- Poster presentation
- Open Access
Atopy in cutaneous and arthropatic psoriasis
Journal of Translational Medicinevolume 8, Article number: P15 (2010)
Psoriasis is a chronic inflammatory disease where keratinocytes are stimulated to hyperplasia by immunocytes organised in a Th17/Th1-type (T- helper cell) dominated response.[1, 2] In about 15% of the patients with psoriasis, arthritis will develop.[3, 4] There have been studies which demonstrated antagonism between atopy and mainly Th-1 driven inflammatory and autoimmune diseases such as rheumatoid arthritis in which the presence of atopy confers a milder course of the disease.
Serum IgE levels have been investigated in psoriatic patients in the past. Nevertheless, there is little account for clinical correlation and no patients with psoriatic arthritis have been included in these investigations. Previous studies have found increased total levels of IgE together with increased sensibilization for specific inhalation allergens and even increased prevalence of atopic diseases.[6–10]
The aim of this paper is to describe clinical and serological atopic manifestations in patients with psoriatic arthritis in more detail and compare this to patients with cutaneous psoriasis and a control group.
Patients and methods
One hundred and fifty outpatients with psoriatic arthritis (PSA), 150 patients with cutaneous psoriasis without arthritis (PSO), and a control group (CO) consisting of 150 patients with varicosities of the legs where included. Patients filled in a questionnaire on clinical atopic manifestations and blood was drawn for total IgE and specific inhalant IgE (Phadia AB, Sweden) determination.
The prevalence of patient reported asthma was 8%, 15% and 20% in PSA, PSO and CO groups respectively. For hay fever we found prevalences of 9%, 14% and 19%. The percentages of patients currently using inhalators were: 3%, 5% and 12%. These differences were only significant for PSA vs. CO (chi square p<0,05).
The percentages of patients with total IgE level > 100 kU/L was significantly lower in the PSA group compared to the PSO and CO group. (13% vs. 31% vs. 23% p=0.022).
Also the percentage of patients with increased level of inhalant allergen specific IgE > 0,35 phadiaU/L was lower in the PSA group (20% vs. 37% vs. 36% p=0,006).
Patients with psoriatic arthritis have lower prevalences of clinical manifestations of atopy as well as of its serological markers when compared to patients with cutaneous psoriasis or non-psoriatic patients.
Nograles KE, Brasington RD, Bowcock AM: New insights into the pathogenesis and genetics of psoriatic arthritis. Nat Clin Pract Rheumatol . 2009, 5 (2): 83-91. 10.1038/ncprheum0987.
Di Cesare A, Di Meglio P, Nestle FO: The IL-23/Th17 axis in the immunopathogenesis of psoriasis. J Invest Dermatol . 2009, 129 (6): 1339-50. 10.1038/jid.2009.59.
Ibrahim G, Waxman R, Helliwell PS: The prevalence of psoriatic arthritis in people with psoriasis. Arthritis Rheum. 2009, 61 (10): 1373-8. 10.1002/art.24608.
van Romunde LK: Psoriasis and arthritis. I. A population study. Rheumatol Int. 1984, 4 (2): 55-60. 10.1007/BF00541197.
Rabin RL, Levinson AI: The nexus between atopic disease and autoimmunity: a review of the epidemiological and mechanistic literature. Clin Exp Immunol. 2008, 153 (1): 19-30. 10.1111/j.1365-2249.2008.03679.x.
Chen ZY: Immunoglobulin E in psoriasis evaluated by paper radioimmunosorbent and paper enzyme-immunosorbent tests. Acta Derm Venereol. 1985, 65 (1): 14-8.
Pigatto PD: Atopy and contact sensitization in psoriasis. Acta Derm Venereol Suppl (Stockh). 2000, 19-20. 10.1080/00015550050500077. 211
Welp K: [Concomitant psoriasis vulgaris and atopic dermatitis. A study of 1,065 patients with psoriasis] Koinzidenz von Psoriasis vulgaris und atopischer Dermatitis. Eine Untersuchung an 1,065 Psoriasis-Patienten. Hautarzt. 1989, 40 (8): 496-500.
Ovcina-Kurtovic N, Kasumagic-Halilovic E: Serum levels of total immunoglobulin E in patients with psoriasis : relationship with clinical type of disease. Med Arh. 2010, 64 (1): 28-9.
Negosanti M: IgE serum levels in psoriasis. Dermatologica. 1981, 163 (6): 474-5. 10.1159/000250218.