Journal de recherche clinique et expérimentale en dermatologie
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Cellular Immune Response in Patients with Chronic Plaque Type Psoriasis: Evaluation of Serum Neopterin, Procalcitonin, Anti-Streptolysin O and C Reactive Protein Levels

Yaşar Ibrahimbaş, Mualla Polat, Erdinç Serin and Ali Haydar Parlak

Background: Psoriasis is characterized by T-cell mediated hyperproliferation of keratinocytes initiated by antigen presenting cells on the skin. Environmental factors including β hemolytic streptococcus infections and multiple genetic components may be responsible for the pathogenesis of the disease. However the antigen which initiates the immunologic reactions has not yet been known. We aimed to evaluate the relationship between streptococcal as well as other bacterial infections and psoriasis via measurement of some infection markers.
Materials and methods: The study included 40 patients with exacerbations of chronic plaque type psoriasis lesions and 40 healthy individuals. Disease activity in study group was determined according to the score of psoriasis area and severity index. Antistreptolysin O, C-reactive protein, procalcitonin and neopterin levels of patients with psoriasis were compared to those of control subjects.
Results: The levels of procalcitonin (p=0.002) and neopterin (p=0.001) in patients with psoriasis were significantly higher than those in control subjects. Additionally, there was significant correlation between psoriasis area and severity index scores and neopterin (p< 0.001) as well as C-reactive protein (p=0.006) levels. However ASO levels in patients with psoriasis did not differ significantly from those in control subjects (p=0.86).
Conclusions: Significant increased levels of serum procalcitonin during exacerbation period of chronic plaque type psoriasis may be resulted from the presence of a bacterial antigenic stimulus and significant elevated levels of neopterin may indicate elevated cellular immune system activity following bacterial antigenic stimulation. However, absence of significant elevated antistreptolysin O levels indicates the possible role of bacterial infections in the pathogenesis of psoriasis rather than streptococcal infections.