Influence of focal infection on the immune status of psoriasis patients
- Authors: Patrushev A.V.1, Samtsov A.V.1, Nikitin V.Y.1, Sukharev A.V.1, Ivanov A.M.1, Gumilevskaya O.P.1, Sukhina I.A.1
-
Affiliations:
- S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
- Issue: Vol 95, No 3 (2019)
- Pages: 16-24
- Section: ORIGINAL STUDIES
- URL: https://ogarev-online.ru/0042-4609/article/view/116982
- DOI: https://doi.org/10.25208/0042-4609-2019-95-3-16-24
- ID: 116982
Cite item
Full Text
Abstract
Objective: to study the influence of focal infection on the immune status of patients with psoriasis.
Materials and methods. 30 patients with psoriasis aged 19 to 61 years (21 people — plaque psoriasis, 9 people — psoriasis guttata) were examined, which were divided into 2 groups. The first group — with the diagnosed of focal infection (18 people), the second group — without the presence of focal infection (12 people). The control group consisted of 15 healthy individuals admitted to the clinic for the removal of benign skin tumors. All patients underwent a comprehensive clinical, instrumental and laboratory examination, as well as an immunogram. Determination of lymphocyte subpopulations was carried out on a flow cytometer “Cytom - ics FC500” by Beckman Coulter using various combinations of direct monoclonal antibodies and isotopic controls. The groups were compared using nonparametric Mann — Whitney test, the differences were considered significant at p < 0.05.
Results. The absence of significant quantitative changes in the main and small subpopulations of T- and В-lymphocytes in both groups of patients with psoriasis was shown. At the same time, the group of patients with psoriasis and focal infection, was characterized by an increase in the relative number of T-lymphocytes (p = 0.034) and T-helpers (p = 0.012), the relative and absolute number of activated CD3+HLA-DR+cells (p = 0.028 and 0.036, respectively), as well as a decrease in regulatory T-helper (p = 0.031). Subpopulation of CLA+CD3+-lymphocytes tropic to the skin in comparison with control was increased both in the first (p = 0.016) and second (p = 0.044) groups. Also, patients with psoriasis differed from healthy individuals by increasing the number of memory T-cells (p = 0.049 for group 1, p = 0.003 for group 2).
Conclusion. Existing focal infection in psoriasis patients lead to an imbalance in the content of individual lymphocyte subpopulations: an increase in the relative number of CD3+CD4+ and CD3+HLA-DR+ cells, as well as a decrease in regulatory T-helper. These changes can lead to a long course of the disease and a reduction in remission periods.
About the authors
A. V. Patrushev
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Author for correspondence.
Email: alexpat2@yandex.ru
Alexander V. Patrushev* — Cand. Sci. (Med.), Research Assistant, Department of Skin and Sexually Transmitted Diseases
tel.: +7 (911) 998-22-64
Russian FederationA. V. Samtsov
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Email: fake@neicon.ru
Alexey V. Samtsov — Dr. Sci. (Med.), Prof., Head of the Department of Skin and Sexually Transmitted Diseases Russian Federation
V. Yu. Nikitin
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Email: vladimiryn@mail.ru
Vladimir Yu. Nikitin — Dr. Sci. (Med.), Head of the Immunological Laboratory of the Centre for Clinical Laboratory Diagnostics Russian Federation
A. V. Sukharev
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Email: asoukharev@mail.ru
Alexey V. Sukharev — Dr. Sci. (Med.), Prof., Prof., Department of Skin and Sexually Transmitted Diseases Russian Federation
A. M. Ivanov
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Email: iamvma@mail.ru
Andrey M. Ivanov — Dr. Sci. (Med.), Prof., Corresponding Member of Russian Academy of Sciences, Head of the Department of Clinical Biochemistry and Laboratory Diagnostics
Russian FederationO. P. Gumilevskaya
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Email: ogum@mail.ru
Oksana P. Gumilevskaya — Dr. Sci. (Med.), Assoc. Prof., Head of the Centre for Clinical Laboratory Diagnostics Russian Federation
I. A. Sukhina
S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation
Email: kinya2000@mail.ru
Irina A. Sukhina — Cand. Sci. (Biol.), Lecturer, Department of Clinical Biochemistry and Laboratory Diagnostics Russian Federation
References
- Патрушев А. В., Сухарев А. В., Иванов А. М. и др. Теория очаговой инфекции: прошлое и настоящее. Вестник дерматологии и венерологии. 2015;(4):36–42. [Patrushev A. V., Suharev A. V., Ivanov A. M. et al. Theory of focal infection: past and present. Vestnik dermatologii i venerologii. 2015;4:36–42. (In Russ.)]
- Караулов А. В., Быков С. А., Быков А. С. Иммунология, микробиология и иммунопатология кожи. М.: Издательство БИНОМ, 2012. [Karaulov A.V., Bykov S.A., Bykov A.S. Immunology, Microbiology and immunopathology in the skin. Moscow: Binom, 2012. (In Russ.)]
- Chapter 5: Antigen presentation to T-lymphocytes. In: Murphy K., Travers P., Walport M. Immunobiology. 7th ed. Garland Science, 2008. P. 206–207.
- Proft T., Fraser J. Superantigenes: just like peptides only different. J Exp Med. 1998;187(6):819–821.
- Пальчун Т. В., Гуров А. В., Аксенова А. В. и др. Современные представления о токсико-аллергических проявлениях хронической тонзиллярной патологии, его этиологическая и патогенетическая роль в возникновении и течении общих заболеваний. Вестник оториноларингологии. 2012;(2):5–12. [Pal’chun T. V., Gurov A. V., Aksenova A. V. et al. Modern conceptions of toxic-allergic manifestations of chronic tonsillar disease, the etiologic and pathogenetic role in the occurrence and progression of common diseases. Vestnik otorinolaringologii. 2012;(2):5–12. (In Russ.)]
- Иорданишвили А. К. Заболевания, повреждения и опухоли челюстно-лицевой области. СПб.: СпецЛит, 2007. [Iordanishvili A. K. Diseases, injuries and tumours of the maxillofacial area. Saint Petersburg: SpecLit, 2007. (In Russ.)]
- Somma F., Castagnola R., Bollino D. Oral inflammatory process and general health. Part 1: The focal infection and the oral inflammatory. Eur Rev Med Pharmacol Sci. 2010;14(12):1085–1095.
- Brzewski P. L., Spalkowska M., Podbielska M. et al. The role of focal infections in the pathogenesis of psoriasis and chronic urticaria. Postepy Dermatol Alergol. 2013;30(2):77–84.
- Gelfand J. M., Stern R. S., Nijsten T. et al. The prevalence of psoriasis in African Americans: results from a population-based study. J Am Acad Dermatol. 2005;52:23–26.
- Rapp S. R., Feldman S. R., Exum M. L. et al. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41:401–424.
- Huerta C., Rivero E., Rodríguez L. A. Incidence and risk factors for psoriasis in the general population. Arch Dermatol. 2007;143:1559–1565.
- Gudjonsson J. E., Thorarinsson A. M., Sigurgeirsson B. et al. Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study. Br J Dermatol. 2003;149:530–534.
- Fortes C., Mastroeni S., Leffondré K. et al. Relationship between smoking and the clinical severity of psoriasis. Arch Dermatol. 2005;141:1580–1584.
- Herron M. D., Hinckley M., Hoffman M. S. et al. Impact of obesity and smoking on psoriasis presentation and management. Arch Dermatol. 2005;141:1527–1534.
- Nestle F. O. Skin immune sentinels in health and disease. Nat Rev Immunol. 2009;9(10):679–691.
- Albanesi C., Madonna S., Gisondi P. et al. The Interplay between Keratinocytes and Immune Cells in the Pathogenesis of Psoriasis. Front Immunol. 2018;9:1549.
- Arakawa A., Siewert K., Stöhr Ju. et al. Melanocyte antigen triggers autoimmunity in human psoriasis. J Exp Med. 2015;212(13):2203–2212.
- Prinz J. C. Melanocytes: Target Cells of an HLA-C*06:02- Restricted Autoimmune Response in Psoriasis. J Invest Dermatol. 2017;137(10):2053–2058.
- Lande R., Botti E., Jandus C., et al. The antimicrobial peptide LL37 is a T-cell autoantigen in psoriasis. Nat Commun. 2014;3(5):5621.
- Cheung K. L., Jarrett R., Subramaniam S. et al. Psoriatic T cells recognize neolipid antigens generated by mast cell phospholipase delivered by exosomes and presented by CD1a. J Exp Med. 2016;213(11):2399–2412.
- Fuentes-Duculan J., Bonifacio K. M., Hawkes J. E. et al. Autoantigens ADAMTSL5 and LL37 are significantly upregulated in active psoriasis and localized with keratinocytes, dendritic cells and other leukocytes. Exp Dermatol. 2017;26(11):1075–1082.
- Bader H. L., Wang L. W., Ho J. C. et al. A disintegrin-like and metalloprotease domain containing thrombospondin type 1 motif-like 5 (ADAMTSL5) is a novel fibrillin-1-, fibrillin-2-, and heparin-binding member of the ADAMTS superfamily containing a netrin-like module. Matrix Biol. 2012;31(7–8):398–411.
- Bonifacio K. M., Kunjravia N., Krueger J. G. et al. Cutaneous expression of A disintegrin-like and metalloprotease domain containing thrombospondin type 1 motif-like 5 (ADAMTSL5) in psoriasis goes beyond melanocytes. J Pigment Disord. 2016;3(3):244.
- Blok S., Vissers W. H., Van Duinhoven M. et al. Aggravation of psoriasis by infections: a constitutional trait or a variable expression? Eur J Dermatol. 2004;14:259–261.
- Nomura K., Mizutani H., Inachi S. Remission of pustular psoriasis after cholecystectomy: role of focal infection in pustularization of psoriasis. J Dermatol. 1995;22:122–124.
- Thorleifsdottir R. H., Sigurdardottir S. L., Sigurgeirsson B. Improvement of psoriasis after tonsillectomy is associated with a decrease in the frequency of circulating T cells that recognize streptococcal determinants and homologous skin determinants. J Immunol. 2012;188 (10):5160–5165.
- Wu W., Debbaneh M., Moslehi H. et al. Tonsillectomy as a treatment for psoriasis: a review. J Dermatolog Treat. 2014;25(6):482–486.
- Leung D. Y., Travers J. B., Giorno R. et al. Evidence for a streptococcal superantigen-driven process in acute guttate psoriasis. J Clin Invest. 1995;96(5):2106–2112.
- Diluvio L., Vollmer S., Besgen P. Identical TCR beta-chain rearrangements in streptococcal angina and skin lesions of patients with psoriasis vulgaris. J Immunol. 2006;176(11):7104–7111.
Supplementary files
