The Role of Adipokines in the Pathogenesis of Psoriasis

Abstract

Psoriasis is a chronic and immune-mediated skin condition characterized by pro-inflammatory cytokines and keratinocyte hyperproliferation. Dendritic cells, T lymphocytes, and keratinocytes represent the main cell subtypes involved in the pathogenesis of psoriasis, while the interleukin-23 (IL-23)/IL-17 pathway enhances the disease progression. Human adipose tissue is an endocrine organ, which secretes multiple proteins, known as adipokines, such as adiponectin, leptin, visfatin, or resistin. Current evidence highlights the immunomodulatory roles of adipokines, which may contribute to the progression or suppression of psoriasis. A better understanding of the complexity of psoriasis pathophysiology linked with adipokines could result in developing novel diagnostic or therapeutic strategies. This review aims to present the pathogenesis of psoriasis and the roles of adipokines in this process.

Psoriasis and Molecular Target Therapies: Evidence of Efficacy in Preventing Cardiovascular Comorbidities

“…There is ample evidence that their altered expression may support inflammatory and autoimmune diseases. These include psoriasis, the pathogenesis of which has been partly but not fully elucidated, but there is evidence of a modulating role of adipokines in this disease [ 24 ]. The inflamed and scaly patches typical of psoriasis result from the uncontrolled proliferation and altered differentiation of keratinocytes, sustained by a modified interaction between innate and adaptive immunity in the skin.…”

“…For example, leptin, the most relevant of the proteins produced by AT, is increased in the serum of psoriasis patients compared to controls, and this also applies to the expression of its receptor [ 26 ]. Leptin promotes the development of psoriasis by increasing the secretion of the pro-inflammatory cytokines IL-1, IL-6, TNF, IL-23 and IL-17, supporting the differentiation of Th17 lymphocytes [ 24 ]. Adiponectin, on the other hand, is an anti-inflammatory protein whose blood levels are reduced in psoriasis.…”

“…This results in increased production of IL-17 and IL-23, as adiponectin negatively correlates with IL-23 gene expression and inhibits IL-17 production [ 27 , 28 ]. As adiponectin levels increased, a reduction in human beta-defensin2 (hBD2) in keratinocytes, a protein related to their proliferation and whose expression is stimulated by IL-23, was also observed [ 24 ]. Other adipokines involved in the pathogenesis of psoriasis include resistin.…”

Traditional Chinese medicine Qingre Huoxue decoction enhances wound healing in through modulation of angiogenic and inflammatory pathways

“…Angiogenic factors, particularly vascular endothelial growth factor (VEGF) and its receptor Flt‐1, are found in increased amounts in psoriatic skin 5 . The upregulation of VEGF is a critical early factor in the pathogenesis of psoriasis 6,7 . Hypoxia‐induced VEGF expression has emerged as a key feature in psoriasis, linking reduced oxygen supply, a result of epidermal thickening, with abnormal rapid cell proliferation.…”

“…In this landscape, Qingre Huoxue Decoction (QHD), a traditional Chinese herbal formulation, has shown promise in alleviating psoriasis in previous studies 6 . Comprising Sophora japonica (Huaihua) , 9 Angelica sinensis (Danggui) , 10 Sparganium stoloniferum (Sanleng) , 11 Curcuma zedoaria (Ezhu) , 12 and Spatholobus suberectus Dunn (Jixu eteng) , 13 QHD contains pharmacologically active ingredients like Rytub , ferulic acid , isocurcumenol , hexadecanoic acid , and formononetin 14 .…”