title: Elevation of serum squamous cell carcinoma antigen 2 in patients with psoriasis: associations with disease severity and response to the treatment.
abstract: BACKGROUND
  Squamous cell carcinoma antigen (SCCA) belongs to the ovalbumin-serpin family and is a known tumour marker. Expression of SCCA is upregulated in the serum and skin of patients with psoriasis.
  
  
  OBJECTIVE
  The aim of this study was to determine SCCA2 levels in association with disease severity and treatment efficacy in patients with psoriasis.
  
  
  METHODS
  Patients with psoriasis (n = 123) and healthy controls (n = 25) were enrolled in this prospective cross-sectional study. Enzyme-linked immunosorbent assay (ELISA) analysis was performed to determine serum SCCA2 levels. SCCA2 expression in skin was evaluated using immunohistochemical analysis. Serum SCCA2 levels were compared with Psoriasis Area Severity Index (PASI) scores. The effect of treatment on serum SCCA2 levels was assessed using serial examinations. Induction of SCCA2 by several psoriatic cytokines in human keratinocytes was evaluated.
  
  
  RESULTS
  The serum levels of SCCA2 were significantly higher in patients with psoriasis than healthy controls and correlated well with disease severity. Increased SCCA2 staining was observed in lesional skin but not in nonlesional skin of patients with psoriasis. In addition, SCCA2 expression levels in skin correlated with serum concentrations of SCCA2. SCCA2 significantly decreased according to improvement of PASI scores. Interleukin (IL)-17 and IL-22 synergistically increased the production of SCCA2 at both mRNA and protein levels in human keratinocytes.
  
  
  CONCLUSIONS
  Significant elevation of SCCA2 is associated with disease severity and reflects treatment efficacy. SCCA2 may be a useful biomarker in psoriasis, reflecting T-helper 17-type inflammation - the main determinant of the severity of psoriasis.
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaguchi
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Komitsu
authors.affiliation: Department of Laboratory Medicine, Saga Medical School, Saga, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ohta
authors.affiliation: Shino-Test Corporation, Sagamihara, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Azuma
authors.affiliation: Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Izuhara
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Aihara
mesh_terms: D000951:Antigens, Neoplasm / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000378:metabolism / Q000502:physiology; D007378:Interleukins / Q000378:metabolism / Q000502:physiology; D015603:Keratinocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000097:blood* / Q000188:drug therapy; D015843:Serpins / Q000378:metabolism*; D012867:Skin / Q000378:metabolism*; D016896:Treatment Outcome; D000097043:Interleukin-22
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D003879:Dermatologic Agents; D020381:Interleukin-17; D007378:Interleukins; D015843:Serpins; D000097043:Interleukin-22; C051072:squamous cell carcinoma-related antigen