Abstract:
Background Psoriasis is a relapsing dermatologic disease with a complex multifactorial etiology. Accumulating evidence has established the presence of cutaneous steroidogenesis with 11 β-hydroxysteroid dehydrogenase (11βHSD) enzyme being the most important final step of this pathway. This enzyme can control local levels of activated glucocorticoids (GCs) in the skin, which is the key to maintaining healthy skin. Methods This case-control study was conducted to evaluate 11βHSD1 level in psoriasis patients, in both lesional and non-lesional skin, compare it to controls, and correlate its activity with the Psoriasis Area and Severity Index (PASI) and the Perceived Stress Scale (PSS). Results A significant decrease of 11βHSD1 level in psoriasis patients compared to healthy controls was observed. In addition, decreased 11βHSD1 level was observed in lesional compared to non-lesional skin in psoriasis patients. There was no significant correlation between the enzyme levels and PASI score or PSS score in patients with psoriasis. However, the PSS score was negatively correlated with 11βHSD1 level in healthy controls. Further histopathological assessment revealed that lower enzyme levels were associated with greater epidermal acanthosis and inflammation. Conclusion This shows the role of 11βHSD1 in controlling psoriatic inflammation, including the degree of epidermal proliferation, which might reveal the complex symphony of psoriasis pathogenesis.
摘要:
背景银屑病是一种具有复杂多因素病因的复发性皮肤病。越来越多的证据已经确定皮肤类固醇生成的存在,其中11β-羟基类固醇脱氢酶(11βHSD)酶是该途径最重要的最后一步。这种酶可以控制皮肤中活化的糖皮质激素(GC)的局部水平,这是保持皮肤健康的关键。方法采用病例对照研究方法评价银屑病患者11βHSD1水平,在病变和非病变皮肤中,将其与控件进行比较,并将其活性与银屑病面积和严重程度指数(PASI)和感知压力量表(PSS)相关联。结果与健康对照组相比,银屑病患者的11βHSD1水平显着降低。此外,与银屑病患者的非皮损相比,皮损中的11βHSD1水平降低。银屑病患者血清酶水平与PASI评分或PSS评分无显著相关性。然而,健康对照组PSS评分与11βHSD1水平呈负相关。进一步的组织病理学评估显示,较低的酶水平与更大的表皮棘皮病和炎症有关。结论这表明11βHSD1在控制银屑病炎症中的作用。包括表皮增生的程度,揭示了银屑病发病机制的复杂交响乐。