Proteins are pivotal in the pathogenesis of psoriasis, contributing to the disease’s structural phenotypic alterations and inflammation. Bjørn Kromann, MD, and colleagues conducted a systematic review to evaluate the consistent upregulation or down regulation of proteins in the skin and blood of patients with psoriasis.
The researchers meticulously reviewed proteomic studies, focusing on differentially expressed proteins (DEPs) in four predefined comparisons. They employed standardized data extraction and alignment procedures, ensuring the reliability and consistency of the results.
Dr. Kromann and coauthors identified 772 studies published between December 2, 1996, and April 28, 2023. Of these, 30 articles inclusion and data availability criteria. The studies collectively reported 5,314 DEPs. The majority of consistently reported upregulated and downregulated proteins were in lesional versus non-lesional skin (n=313), followed by lesional versus healthy skin (n=185), blood from patients with psoriasis versus healthy patients (n=140), and nonlesional versus healthy skin (n=1).
An analysis of upregulated proteins demonstrated distinct functional clusters, including interleukin (IL)-6, IL-8, IL-17A, C-C motif chemokine (CCL) 20, signal transducer and activator of transcription (STAT) 3, and interferon (IFN)- γ, alongside lesser studied proteins with central roles. Several protein changes demonstrated anti inflammatory effects. In addition, the authors found that proteomic dysregulation involved antimicrobial peptides, alarmins, angiogenic factors, and proteins associated with protein synthesis.
“The functional associations among these reported DEPs reflect the histological changes seen in lesional psoriatic skin, such as thickened epidermis with acanthosis and increased cell turnover, indicated by the up – regulation of cytosolic proteins, of which many are involved in protein synthesis. Several proteins involved in immunity and, especially, neutrophil degranulation are upregulated in lesional skin as well,” the researchers explained.
The review’s findings confirmed existing knowledge about psoriasis pathogenesis and unveiled novel insights, according to the authors.
“Some consistently upregulated proteins in the included studies have not or only to a very limited extent been discussed before in the context of psoriasis and could represent novel and interesting topics for future research. The present study is the first to identify proteins consistently reported in proteomic studies as upregulated or downregulated in the skin and blood from patients with psoriasis,” Dr. Kromann and colleagues concluded.