title: Perfusion Intensity Correlates with Expression Levels of Psoriasis-Related Genes and Proteins.
abstract: BACKGROUND
  Previous research revealed heterogeneity in the perfusion intensity within clinically homogenous-appearing plaques, without differences in erythema. In addition, an increased perfusion was found within the perilesional skin. This raises the question whether the heterogeneity in perfusion found both inside and outside a lesion influences the expression levels of genes and proteins involved in the pathogenesis of psoriasis.
  
  
  OBJECTIVE
  To correlate the perfusion intensity to mRNA and protein expression of genes associated with the pathogenesis of psoriasis and to visualize the dynamics of the perfusion intensity over time using laser Doppler perfusion imaging.
  
  
  METHODS
  Fourteen patients with plaque psoriasis were included. The superficial microcirculation and clinical local scores (single usability metric, SUM, scores) were analysed in one representative lesion every 2 weeks. After 8 weeks 4 biopsies were taken, one from a highly perfused area (hotspot) and one from a low perfusion area (coldspot) of the lesional skin, one biopsy from the highly perfused perilesional skin and one from the distant uninvolved skin.
  
  
  RESULTS
  Statistically significant differences in mRNA and protein expression, including IL-17 and TBX21/T-Bet, were found between hotspots and coldspots, and between the highly perfused perilesional and the uninvolved skin. Hotspots tend to remain on the same location during 8 weeks of follow-up.
  
  
  CONCLUSIONS
  Within homogenous-appearing psoriatic plaques, there are remarkable differences in mRNA and protein levels, which are correlated with the perfusion intensity and can be detected by using laser Doppler perfusion imaging. In addition, differences in mRNA and protein expression between the highly perfused perilesional skin and the uninvolved skin were found, indicating that several biological changes occur well before clinical changes become manifest.
authors.affiliation: Department of Dermatology, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Anke G M
authors.initials: AG
authors.lastname: Hendriks
authors.forename: Wiendelt
authors.initials: W
authors.lastname: Steenbergen
authors.forename: Patrick L J M
authors.initials: PL
authors.lastname: Zeeuwen
authors.forename: Joost
authors.initials: J
authors.lastname: Schalkwijk
authors.forename: Erwin
authors.initials: E
authors.lastname: Hondebrink
authors.forename: Michiel A J
authors.initials: MA
authors.lastname: Klitsie
authors.forename: Ruud
authors.initials: R
authors.lastname: Schreurs
authors.forename: Peter C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.forename: Marieke M B
authors.initials: MM
authors.lastname: Seyger
mesh_terms: D000328:Adult; D000368:Aged; D017252:CD3 Complex / Q000235:genetics / Q000378:metabolism; D053492:Elafin / Q000235:genetics / Q000378:metabolism; D005260:Female; D015870:Gene Expression; D006801:Humans; D020381:Interleukin-17 / Q000235:genetics / Q000378:metabolism; D016209:Interleukin-8 / Q000235:genetics / Q000378:metabolism; D053536:Keratin-16 / Q000235:genetics / Q000378:metabolism; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000235:genetics / Q000378:metabolism; D011565:Psoriasis / Q000378:metabolism* / Q000503:physiopathology*; D012333:RNA, Messenger / Q000378:metabolism; D012867:Skin / Q000098:blood supply* / Q000378:metabolism*; D020825:T-Box Domain Proteins / Q000235:genetics / Q000378:metabolism; D023083:beta-Defensins / Q000235:genetics / Q000378:metabolism; D000098815:T-bet Transcription Factor
chemical_list: D017252:CD3 Complex; C106641:DEFB4A protein, human; D053492:Elafin; D020381:Interleukin-17; D016209:Interleukin-8; C507431:KRT16 protein, human; D053536:Keratin-16; C506806:PI3 protein, human; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D012333:RNA, Messenger; D020825:T-Box Domain Proteins; D000098815:T-bet Transcription Factor; D023083:beta-Defensins