Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms

Abstract

Goeckerman therapy (GT) of psoriasis vulgaris is based on the application of crude coal tar and ultraviolet radiation. We investigated DNA damage by the number of micronucleated binucleated cells (MNBC) in lymphocytes, serum homocysteine, vitamin B12, folic acid, and two polymorphisms (C677T and A1298C) in the MTHFR gene in 35 patients with exacerbated psoriasis vulgaris classified according to the psoriasis area and severity index (PASI) score and treated by GT. The median of PASI score decreased from nineteen to five, and MNBC increased from 10 to 18‰ after GT (p < 0.001 in both cases). Correlations of MNBC with homocysteine (Spearman’s rho = 0.420, p = 0.012) and vitamin B12 (rho = −0.389, p = 0.021) before the therapy were observed. Hyperhomocysteinemia was an independent predictor of genotoxicity (OR 9.91; 95% CI, 2.09–55.67; p = 0.003). Homocysteine was higher in females than in males (13 vs. 12 µmol/L, p = 0.045). In contrast, vitamin B12 levels in the females were lower than in the males (160 vs. 192 pmol/L, p = 0.047). Vitamin B12 in the females were negatively influenced by smoking status (160 pmol/L in smokers vs. 192 pmol/L in non-smokers, p = 0.025). A significantly higher MNBC was found in CC homozygous patients (A1298C polymorphism) than in AC heterozygotes (32 vs. 16‰, p = 0.005) and AA homozygotes (32 vs. 18‰, p = 0.036). Our data showed that homocysteine participates in the pathogenesis of psoriasis. Its serum levels correlated with MNBC and allowed the prediction of DNA damage to appear within GT. Both micronutrients status and homocysteine metabolic pathway contribute to the genotoxicity of GT.

Genotoxic effect of simultaneous therapeutic exposure to polycyclic aromatic hydrocarbons and UV radiation

“…The uncertainty of interpretation is also supported by the absence of information about nutritional factors, especially levels of vitamin B 12 and folate, which may affect DNA synthesis and repair, and hence the levels of aberrated cells (Beranek et al, 2019).…”

Association between Genetic Polymorphisms in Methylenetetrahydrofolate Reductase and Risk of Autoimmune Diseases: A Systematic Review and Meta-Analysis

“…The results, however, are contradictory to the findings from other authors. For example, Asefi et al reported that the MTHFR 677 T allele was associated with an increased risk of psoriasis [ 50 ], whereas Beranek et al failed to find any association between the SNP and risk of psoriasis [ 45 ]. Two previous meta-analyses were conducted, and no significant association of the MTHFR 677 C/T with the etiology of psoriasis was found [ 51 , 52 ].…”

Biochemical Pathways of Metabolic Disorders in Psoriasis

“…A positive correlation was found between Hcy and TNF-α, IFN-γ, IL-17α, IL-1β, TNF-α and IL-6 and increases the activity of matrix metalloproteinases, increases the activity of the nuclear transcription factor Nf-kB. Given these data, we can assume a positive correlation between homocysteine levels and psoriasis severity [36,38,39].…”