Lipid Disturbances in Psoriasis: An Update

Abstract

Psoriasis is a common disease with the population prevalence ranging from 2% to 3%. Its prevalence in the population is affected by genetic, environmental, viral, infectious, immunological, biochemical, endocrinological, and psychological factors, as well as alcohol and drug abuse. In the recent years, psoriasis has been recognised as a systemic disease associated with numerous multiorgan abnormalities and complications. Dyslipidemia is one of comorbidities in psoriatic patients. Lipid metabolism studies in psoriasis have been started at the beginning of the 20th century and are concentrated on skin surface lipids, stratum corneum lipids and epidermal phospholipids, serum lipids, dermal low-density lipoproteins in the psoriatic skin, lipid metabolism, oxidative stress and correlations between inflammatory parameters, lipid parameters and clinical symptoms of the disease. On the basis of the literature data, psoriasis can be described as an immunometabolic disease.

The role of lipids in psoriasis

“…The substances are then further metabolized to FFAs, ceramides and cholesterol in the intercellular matrix. They are arranged in the form of a compact spatial structure and together with corneocytes and protein envelopes create a brick-and-mortar-like pattern, thus providing a protective barrier [9,10]. Multiple studies investigating psoriasis have shown abnormalities in the stratum corneum structure itself, along with impairment in the function of enzymes involved in lipid metabolism, resulting in changes in their composition, and increased epidermal exfoliation and TEWL [10][11][12][13][14].…”

“…A high content of cholesterol has been found in skin scales shed in the process of psoriatic scaling. The skin of healthy individuals produces 85 mg of cholesterol a day, however patients with psoriasis lose 1-2 g of cholesterol with skin scales over the same period [9,15]. Vaccaro et al confirmed, both in vivo and in vitro, significant molecular and structural anomalies in the dermoepidermal junction in psoriatic lesions, potentially leading to abnormal keratinooraz chroni przed nadmierną utratą wody (transepidermal water loss -TEWL).…”

“…Substancje te ulegają następnie w macierzy międzykomórkowej dalszemu metabolizmowi do FFAs, ceramidów i cholesterolu. Są ułożone w postaci przestrzennej, ścisłej struktury i wraz z korneocytami i kopertami białkowymi tworzą swoisty model "cegły i zaprawy", utrzymując w ten sposób barierę ochronną [9,10]. W wielu badaniach nad łuszczycą wykazano nieprawidłowości dotyczące struktury warstwy rogowej oraz upośle-dzonej funkcji enzymów biorących udział w metabolizmie lipidów, co skutkuje zaburzeniami w ich skła-dzie, nasila złuszczanie naskórka oraz TEWL [10][11][12][13][14].…”

“…Stwierdzono, że dużą ilość tej substancji zawierają łuski, a pacjenci tracą ją wraz z ich złuszczaniem. Skóra osób zdrowych produkuje 85 mg/dobę cholesterolu, natomiast chorzy na łuszczycę tracą w tym czasie 1-2 g cholesterolu wraz z łuskami [9,15]. Vaccaro i wsp.…”

Eicosanoids in skin inflammation

“…Psoriasis is a relatively common chronic inflammatory and proliferative skin disease, with genetic and environmental aetiologies, that is characterized by abnormalities in skin lipids and increased production of inflammatory mediators [93,94].…”