Expression of lymphatic markers and lymphatic growth factors in psoriasis before and after anti-TNF treatment.
BACKGROUND
Angiogenesis is an early stage of psoriatic lesion development, but less is known about lymphagiogenesis and its role in the development of psoriasis.


OBJECTIVE
To examine the expression of specific lymphatic markers and lymphatic growth factors in untreated psoriatic skin, in the unaffected skin of patients and skin of healthy volunteers, as well as their alteration after treatment with an anti-TNF agent.


METHODS
Immunohistochemistry for the lymphatic markers D2-40 and LYVE-1, in addition to the VEGF-C and VEGF-D growth factors, was performed in the skin biopsies of psoriatic lesions and adjacent non-psoriatic skin of 19 patients before and after treatment with etanercept, as well as in the skin biopsies of 10 healthy volunteers.


RESULTS
The expressions of D2-40, VEGF-C and VEGF-D on lymphatic vessels underwent statistically significant increases in untreated psoriatic skin compared with non-lesional skin, in contrast to LYVE-1, which did not involve significant increase in expression in psoriatic skin. VEGF-C expression on lymphatic vessels diminished after treatment with etanercept. Moreover VEGF-C and VEGF-D staining on fibroblasts presented with higher expression in lesional skin than in non-lesional adjacent skin.


CONCLUSIONS
Remodeling of lymphatic vessels possibly occurs during psoriatic lesion development, parallel to blood vessel formation. The exact role of this alteration is not yet clear and more studies are necessary to confirm these results.
Medical School, University of Athens, Athens, Greece.
Aikaterini Evangelia
AE
Moustou
Department of Pathology, Medical School, Athens, Greece.
Paraskevi
P
Alexandrou
Medical School, University of Athens, Athens, Greece.
Alexander J
AJ
Stratigos
Department of Pathology, Medical School, Athens, Greece.
Ioanna
I
Giannopoulou
Medical School, University of Athens, Athens, Greece.
Theognosia
T
Vergou
Medical School, University of Athens, Athens, Greece.
Andreas
A
Katsambas
Medical School, University of Athens, Athens, Greece.
Christina
C
Antoniou
D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000032:analysis* / Q000187:drug effects; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007150:Immunohistochemistry; D007155:Immunologic Factors / Q000627:therapeutic use; D042583:Lymphangiogenesis / Q000187:drug effects; D042601:Lymphatic Vessels / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012016:Reference Values; D012867:Skin / Q000187:drug effects / Q000473:pathology; D018709:Statistics, Nonparametric; D000079424:Tumor Necrosis Factor Inhibitors; D042442:Vascular Endothelial Growth Factors / Q000032:analysis* / Q000187:drug effects; D033921:Vesicular Transport Proteins / Q000032:analysis* / Q000187:drug effects
D058846:Antibodies, Monoclonal, Murine-Derived; D015415:Biomarkers; D007074:Immunoglobulin G; D007155:Immunologic Factors; C119248:LYVE1 protein, human; D018124:Receptors, Tumor Necrosis Factor; D000079424:Tumor Necrosis Factor Inhibitors; D042442:Vascular Endothelial Growth Factors; D033921:Vesicular Transport Proteins; C500987:monoclonal antibody D2-40; D000068800:Etanercept