Quantification of microvascular changes in the skin in patients with psoriasis

Abstract

It has been suggested that there is a widespread abnormality of the capillaries in the skin of patients with psoriasis. This study was carried out to obtain more evidence on this point. lesions of 20 patients with typical psoriasis, and uninvoived skin 3 cm from these lesions, were biopsied and compared with biopsies from 10 normal healthy control subjects. The dermal microvasculature was quantified in all these biopsies with regard to endothelial and luminal volume relative to the volume of dermal components of skin using stereological point counting methods utilizing the Delesse principle.The values for endothelial volume in specimens taken from the centre of the lesions did not differ significantly from those taken from the margins (3 3-6 x 10 ' and 35•8xlO"^ respectively). The same was true for the luminal volume from the two sites (9 1 x 10' and 10-0 x 10"', respectively). There was a highly significant difference, however, between the value for endothelial volume in biopsies from psoriatic patients compared to controls (P<0001) and specimens from uninvoived psoriatic skin also showed a highly significant difference (P<()(){)1) from involved areas. There was no significant difference between uninvoived areas in psoriasis patients and control specimens. Significant differences were also found between values for control subjects and those for both involved and uninvoived psoriatic skin for luminal volume (F<OO()1). The number of capiUary profiles counted in each group produced a similar rank ordering to the other parameters examined, i.e. psoriasis> psoriatic uninvoived > normal.

The Role of Angiogenesis in the Pathogenesis of Psoriasis: Mechanisms and Clinical Implications

“…Many studies confirm that those capillaries are wide, dilated, tortuous and leaky [9,10]. These alterations would be more important within the papillary dermis than the upper reticular dermis [11].…”

“…The size of capillaries within psoriatic lesions has been demonstrated to be higher than in normal skin or even uninvolved psoriatic skin [9,10]. Many studies confirm that those capillaries are wide, dilated, tortuous and leaky [9,10].…”

Severe combined immunodeficiency mouse-psoriatic human skin xenograft model: A modern tool connecting bench to bedside

“…Thus the SCID model has proved to be a very effective model to explore the role of neurogenic inflammation in psoriasis and has opened a door to the development of drugs targeting the NGF/NGF-R system. [73,74,[81][82][83] In psoriasis there is increased expression of endothelial cell adhesion molecules (E-selectin, ICAM, VCAM), [84][85][86][87] angiogenesis with upregulation of endothelial cell-stimulating angiogenesis factor (ESAF) and VEGF [88,89] activated T-cells (CD4, CD8, NK cells) infiltrates [90][91][92][93] neutrophils (Munro's and Kogoji microabscess), mast cells, [93,94] upregulation of chemokines such as IL-8, RANTES, fractalkine, [17,[95][96][97] and neuropeptides. [71,72,98,99] Likewise, the transplanted psoriatic plaques in SCID mice, demonstrate upregulation of molecules like p38 MAPK, STAT3, ICAM, CXCR3, fractalkine, IL-8, CD3, CD4, CD8, CD40, CD80, CD86, HLA-DR, OX-40R, K16, Ki67, SP, NGF, and NGF-R. Upregulation of CD80/CD86 supports the role of CD28/B7 co-stimulatory cascades in psoriatic inflammation.…”

Study of In Vitro Capillary-Like Structures in Psoriatic Skin Substitutes

“…Some researchers suggest that these alterations appear during the initial stages of psoriatic plaque development even before epidermal hyperplasia is histologically observable. 15–17 This assumes that angiogenesis is one of the first signs of psoriasis and plays an active role in the complex pathology of the disease.…”