Evaluation of serum and urinary orsomucoid protein A in psoriatic patients and their relation to severity of disease

Abstract

Background: Orsomucoid protein A (ORM) is a major acute-phase protein. Serum ORM (se-ORM) protein A elevates in infections, malignancies, and autoimmune diseases. Urinary ORM (u-ORM) protein A is more accurate and less invasive marker of inflammation. Elevated u-ORM was associated with pathomechanism factors related to psoriasis such as endothelial dysfunction; however, the clinical significance of it has not been explored yet. Aim: To evaluate se-ORM/u-ORM protein A and urinary orsomucoid protein A/urinary creatinine (u-ORM/u-CREAT) in patient with psoriasis and their relations to severity of the disease. Methods: This case-control study was conducted at Dermatology and Andrology Department; 35 psoriasis patients and 35 age-and sex-matched healthy controls were included. They were subjected to history taking and general and dermatological examination. Psoriasis severity was assessed by Psoriasis Area and Severity Index (PASI) score. Measurement of se-ORM/u-ORM protein A using ELISA and u-ORM/u-CREAT using colorimetric method.Results: Highly significant difference between psoriasis patients and controls regarding u-ORM protein A level (p value = 0.01). It was also higher in severe cases than moderate and mild ones and higher in moderate than mild cases (p value 0.001, 0.001, and 0.004, respectively). There were significantly higher u-ORM/u-CREAT (p ˂ 0.001) levels in psoriasis patients than in controls. Also, significantly higher U-ORM/u-CREAT levels were found in severe psoriasis cases than in mild and moderate cases (p = 0.003 and 0.006, respectively). While the se-ORM levels showed no significant differences between the studied groups.Conclusion: u-ORM/u-CREAT is a highly sensitive, easily available, and new inflammatory biomarker of psoriasis which correlates to the disease severity.

Urinary Orosomucoid as a Potential Marker of Inflammation in Psoriasis Vulgaris

“…The current study revealed that median uORM A statistically increased among PV cases compared to the controls and also among severe PV cases compared to mild and moderate ones (P=0.03). Likewise, Khalid et al (32) noted a significant increase in uORM values among PV cases compared to the controls which is in agreement with the current study. Also, Kustán et al (13) and Nowowiejski et al (33) came to the same conclusion.…”

Tumor Necrosis Factor (TNF) α, Endothelin (ET) 1 and α1-Acid Glycoprotein (AGP) as Potential Urine and Serum Markers of Metabolic Complications in Psoriasis?

“…That slightly limits its use as a urine marker, as the use of only absolute values could be confusing considering that kidney function differs between patients. Nevertheless, it is an interesting target and requires further research to determine its true application in clinical practice with regard to CVD, especially since urinary α1AGP is believed to be a more sensitive marker than its serum concentration [ 31 ]. Interestingly, it is suspected that elevated secretion of α1AGP into the urine is associated with the activation of the immune system and is observed in other autoimmune conditions [ 31 ].…”

“…Nevertheless, it is an interesting target and requires further research to determine its true application in clinical practice with regard to CVD, especially since urinary α1AGP is believed to be a more sensitive marker than its serum concentration [ 31 ]. Interestingly, it is suspected that elevated secretion of α1AGP into the urine is associated with the activation of the immune system and is observed in other autoimmune conditions [ 31 ]. Moreover, some scientists have found that both the absolute α1AGP concentration and and the α1AGP to creatinine ratio in urine are elevated in psoriatics [ 24 , 31 , 32 ].…”

“…Interestingly, it is suspected that elevated secretion of α1AGP into the urine is associated with the activation of the immune system and is observed in other autoimmune conditions [ 31 ]. Moreover, some scientists have found that both the absolute α1AGP concentration and and the α1AGP to creatinine ratio in urine are elevated in psoriatics [ 24 , 31 , 32 ]. Similar results were obtained by Singh et al [ 6 ].…”

“…Based on the study by Nemeth et al and ours, there seems to be no correlation, though, between psoriasis severity and urinary α1AGP [ 24 ], contrary to what Khalid et al observed. Their team found a positive correlation with PASI score [ 31 ]; however, their study was performed on a small sample.…”