expressed only in the basal cells and basal upper layers of the epidermis and not inside the granular layer and stratum corneum. http://www.ncbi.nlm.nih.gov/pubmed/?term=Lindqvist%20U%5BAuthor%5D&cauthor=true&cauthor_uid=22278305 found that HA was mainly distributed within the papillary layer's intercellular regions of normal skin, which exhibited strong and non‐uniform staining distribution inside the reticular layer of dermis. In addition, the epidermal basement membrane area was the region that had the most intense staining.…”