Cell-wall-deficient bacteria: a major etiological factor for psoriasis?
BACKGROUND
Psoriasis is a common inflammatory skin disease, yet knowledge of the factors that may induce, trigger, or exacerbate psoriasis is not fully delineated. Recent advances have improved our understanding of the link between psoriasis and cell-wall-deficient bacteria (CWDB) infections. In the present study we assessed the prevalence of CWDB infection in patients with psoriasis.


METHODS
The carriage rate of CWDB in the tonsil or pharynx of psoriasis patients, chronic tonsillitis patients and controls were investigated using hypertonic medium. Psoriasis patients with CWDB were randomly assigned to two groups and respectively treated with antibiotics or systemic therapy without antibiotic. Human peripheral blood mononuclear cells (PBMC) from psoriasis patients, chronic tonsillitis patients and control subjects were stimulated with bacteria antigens and extra-cellular levels of interferon-gamma (IFN-gamma) and interleukin (IL)-10 were measured in the supernatants using the ELISA technique, in vitro. Meanwhile, the proliferation ability of PBMC to respond to bacteria antigens was detected by MTT assay.


RESULTS
CWDB were isolated from 74.2% of psoriasis patients, 23.5% of chronic tonsillitis patients and only 6.3% of controls. Antibiotic therapy was appropriate for approximately 80% of psoriasis patients with CWDB infection, and in only 8.9% psoriasis patients CWDB infection was detected after antibiotic therapy. Meanwhile, our study showed that CWDB and wide-type bacteria did remarkably enhance the production of IFN-gamma, in vitro, and PBMC proliferation.


CONCLUSIONS
CWDB infection may be a virtual triggering factor in psoriasis by regulating T-cell activation.
Department of Clinical Laboratory, Weihai Municipal Hospital Affiliated to Dalian Medical University, Weihai, Shandong 264200, China. ways1117@sohu.com
Guo-Li
GL
Wang
Xiu-Yun
XY
Li
Ming-Yi
MY
Wang
De-Gui
DG
Xiao
Yong-Yu
YY
Zhang
Xiao-Yan
XY
Yuan
Qi-You
QY
Wang
Jian-Jing
JJ
Song
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000166:cytology* / Q000187:drug effects / Q000302:isolation & purification*; D002473:Cell Wall / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism / Q000382:microbiology*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D016753:Interleukin-10; D007371:Interferon-gamma