This study was aimed to analyse the prevalence of antinuclear antibodies in patients with psoriasis after treatment with infliximab and correlates the development of antibodies with both response to treatment and adipokines levels. Serum levels of ANA, anti-dsDNA, anti-histone, anti-nucleosome and anti-ENA antibodies at baseline after 2 and 12 months of treatment with infliximab were measured in 27 patients with psoriasis, as well as in 27 matched controls. Serum C-reactive protein (CRP), chemerin, visfatin and resistin were also assessed. The prevalence of ANA increased from 22 to 37 % and 63 % (p < 0.01) during treatment with infliximab, with a gradual progressive increase both in ANA titre and in percentage of ANA pattern. The prevalence of other antibodies also increased from 7 to 30 % and 48 % (p < 0.01) for anti-ds-DNA and from 7 to 26 % and 37 % for anti-nucleosome antibodies (p < 0.05), whereas the prevalence of anti-histone and anti-ENA antibodies was unchanged throughout the study period. Basal chemerin, resistin and CRP levels were higher in patients than in controls, and their levels progressively normalized during treatment (p < 0.01). Conversely, visfatin levels gradually increased (p < 0.01). ANA+ patients tended to show a faster decrease in PASI score, CRP and chemerin levels after 2 months, but the PASI score did not differ between ANA+ and ANA- patients at 12 months. A higher increase of visfatin was also found in ANA+ patients at 2 and 12 months. The antinuclear antibody response induced by infliximab was restricted to ANA, anti-dsDNA and anti-nucleosome antibodies. Patients who developed ANA positivity showed a faster clinical, inflammatory and immunological response to infliximab therapy.
[Show abstract][Hide abstract] ABSTRACT: The pathogenesis of autoimmune diseases (ADs) is characterized by a complex interaction between genetic, immune defects, environmental and hormonal factors. The concept of "mosaic of autoimmunity" deals with the multi-factorial origin and diversity of expression of ADs in humans. Genetic leads to a predisposition in developing an autoimmune syndrome, but the presence of an external or endogenous environmental factor, recently called "exposome," is essential in triggering the immune response. Infections as well as the expositions to different other external environmental agents have been identified as potential trigger for ADs. A new syndrome, namely the autoimmune/inflammatory syndrome induced by adjuvants, has recently been defined alluding to the key role of adjuvant in inducing an immune-mediated condition. Aluminum and silicone, respectively found in vaccines and breast implants, are the most commonly known adjuvants charged with development of autoimmune conditions. Similarly to playing chess, unraveling the pathogenesis of autoimmune diseases with every new discovery is adding a move to the game aiming at checkmating ADs.
Immunologic Research 06/2013; 56(2). DOI:10.1007/s12026-013-8429-4 · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A great deal of research has addressed the elevation of C-reactive protein (CRP) among psoriatic patients and the role of this marker in assessment of disease severity and progression. However, there are some discrepancies in this area. We sought to figure out the relationship between CRP values and disease severity as well as the changes in marker levels after treatment through an extensive literature review. Comparison between CRP levels in psoriatic patients and those in healthy or non-psoriatic individuals was also another focus of this review. A thorough search in Pubmed and Embase was conducted for articles investigating different aspects of CRP measurement in patients with psoriasis. Overall, 32 articles were found to meet our inclusion criteria. Of 28 studies comparing the CRP values in psoriatic patients with those of controls, 24 found a statistically significant difference. In addition, 12 out of 16 papers examining the association between disease severity and CRP values noted significant results. With regard to CRP changes over the course of a treatment, all 15 studies addressing this issue revealed a significant decrease in marker levels. In conclusion, high CRP levels only for moderate and severe forms of disease might be inferred from the literature and there is no sufficient evidence suggesting a similar association for mild disease as well. Moreover, CRP may serve interchangeably with Psoriasis Area and Severity Index (PASI) as a measure of disease severity in the case of untreated psoriatic patients who do not have disease related arthritis. For other patients, however, a careful clinical examination and PASI calculation still remain the mainstay of severity assessment.
Journal of the European Academy of Dermatology and Venereology 09/2013; 28(6). DOI:10.1111/jdv.12257 · 2.83 Impact Factor
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