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American Journal of Clinical Dermatology
Published in: American Journal of Clinical Dermatology 1/2012

01-02-2012 | Original Research Article

Erythroid Disturbances Before and After Treatment of Portuguese Psoriasis Vulgaris Patients

A Cross-Sectional and Longitudinal Study

Authors: Susana Coimbra, Hugo Oliveira, Flávio Reis, Luís Belo, Susana Rocha, Alexandre Quintanilha, Américo Figueiredo, Frederico Teixeira, Elisabeth Castro, Petronila Rocha-Pereira, Alice Santos-Silva

Published in: American Journal of Clinical Dermatology | Issue 1/2012

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Abstract

Background: A few studies in psoriasis vulgaris patients have reported changes suggesting red blood cell (RBC) damage is linked to neutrophil activation, oxidative stress, and psoriasis worsening.
Objective: The aim of this study was to evaluate erythroid disturbances in Portuguese psoriasis vulgaris patients, before, during, and after treatment.
Methods: Across-sectional study (n = 73 patients vs 40 healthy control subjects) followed by a longitudinal study (n = 47 patients)was performed, with assessments before, and at 3, 6, and 12weeks of therapy (10 patients started topical treatment, 17 narrow-band UVB, and 20 photochemotherapy [psoralen plus UVA; PUVA]). Evaluations included hematologic data, total bilirubin levels,membrane-bound hemoglobin (MBH),membrane protein band 3 profile, total plasma antioxidant status (TAS), lipid peroxidation (thiobarbituric acid [TBA] assay), elastase, lactoferrin, and C-reactive protein (CRP).
Results: Before treatment, patients presented with higher leukocyte/neutrophil and reticulocyte counts, elastase, lactoferrin, TBA, TBA/TAS, reticulocyte production index, total bilirubin and MBH values, lower RBC and hematocrit, higher percentages of high-molecular-weight aggregates, and lower percentages of band 3 monomer. After treatment, we observed a reversal in most of the parameters. However, patients still presented with values suggestive of accelerated RBC damage, removal, and production, as most of the parameters were still higher than those in the control group; the same occurred with CRP.
Conclusion: Our data suggest that psoriasis vulgaris triggers an inflammatory response, with release of acutephase reactants, reactive oxygen species, cationic proteins, and proteases, leading to enhanced RBC damage/ aging and, ultimately, to enhanced RBC removal. These assumptions were strengthened by the observation that, with treatment, all of these changeswere reversed, the inflammation was reduced, the production of reticulocytes was increased, and the RBCs presented changes usually observed in younger/less damaged RBCs. These erythroid changes were enhanced with PUVA therapy, probably due to the more pronounced clearing of the lesions, as suggested by Psoriasis Area and Severity Index (PASI) scores. Finally, after treatment, a residual inflammation still persisted that might contribute to the observed erythroid disturbances.
Literature
1.
Rocha-Pereira P, Santos-Silva A, Rebelo I, et al. The inflammatory response in mild and in severe psoriasis. Br J Dermatol 2004 May; 150 (5): 917–28
2.
Krueger JG, Bowcock A. Psoriasis pathophysiology: current concepts of pathogenesis. Ann Rheum Dis 2005 Mar; 64 Suppl. 2: ii30–6
3.
Krueger G, Ellis CN. Psoriasis: recent advances in understanding its pathogenesis and treatment. J Am Acad Dermatol 2005 Jul; 53 (1 Suppl. 1): S94–100
4.
Chowaniec O, Jablonska S, Beutner EH, et al. Earliest clinical and histological changes in psoriasis. Dermatologica 1981; 163 (1): 42–51PubMedCrossRef
5.
Orem A, Deger O, Cimsit G, et al. Plasma polymorphonuclear leukocyte elastase levels and its relation to disease activity in psoriasis. Clin Chim Acta 1997 Aug 8; 264 (1): 49–56
6.
Arican O, Aral M, Sasmaz S, et al. Serum levels of TNF-alpha, IFN-gamma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity. Mediators Inflamm 2005 Oct 24; 2005 (5): 273–9
7.
Scirica BM, Morrow DA. Is C-reactive protein an innocent bystander or proatherogenic culprit? The verdict is still out. Circulation 2006 May 2; 113 (17): 2128–34; discussion 51
8.
Yeh ET. CRP as a mediator of disease. Circulation 2004 Jun 1; 109 (21 Suppl. 1): II11–4
9.
Friedewald VE, Cather JC, Gelfand JM, et al. AJC editor’s consensus: psoriasis and coronary artery disease. Am J Cardiol 2008 Dec 15; 102 (12): 1631–43
10.
Friedewald Jr VE, Cather JC, Gordon KB, et al. The editor’s roundtable: psoriasis, inflammation, and coronary artery disease. Am J Cardiol 2008 Apr 15; 101 (8): 1119–26
11.
Pelle E, Mammone T, Maes D, et al. Keratinocytes act as a source of reactive oxygen species by transferring hydrogen peroxide to melanocytes. J Invest Dermatol 2005 Apr; 124 (4): 793–7
12.
Rocha-Pereira P, Santos-Silva A, Rebelo I, et al. Erythrocyte damage in mild and severe psoriasis. Br J Dermatol 2004 Feb; 150 (2): 232–44
13.
Setty AR, Curhan G, Choi HK. Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses’ Health Study II. Arch Intern Med 2007 Aug 13-27; 167 (15): 1670–5
14.
Shirai K. Obesity as the core of the metabolic syndrome and the management of coronary heart disease. Curr Med Res Opin 2004 Mar; 20 (3): 295–304
15.
Sterry W, Strober BE, Menter A. Obesity in psoriasis: the metabolic, clinical and therapeutic implications. Report of an interdisciplinary conference and review. Br J Dermatol 2007 Oct; 157 (4): 649–55
16.
Coimbra S, Oliveira H, Reis F, et al. Circulating levels of adiponectin, oxidized LDL and C-reactive protein in Portuguese patients with psoriasis vulgaris, according to body mass index, severity and duration of the disease. J Dermatol Sci 2009 Sep; 55 (3): 202–4
17.
Panagiotakos DB, Pitsavos C, Yannakoulia M, et al. The implication of obesity and central fat on markers of chronic inflammation: the ATTICA study. Atherosclerosis 2005 Dec; 183 (2): 308–15
18.
Wellen KE, Hotamisligil GS. Obesity-induced inflammatory changes in adipose tissue. J Clin Invest 2003 Dec; 112 (12): 1785–8
19.
Rao GM, Morghom LO. Effect of obesity on erythrocyte count and hemoglobin levels in Libyan diabetic patients. Clin Physiol Biochem 1986; 4 (4): 277–80PubMed
20.
Lutz HU. Erythocyte clearance. In: Harris J, editor. Blood cell biochemistry. New York (NY): Plenum Press, 1990: 81
21.
Kay MM. Role of physiologic autoantibody in the removal of senescent human red cells. J Supramol Struct 1978; 9 (4): 555–67PubMedCrossRef
22.
Kay MM. Localization of senescent cell antigen on band 3. Proc Natl Acad Sci U S A 1984 Sep; 81 (18): 5753–7
23.
Kay MM, Goodman SR, Sorensen K, et al. Senescent cell antigen is immunologically related to band 3. Proc Natl Acad Sci U S A 1983 Mar; 80 (6): 1631–5
24.
Bosman GJ, Werre JM, Willekens FL, et al. Erythrocyte ageing in vivo and in vitro: structural aspects and implications for transfusion. Transfus Med 2008 Dec; 18 (6): 335–47
25.
Lutz HU, Bussolino F, Flepp R, et al. Naturally occurring anti-band-3 antibodies and complement together mediate phagocytosis of oxidatively stressed human erythrocytes. Proc Natl Acad Sci U S A 1987 Nov; 84 (21): 7368–72
26.
Lutz HU. Naturally occurring anti-band 3 antibodies. Transfus Med Rev 1992 Jul; 6 (3): 201–11
27.
Low PS. Role of hemoglobin denaturation and band 3 clustering in initiating red cell removal. In: Magnani M, De Flora A, editors. Red blood cell aging. New York (NY): Plenum Press, 1991: 173–83CrossRef
28.
Santos-Silva A, Rebelo MI, Castro EM, et al. Leukocyte activation, erythrocyte damage, lipid profile and oxidative stress imposed by high competition physical exercise in adolescents. in Chim Acta 2001 Apr; 306 (1-2): 119–26
29.
Santos-Silva A, Rebelo I, Castro E, et al. Erythrocyte damage and leukocyte activation in ischemic stroke. Clin Chim Acta 2002 Jun; 320 (1-2): 29–35
30.
Belo L, Rebelo I, Castro EM, et al. Band 3 as a marker of erythrocyte changes in pregnancy. Eur J Haematol 2002 Sep; 69 (3): 145–51
31.
Coimbra S, Castro E, Rocha-Pereira P, et al. The effect of green tea in oxidative stress. Clin Nutr 2006 Oct; 25 (5): 790–6
32.
Catarino C, Rebelo I, Belo L, et al. Erythrocyte changes in preeclampsia: relationship between maternal and cord blood erythrocyte damage. J Perinat Med 2009; 37 (1): 19–27PubMedCrossRef
33.
Rocha S, Vitorino RM, Lemos-Amado FM, et al. Presence of cytosolic peroxiredoxin 2 in the erythrocyte membrane of patients with hereditary spherocytosis. Blood Cells Mol Dis 2008 Jul-Aug; 41 (1): 5–9
34.
Costa E, Rocha S, Rocha-Pereira P, et al. Band 3 profile as amarker of erythrocyte changes in chronic kidney disease patients. Open Clin Chem J 2008; 1: 57–63CrossRef
35.
Santos-Silva A, Castro EM, Teixeira NA, et al. Altered erythrocyte membrane band 3 profile as a marker in patients at risk for cardiovascular disease. Atherosclerosis 1995 Aug; 116 (2): 199–209
36.
Santos-Silva A, Castro EM, Teixeira NA, et al. Erythrocyte membrane band 3 profile imposed by cellular aging, by activated neutrophils and by neutrophilic elastase. Clin Chim Acta 1998 Jul 28; 275 (2): 185–96
37.
Gornicki A, Gutsze A. Erythrocyte membrane fluidity changes in psoriasis: an EPR study. J Dermatol Sci 2001 Sep; 27 (1): 27–30
38.
Gornicki A. Domain structure of erythrocyte membranes in psoriasis: an EPR study. J Dermatol Sci 2002 Sep; 29 (3): 214–21
39.
Corrocher R, Bassi A, Gandini A, et al. Transmembrane cation fluxes and fatty acid composition of erythrocytes in psoriatic patients. Clin Chim Acta 1990 Jan 31; 186 (3): 335–44
40.
Schopf RE, Langendorf Y, Benz RE, et al. A highly decreased binding of cyclic adenosine monophosphate to protein kinase A in erythrocyte membranes is specific for active psoriasis. J Invest Dermatol 2002 Jul; 119 (1): 160–5
41.
Shimizu T, Takakuwa Y, Koizumi H, et al. Localization of immuno-analogues of erythrocyte protein 4.1 and spectrin in epidermis of psoriasis vulgaris. Histochem Cell Biol 1995 May; 103 (5): 363–8
42.
Lebwohl M, Feldman SR, Walther R, et al. Clinical management of psoriasis: principles and practice. Cutis 2001 Jan; 67 (1 Suppl.): 1–15
43.
Frederiksson T, Pettersson U. Severe psoriasis: oral therapy with a new retinoid. Dermatologica 1978; 157: 238–44CrossRef
44.
Dodge JT, Mitchell C, Hanahan DJ. The preparation and chemical characteristics of hemoglobin-free ghosts of human erythrocytes. Arch Biochem Biophys 1963 Jan; 100: 119–30
45.
Bradford MM. Arapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 1976 May 7; 72: 248–54
46.
Niehaus Jr WG, Samuelsson B. Formation of malonaldehyde from phospholipid arachidonate during microsomal lipid peroxidation. Eur J Biochem 1968 Oct 17; 6 (1): 126–30
47.
Laemmli UK. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 1970 Aug 15; 227 (5259): 680–5
48.
Towbin H, Staehelin T, Gordon J. Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications. Proc Natl Acad Sci U S A 1979 Sep; 76 (9): 4350–4
49.
Czerwinski M, Wasniowska K, Steuden I, et al. Degradation of the human erythrocyte membrane band 3 studied with monoclonal antibody directed against an epitope on the cytoplasmic fragment of band 3. Eur J Biochem 1988 Jul 1; 174 (4): 647–54
50.
Mamus SW, Beck-Schroeder S, Zanjani ED. Suppression of normal human erythropoiesis by gamma interferon in vitro: role of monocytes and T lymphocytes. J Clin Invest 1985 May; 75 (5): 1496–503
51.
Means Jr RT, Krantz SB. Inhibition of human erythroid colony-forming units by tumor necrosis factor requires beta interferon. J Clin Invest 1993 Feb; 91 (2): 416–9
52.
Lebwohl M, Ali S. Treatment of psoriasis: part 1. Topical therapy and phototherapy. J Am Acad Dermatol 2001 Oct; 45 (4): 487–98; quiz 499-502
53.
Lebwohl M, Ting PT, Koo JY. Psoriasis treatment: traditional therapy. Ann Rheum Dis 2005 Mar; 64 Suppl. 2: ii83–6
54.
Silny W, Pehamberger H, Zielinsky C, et al. Effect of PUVA treatment on the locomotion of polymorphonuclear leukocytes and mononuclear cells in psoriasis. J Invest Dermatol 1980 Aug; 75 (2): 187–8
55.
Kapuscinska R, Wysocka J, Niczyporuk W, et al. Cytofluorimetric assay for evaluation of CD16 receptor expression and myeloperoxidase (MPO) activity of neutrophils in patients with psoriasis vulgaris treated with PUVA. Wiad Lek 2004; 57 (11-12): 599–602PubMed
56.
Bredberg A, Forsgren A. Effects of in vitro PUVA on human leukocyte function. Br J Dermatol 1984 Aug; 111 (2): 159–68
57.
Piskin G, Tursen U, Bos JD, et al. IL-4 expression by neutrophils in psoriasis lesional skin upon high-dose UVB exposure. Dermatology 2003; 207 (1): 51–3PubMedCrossRef
Metadata
Title
Erythroid Disturbances Before and After Treatment of Portuguese Psoriasis Vulgaris Patients
A Cross-Sectional and Longitudinal Study
Authors
Susana Coimbra
Hugo Oliveira
Flávio Reis
Luís Belo
Susana Rocha
Alexandre Quintanilha
Américo Figueiredo
Frederico Teixeira
Elisabeth Castro
Petronila Rocha-Pereira
Alice Santos-Silva
Publication date
01-02-2012
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 1/2012
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.2165/11592110-000000000-00000

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