Clinical significance of plasma markers of angiogenesis in patients with psoriasis

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BACKGROUND: Currently, many researchers attach great importance in psoriasis pathogenesis to hyperproduction of vascular endothelial growth factor (VEGF) and endothelin-1, which leads to increased angiogenesis in dermis and mediates processes of immune inflammation. At the same time, possibility of using these angiogenesis biomarkers as additional indicators of immune inflammation activity and disease activity has been poorly studied.

AIMS: the purpose of the study was to assess the relationship between serum concentrations of VEGF and endothelin-1, structural changes in the capillary bed according to videodermatoscopy, and severity and prevalence of skin lesions in patients with psoriasis, duration of disease, presence of nail lesions, synovitis, enthesitis and spondylitis, as well as concomitant diseases of the cardiovascular system.

MATERIALS AND METHODS: The work is based on examination data analysis of 132 patients with moderate and severe psoriasis vulgaris for the period 2020–2022. Patients were determined the levels of VEGF and endothelin-1 in blood plasma and underwent digital dermatoscopy to study the characteristics of angiogenesis vascular loci (vascular glomeruli) in the papillary dermis. All psoriasis patients with symptoms of musculoskeletal system lesions were examined by a rheumatologist, which was supplemented by ultrasonography of the joints.

RESULTS: According to the results of enzyme immunoassay, it was found that the examined patients had an increased concentration of VEGF and endothelin-1 in blood plasma compared to the control group (respectively 19.5 [4.7; 48.1] pg/ml and 274.5 [146; 439] pg/ml versus 5.2 [0.5; 9.8] pg/ml and 96.5 [32; 188] pg/ml, p=0.004 and p=0.002). It was found that an increase in plasma concentrations of VEGF and endothelin-1 correlates with an increase in density of vascular glomeruli (respectively r=0.65 and r=0.74) and the average diameter of the glomerulus (respectively r=0.58 and r=0.56). A more pronounced increase in plasma concentrations of VEGF and endothelin-1 in patients with psoriasis was noted in patients with psoriatic arthritis and in the presence of synovitis. VEGF levels were higher in patients with severe psoriasis and in patients with nail lesions. Correlation analysis showed the strongest relationship between VEGF concentration and DAS28, DLQI, PASI and NAPSI values, as well as endothelin-1 concentration and PASI, BSA and DLQI values.

CONCLUSIONS: The work showed that the plasma concentration of VEGF and endothelin-1 characterizes the degree of angiogenesis expression in the psoriasis pathogenesis, reflects morphology changes in capillaries of the affected skin, and can also be used as a marker of severe psoriasis and an increased risk of developing damage to the nails and synovial membranes of the joints.

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About the authors

Olga A. Pritulo

V.I. Vernadsky Crimean Federal University, S.I. Georgievsky Medical Academy

Author for correspondence.
ORCID iD: 0000-0001-6515-1924
SPIN-code: 2988-8463

MD, Dr. Sci. (Med.), Professor

Russian Federation, 4 Acad. Vernadsky ave, Simferopol, Crimean Republic, 295007

Alexey A. Petrov

V.I. Vernadsky Crimean Federal University, S.I. Georgievsky Medical Academy

ORCID iD: 0000-0003-4533-2415
SPIN-code: 6070-2810

Graduate Student

Russian Federation, Simferopol

Marwan Ya.N. Maraqa

V.I. Vernadsky Crimean Federal University, S.I. Georgievsky Medical Academy

ORCID iD: 0000-0002-5579-4413
SPIN-code: 5558-4308

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Simferopol


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Supplementary files

Supplementary Files
1. Fig. Videodermatoscopy: a ― multiple vascular glomeruli in papillary dermis in psoriatic plaque area; b ― single small capillaries in papillary layer in intact skin of patients with psoriasis. ×100.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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