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Previous issue date: 2015-12-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction. Psoriasis is a common and clinically polymorphic autoimmune disease. Proinflammatory cytokines are probably involved in genesis and perpetuation of disease. The relationship of cytokines with atherogenesis in patients with psoriasis is an open theme. In this study, we aimed to compare levels of pro and anti-inflammatory cytokines and the carotid intima-media thickness (cIMT, an atherogenesis predictor) of psoriatics and controls. In parallel, we correlated such variables to each other, and both with disease activity parameters.
Methods. The study was cross-sectional, and included patients with psoriasis according to traditional criteria. The cIMT was calculated by an experienced Radiologist. The cytokines IL-12p70, TNF, IL-10, IL-6, IL-1? and IL-8 were assayed by flow cytometry. The activity of psoriatic disease was evaluated by the PASI (psoriasis area and severity index) and the BSA (body surface area). Results. Sixty-five psoriatic patients and 64 controls were studied. Mean age of patients (51 years) did not differ from controls (p = 0.454). The vulgaris form was documented in 84.6% of patients. Mild disease (PASI or BSA<10) was observed in more than half of cases. Diabetes mellitus and smoking significantly predominated in cases (p<0.05), while metabolic syndrome (MS) occurred with similar frequency in both groups (p = 0.822). Median of IL-12p70, TNF, IL-1? and IL-10 were significantly lower in cases than in controls (adjusted p<0.05). An altered cIMT (?0.9 mm) was more frequently observed in cases (p=0.039). There was no association of altered cIMT and cytokine concentrations (p> 0.05). IL-12p70 concentrations correlated with BSA and PASI (rs>0.3; p <0.05). The IL-10 concentrations were significantly lower in psoriatic with MS than without MS (p=0.006), finding not observed in controls.
Conclusions. The profile of pro-inflammatory (12p70, TNF, IL-1?) and anti-inflammatory (IL-10) cytokines was reduced in our psoriatic population with predominance of mild disease. The cIMT data pointed to subclinical atherosclerosis in psoriasis. IL-12p70 concentrations correlated with active disease, whereas low concentrations of IL-10 were associated with SM in psoriatics. Further studies should clarify the cytokine-atherogenesis binomial in patients with psoriasis. / Introdu??o. A psor?ase ? uma doen?a autoimune frequente e clinicamente polim?rfica. Citocinas pr?-inflamat?rias est?o provavelmente envolvidas na g?nese e perpetua??o da doen?a. A rela??o destas citocinas com a aterog?nese em pacientes com psor?ase ? tema em aberto. Neste estudo, objetivamos comparar n?veis de citocinas pr? e anti-inflamat?rias e espessura m?dio-intimal de car?tidas (cIMT, m?todo preditor de aterog?nese) em psori?ticos e controles sadios. Em paralelo, correlacionamos as duas vari?veis entre si e ambas com os ?ndices de atividade da doen?a.
M?todos. O estudo, transversal controlado, incluiu pacientes com psor?ase de acordo com os crit?rios tradicionais e controles sadios. O cIMT foi calculado por ecografista especializado. As citocinas IL-12p70, TNF, IL-10, IL-6, IL-1? e IL-8 foram testadas por citometria de fluxo. A atividade da doen?a psori?tica foi avaliada pelo PASI (psoriasis area and severity index) e pelo BSA (body surface area).
Resultados. Foram estudados 65 pacientes psori?ticos e 64 controles. A m?dia de idade dos pacientes (51 anos) n?o diferiu daquela dos controles (p=0,454). A forma vulgar foi documentada em 84,6% % dos pacientes com psor?ase. Doen?a leve (PASI ou BSA<10) foi observada em mais da metade dos casos. Diabetes mellitus e tabagismo predominaram nos casos (p<0,05), enquanto s?ndrome metab?lica (SM) ocorreu com frequ?ncia similar em ambos os grupos (p=0,822). As medianas da IL-12p70, TNF, IL-1? e IL-10 foram significativamente mais baixas nos casos do que em controles (p ajustado <0,05). Um cIMT alterado (?0,9 mm) foi observado mais frequentemente nos casos (p=0,039). N?o houve associa??o entre cIMT alterado e concentra??es de citocinas (p>0,05). As concentra??es de IL-12p70 se correlacionaram com BSA e PASI (rs>0,3; p<0,05). As concentra??es de IL-10 foram significativamente menores em psori?ticos com SM do que sem SM (p=0,006), achado n?o observado nos controles.
Conclus?es. O perfil de citocinas pr?-inflamat?rias (12p70, TNF, IL-1?) e anti-inflamat?ria (IL-10) foi de regula??o diminu?da nesta popula??o psori?tica com doen?a predominantemente leve. Os dados do cIMT apontaram para aterosclerose subcl?nica em psori?ticos. As concentra??es de IL-12p70 se correlacionaram com doen?a ativa, enquanto baixas concentra??es de IL-10 se associaram ? SM em psori?ticos. Novos estudos dever?o esclarecer o bin?mio citocinas-aterog?nese em pacientes com psor?ase.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6515 |
| Date | 18 December 2015 |
| Creators | Lise, Michelle Larissa Zini |
| Contributors | Staub, Henrique Luiz |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 600, 600, 600, 600, -8624664729441623247, -969369452308786627, 2075167498588264571 |
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