C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy.
BACKGROUND
Psoriasis vulgaris is a chronic recurrent inflammatory skin disease and psoriatic lesions have shown leucocyte infiltration.


OBJECTIVE
We aimed to study C-reactive protein (CRP) and leucocyte activation markers/inhibitors as potential monitors of psoriasis vulgaris.


METHODS
A cross-sectional (n = 73) and a longitudinal study (before, at 3, 6 and 12 weeks of therapy; n = 47) was performed; 10 patients started topical treatment, 17 narrow-band ultraviolet light B (NBUVB) and 20 psolaren associated to UVA (PUVA); psoriasis severity was defined by Psoriasis Area and Severity Index (PASI).


RESULTS
Compared with control (n = 38), we found higher CRP levels, total leukocyte/neutrophil count, elastase, lactoferrin and alpha1-antitrypsin. Increasing PASI was linked to increasing CRP and a trend to higher elastase and lactoferrin, suggesting that worsening enhances inflammatory response with neutrophil activation. CRP correlated with PASI, total leucocytes, neutrophils, elastase, lactoferrin and alpha1-antitrypsin. NBUVB and PUVA presented similar effects.


CONCLUSIONS
We propose CRP as a useful marker of psoriasis severity that could be used to monitor psoriasis and its treatment, and, together with PASI and elastase, could also be used as a global index of severity.
Coimbra
S
S
Faculdade de Farmácia, Serviço de Bioquímica, Universidade do Porto, Porto, Portugal. ssn.coimbra@gmail.com
Oliveira
H
H
Reis
F
F
Belo
L
L
Rocha
S
S
Quintanilha
A
A
Figueiredo
A
A
Teixeira
F
F
Castro
E
E
Rocha-Pereira
P
P
Santos-Silva
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000276:immunology*; D008137:Longitudinal Studies; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011565:Psoriasis / Q000097:blood* / Q000628:therapy; D012720:Severity of Illness Index; D055815:Young Adult
D015415:Biomarkers; D003879:Dermatologic Agents; D002097:C-Reactive Protein