Elsevier

Cytokine

Volume 77, January 2016, Pages 10-13
Cytokine

Short communication
Serum levels of TWEAK in patients with psoriasis vulgaris

https://doi.org/10.1016/j.cyto.2015.10.004Get rights and content

Highlights

  • Serum levels of TWEAK were significantly higher in psoriasis patients compared to controls.

  • Serum TWEAK levels showed a significant correlation with serum IL-23 levels.

  • Targeting TWEAK may be of therapeutic benefit in psoriasis.

Abstract

Tumour necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) has been implicated in the pathogenesis of a variety of inflammatory disorders and autoimmune diseases. However, studies conducted on the relationship of TWEAK and psoriasis patients are limited. In this study, we aimed to explore the serum levels of TWEAK and investigated whether TWEAK levels are associated with clinical variables and expression of other well-known psoriasis-related cytokines including IL-6, IL-23 and TNF-α. Forty-five patients with chronic plaque psoriasis and 43 controls were enrolled in this study. The severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). Serum levels of cytokines were measured using commercial enzyme-linked immunosorbent assay (ELISA) kits. The mean TWEAK, IL-6, IL-23, and TN-α levels were significantly higher in psoriasis patients than in control subjects. However, there were no significant correlations between the psoriasis severity, the illness duration and serum cytokine levels. This study shows that TWEAK may be associated with the pathogenesis of psoriasis, like TNF-α, IL-6, and IL-23.

Introduction

Psoriasis is a common chronic inflammatory disease of the skin and joints affecting approximately 2–3% of the world’s population [1]. Skin lesions are characterized by red, scaly and well-demarcated plaques that are the result of increased keratinocyte proliferation, dermal angiogenesis and infiltration of T cells, dendritic cells and monocytes [1]. Although the pathogenesis of psoriasis is still not fully understood, various proinflammatory cytokines (e.g., TNF-α, IL-1, IL-6, IL-17, IL-22, IL-23), and a number of cytokine receptors have been implicated in its pathogenesis and currently some of these are now under investigation as therapeutic targets [1].

Tumour necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) is a relatively new member of the TNF superfamily and has some pleiotropic effects, including stimulation of cell growth, apoptosis, angiogenesis and the modulation of immune responses [2], [3], [4]. Recent studies have showed that TWEAK may play a crucial role in the pathogenesis of a variety of inflammatory disorders and autoimmune diseases such as lupus, rheumatoid arthritis and multiple sclerosis [4]. Additionally, it has been offered that a TWEAK blockade could be of therapeutic benefit in inflammatory conditions [4]. However, studies conducted on patients with psoriasis are limited. Three different studies involving small groups of patients with psoriasis have reported no significant differences in terms of serum TWEAK levels between the patient and control groups [5], [6], [7]. However, a recent study has reported increased serum TWEAK levels, which were also positively correlated with disease activity, in psoriatic arthritis patients [8].

In this study, we aimed to determine: (i) the serum levels of TWEAK in psoriasis patients and (ii) whether TWEAK levels are related with clinical variables, such as disease severity and duration of disease, and expression of other well-known psoriasis-related cytokines including IL-6, IL-23, and TNF-α.

Section snippets

Patients

This study was approved by the institutional ethical committee, and informed consent was obtained from all participants. Psoriasis patients referred to the dermatology clinic were consecutively enrolled in the study. Patients with chronic plaque psoriasis who were not receiving systemic treatments (e.g., systemic retinoids, cyclosporine, methotrexate or biological therapeutics) for psoriasis for at least three months, and with no other comorbid autoimmune or inflammatory diseases, were included

Clinical and demographic variables

The study population consisted of a total of 45 patients with psoriasis and 43 healthy controls. The mean age did not differ significantly between the patient (35.8 ± 11.8 years) and control (33.6 ± 9.5 years) groups (range: 18–60 years; t = 0.931; p = 0.354). The sex distribution was also similar in the psoriasis group (23 males, 22 females) and control group (23 males, 20 females) (χ2 = 0.050, p = 0.823). The mean PASI scores were 12.0 ± 9.3 (range: 3.2–46.0), and the duration of illness was 13.9 ± 8.8 years

Discussion

The present study has demonstrated significantly increased serum TWEAK levels and accompanying increased serum IL-6, IL-23, and TNF-α levels in psoriasis patients. Furthermore, results show a significant relationship between serum TWEAK levels and serum IL-23 levels in the patient group. However, no significant correlations were observed between serum TWEAK levels and psoriasis severity or duration. These results suggest that serum TWEAK levels may be related to the pathogenesis of psoriasis,

Conflict of interest

This report does not have any conflict of interest.

Acknowledgement

Funding for this study was provided by a grant from the Scientific Research Project Coordination Unit of Selcuk University (Project no: 13401129).

References (15)

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    The study showed that serum level of TWEAK has found to be elevated in psoriasis patients than healthy one [181]. Bilgiç et al. reported considerably higher mean serum concentration of TWEAK in addition with increased level of TNF-α, IL-6, and IL-23 among patients with plaque psoriasis (n = 45) than in control (n = 43) [182]. The finding also suggested a positive alliance between the level of TWEAK and IL-23 in psoriasis patients evidenced to the synergism of TWEAK and IL-23 via IL-23/Th17 pathways [183].

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