Adipokines and cytokines in the pathogenesis of psoriasis and metabolic disorders

Background: Psoriasis is a systemic immune-associated disease with a specific comorbidity. The manifestations of the metabolic syndrome in this category of patients are changes that develop on systemic immune-associated inflammatory psoriatic process background and contribute to the progression of chronic inflammation. Objectives: The aim of the study was determination of the main adipokines and cytokines content in the serum of peripheral blood, severity and activity of the disease in patients with psoriasis; clinical and laboratory evaluation of metabolic disorders. The interconnection between the production of adipokines and cytokines in psoriasis was analysed depending on the severity and activity of the psoriatic process and the nature of metabolic disorders. Methods: Serum levels of adipokines (C-peptide, ghrelin, insulin, glucagon, leptin, visfatin, resistin, GIP, GLP-1 and PAI-1) and cytokines (IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL- 12 (p70), IL-13, IL-15, IL-17, eotaxin, FGF-2, G-CSF, GM-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, MIP-1β, PDGF-BB, RANTES, TNF-α and VEGF) were measured in 36 patients with moderate and severe psoriasis, psoriatic arthritis. There was control group of 15 basically healthy persons. Clinical and laboratory evaluation of metabolic disorders (BMI, dyslipidemia, carbohydrate metabolism disorders) and cardiovascular diseases was performed for all examined patients. The duration, severity and the amount of body surface area involved in psoriasis were evaluated in all patients using recommended indices (BSA, PASI). Results: Patients with psoriasis showed an increase in the production of glucagon, leptin, visfatin, GLP-1 (p<1,0E-03) and a decrease in the level of C-peptide, insulin, GIP, PAI-1, resistin (p<1,0E-06) compared with the control group. The difference of ghrelin concentrations in both group was not statistically significant. Patients with psoriasis showed an increase in the level of IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17, eotaxin, FGF-2, GM-CSF, IFN-γ, IP-10, MCP-1, MIP-1β and TNF-α compared to control group (p<0, 01). Positive correlations between the level of adipokines and cytokines were revealed. Conclusions: The obtained data allow us to define adipokines as mediators between immune and endocrine systems. The imbalance between the proinflammatory and anti-inflammatory effects of adipokines observed in psoriasis demonstrates lipid metabolism dysfunction as one of the possible provoking factors of chronic inflammation determining the severity of the underlying disease. According to the results of the study, the following biological adipokines and cytokines should be classified as early biological markers of severity of the psoriatic immune-associated inflammatory process, with all its comorbid risks: GLP-1, glucagon, leptin, wisfatin, IL-1ra, IL-2, IL-4 IL-5, IL-6, IL-7, IL-8, IL-12, IL-13, IL-17, eotaxin, FGF-2, GM-CSF, IFN-γ, IP-10, MCP-1, MIP-1β, TNF-α. The levels of adipokines and cytokines are probably the earliest biological markers in patients with metabolic syndrome and psoriasis, the control of adipokines and cytokines level can be used to optimise therapy. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2018-eular.5684 Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A1233Session: Cytokines and inflammatory mediators