Evaluation of ADA activity as a potential marker of disease severity in psoriasis patients

Abstract

BackgroundPsoriasis is a dermatological disorder with a multifactorial origin and is associated with many biochemical and immunological changes.PurposeThis study aimed to examine the association of serum ADA activity, uric acid (UA), and high-sensitivity CRP (hs-CRP) with psoriasis and the role of ADA in disease severity.Materials and methodsIn this comparative cross-sectional study, 50 clinically and histopathologically diagnosed psoriasis patients and 50 age- and sex-matched healthy controls were enrolled. Blood samples were taken and analysis of the biochemical parameters was performed according to Giuisti and Galanti method, uricase and ELISA technique for ADA activity, UA, and hs-CRP, respectively. The severity of the disease was scored according to Psoriasis Area and Severity Index (PASI). Statistical analysis of differences within and between the study groups was carried out using the Student’s t-test, one-way post hoc ANOVA, and Pearson’s correlation. Linear regression was used to establish the independent association of ADA with disease severity.ResultsThe serum ADA activity, UA, and hs-CRP levels of the psoriatic patients were found to be significantly higher (P<0.001). hs-CRP was positively correlated with ADA and UA in patients (P<0.001). There was no significant difference in total cholesterol, low-density lipoprotein, and triacylglycerol in psoriasis patients, whereas we noted a decreased high-density lipoprotein level in psoriasis patients as compared to controls. Linear regression showed that ADA was independently associated with the disease severity and was statistically significant (P<0.001).ConclusionADA activity was positively and significantly associated with the severity of psoriasis, therefore, it could be suggested as a marker for disease severity in psoriasis patients.

Evaluation of Serum Uric Acid Levels in Psoriasis Vulgaris

“…The difference between SUA levels of cases and controls was found to be statistically significant. (p=0.011) This was in accordance with the study conducted by Gisondiet al 13 , Yilmaz et al 14 , Khan et al 15 , while contrasting results were reported by Agravatt et al 16 .and Nicolae et al 17 The higher SUA levels among patients with Psoriasis can be explained by increased rate of purine metabolism, due to the rapid epidermal turnover, leading to accumulation of uric acid which is the end product of purine degradation.…”

Updated Evidence of the Association Between Elevated Serum Uric Acid Level and Psoriasis

“…The MD value of 0 was outside the 95% CI of SUA level in the three subgroups (European and American regions, Southeast Asia, and the Middle East). In seven studies ( 11 , 15 , 18 , 39 , 40 , 43 , 44 ), a significant correlation was observed between SUA levels and PASI scores, whereas five studies ( 27 , 28 , 34 , 36 , 42 ) presented contradictory results. In our study, the stratification of psoriasis patients by PASI score into the mild and moderate to severe psoriasis subgroups revealed that moderate to severe psoriasis patients from European and American regions and Southeast Asia were more likely to have hyperuricemia.…”

“…To determine SUA levels in patients with mild and moderate to severe psoriasis, we conducted a meta-analysis of significant inter-study heterogeneity in the mild psoriasis group ( I 2 = 96%, P < 0.00001) and the moderate to severe psoriasis groups ( I 2 = 94%, P < 0.00001). Using random-effects modeling, the pooled MD of five studies ( 10 , 17 , 38 , 42 , 44 ) in the mild psoriasis group was 0.11 (95% CI −0.68 to 0.89; P = 0.79). There was heterogeneity in the Middle East and Southeast Asian subgroups, but no significant differences were observed (MD 0.30, 95% CI −1.42 to 2.02, P = 0.73; MD 0.53, 95% CI −0.46 to 1.51, P = 0.29) ( Figure 3 ).…”

“…There was heterogeneity in the Middle East and Southeast Asian subgroups, but no significant differences were observed (MD 0.30, 95% CI −1.42 to 2.02, P = 0.73; MD 0.53, 95% CI −0.46 to 1.51, P = 0.29) ( Figure 3 ). Using random-effects modeling, the pooled MD of nine studies ( 10 , 17 , 26 , 30 , 38 , 40 , 42 – 44 ) in the moderate to severe psoriasis group was determined as 1.04 (95% CI 0.21–1.86, P = 0.01). There was heterogeneity in the Middle East and Southeast Asian subgroups; in the European and American area subgroups, the heterogeneity was small ( I 2 = 14%, P = 0.28).…”

“…The metaanalysis consisted of two parts based on the type of response variable. The first part included the 27 studies (10,11,(14)(15)(16)(17)(18)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) that used continuous SUA as the response variable. These studies consisted of 31,314 participants (2,951 with psoriasis and 28,363 controls).…”