D2.312 - Impact of metabolic disorders on immune dysregulation in psoriasis and atopic dermatitis

Multiple studies support the crucial link between most skin inflammatory diseases,  immune   and metabolic disorders.   Psoriasis (PS), Atopic Dermatitis (AD) and obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. This study assesses  immune disturbances in   PS and  AD  patients with  comorbid metabolic disorders.

The prevalence of comorbidity of PS and AD included review of 1406 patient histories analyzed for severity of disease using the PASI index (Psoriasis Area and Severity Index). The determination of the concentration of a multiple pro-inflammatory cytokines   and chemokines   in sera and 48h-cultivated peripheral blood mononuclear cell (PBMC) supernatants of  psoriasis patients (n=59) and healthy volunteers (36 adults) was done by multiplex assay (Luminex Corporation, USA) in   patients (n=59) with psoriasis of different localizations of lesions and severity, as well as with different body mass indices (BMI). The serum concentrations of adipokines (Leptin, Adipokine and Resistin) were assayed by ELISA.

25 of 59 (42.4%) of PS patients had various atopic comorbiditis  the most common being  bronchial asthma and allergic rhinitis. Occurrence of AD in PS patients was diagnosed in 5 cases. It has been shown that serum levels of the main  studied proinflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa)   were higher in PS patients than in those with AD and healthy controls (p<0.05). Synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results. The mean serum chemokine  (RANTES, IP-10, MCP-1, EOTAXIN)  levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid obesity. The study demonstrated the high correlation between BMI, immune mediators and the concentrations of adipokines (p<0.05). Thus, the concentrations of Leptin and Resistin in obese PS patients were greater by 28.6% and 17%, respectively, and levels of adiponectin were decreased up to 1.3-fold than in non-co-morbid patients.

The study demonstrated an important role of cytokine and chemokine dysregulation in inflammatory skin diseases, especially in patients with comorbid  obesity. Metabolic comorbidity  disorders have a negative impact on  the severity of PS and AD, with highly increased immune and  adipokine  dysregulation.