Serum biomarkers for diagnosis and assessment of severity in psoriasis

Introduction: Psoriasis is a common inflammatory and proliferative disease of the skin. The current gold standard for assessment of extensive psoriasis has been Psoriasis Area and Severity Index (PASI). However the limitations of using PASI score in clinical practice and research necessitates for search of biomarkers.

Aims & Objectives: To determine the role of serum high sensitivity C-Reactive Protein (hs-CRP), Ceruloplasmin and Malondialdehyde (MDA) as biomarkers in psoriasis and their significance in assessment of disease severity in patients with mild, moderate and severe psoriasis.

Materials & Methods: The study group consisted of 120 subjects of age group 20-50 years and of both sexes. Of these 40 patients had active psoriasis with PASI score <10 (Group 2), 30 patients had active psoriasis with PASI score > 10 (Group 3) and 50 were healthy age and sex matched controls (Group 1).

Results & Observations: The serum levels of CRP, ceruloplasmin and MDA are elevated in both the groups of psoriasis patients when compared to controls. The increase is statistically highly significant (p < 0.001). Very large positive correlation was obtained for hs-CRP and MDA values with PASI score in both the groups, while moderate correlation was obtained for Ceruloplasmin with PASI score.

Conclusion: Finally, it can be concluded that hs-CRP, MDA and Ceruloplasmin levels can be used as biomarkers and also to assess the disease severity in psoriasis.

Psoriasis, PASI score, hs-CRP, Ceruloplasmin, MDA

Sunil Dogra and Savita Yadav. Psoriasis in India: prevalence and pattern. IJDVL 2010; 76 (6): 595-601.

Sibel Dogan and Nilgiin Atakan. Psoriasis-A disease of systemic inflammation with co morbities. Psoriasis – Types, Causes and Medication.

Silva Moltani and Eva Reali. Biomarkers in pathogenesis, diagnosis and treatment of psoriasis.

Lucy Piper. CRP proposed as marker for psoriasis severity. J Eur Acad Dermatol Venereol 2009; Advance online publication.

Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A, Quintanilha F, Teixeira A. The inflammatory response in mild and in severe psoriasis. BJD. 2004; 150(5): 917928.

A study of ceruloplasmin in psoriasis and its correlation with disease severity-ijapbs-Chetana Shenoy, Manjula Shantaram, Kalashree K, Neevan D.R. DSouza, Manjunath Shenoy M.

Giurgea N, Constantinescu MI, Stanciu R, Suciu S, Muresan A.

Ceruloplasmin acute phase reactant or endogenous antioxidant? The case of cardiovascular disease. Med Sci Monit. 2005; 11: 4851.

Turbidimetric immunoassay for determination of C-reactive protein Turbilyte CRPTM.

A Rapid Colorimetric Method for the Quantitative Determination of Copper Oxidase Activity (Ceruloplasmin) – 0. Boyd Houchin, Clinical chemistry. 1958; 4 (6).

Usha Kiran P. Comparison of transudates and exudates using malondialdehyde and lipid profile. IJHSR 2014; 4(5): 66-70.

Susana Coimbra and Alice Santos-Silva Biomarkers of psoriasis severity and therapy monitoring. World J Dermatol 2014 May 2; 3(2): 15-27.

Volanakis, J.E. Complement activation by C-reactive protein complexes. Ann. N. Y. Acad. Sci. 1982; 389:235250.

Mold, C., Gewurz, H., and Du Clos, T.W. 1999. Regulation of complement activation by C-reactive protein. Immunopharmacology. 42: 2330.

Mark B. Pepys and Gideon M. Hirschfield. C-reactive protein: a critical update. J. Clin. Invest. 2003; 111:18051812.

Coimbra S, Oliveira H, Reis F, et al. C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy. J Eur Acad Dermatol Venereol. 2010; 24(7):789796.

Yiu KH, Yeung CK, Chan HT, Wong RM, Tam S, Lam KF, Yan GH, Yue WS, Chan HH, Tse HFB. Increased arterial stiffness in patients with psoriasis is associated with active systemic inflammation. Br J Dermatol. 2011; 164(3):514-20.

Marnett L. J., Oxy radicals, lipid peroxidation and DNA damage, Toxicology, 2002; 181-182; 219222,

Mahmoud Yousry Abdel-Mawla, Eman Nofal, Najlaa Khalifa, Rowida Abdel-Shakoor1 and Mohamad Nasr. Role of Oxidative Stress in Psoriasis: An Evaluation Study. Journal of American Science 2013; 9(8):151-155.

Jyothi. R.S, Govindaswamy. K.S, Gurupadappa. K. Psoriasis: An oxidative stress condition. Journal of Clinical and Diagnostic Research. 2011; 5(2): 252-253.