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Elevation of serum squamous cell carcinoma antigen 2 in patients with psoriasis: associations with disease severity and response to the treatment
Author(s) -
Watanabe Y.,
Yamaguchi Y.,
Komitsu N.,
Ohta S.,
Azuma Y.,
Izuhara K.,
Aihara M.
Publication year - 2016
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14426
Subject(s) - psoriasis , medicine , biomarker , immunohistochemistry , psoriasis area and severity index , interleukin 17 , antigen , immunology , gastroenterology , oncology , inflammation , biology , biochemistry
Summary Background Squamous cell carcinoma antigen ( SCCA ) belongs to the ovalbumin–serpin family and is a known tumour marker. Expression of SCCA is upregulated in the serum and skin of patients with psoriasis. Objectives The aim of this study was to determine SCCA 2 levels in association with disease severity and treatment efficacy in patients with psoriasis. Materials and methods Patients with psoriasis ( n = 123) and healthy controls ( n = 25) were enrolled in this prospective cross‐sectional study. Enzyme‐linked immunosorbent assay ( ELISA ) analysis was performed to determine serum SCCA 2 levels. SCCA 2 expression in skin was evaluated using immunohistochemical analysis. Serum SCCA 2 levels were compared with Psoriasis Area Severity Index ( PASI ) scores. The effect of treatment on serum SCCA 2 levels was assessed using serial examinations. Induction of SCCA 2 by several psoriatic cytokines in human keratinocytes was evaluated. Results The serum levels of SCCA 2 were significantly higher in patients with psoriasis than healthy controls and correlated well with disease severity. Increased SCCA 2 staining was observed in lesional skin but not in nonlesional skin of patients with psoriasis. In addition, SCCA 2 expression levels in skin correlated with serum concentrations of SCCA 2. SCCA 2 significantly decreased according to improvement of PASI scores. Interleukin ( IL )‐17 and IL ‐22 synergistically increased the production of SCCA 2 at both mRNA and protein levels in human keratinocytes. Conclusions Significant elevation of SCCA 2 is associated with disease severity and reflects treatment efficacy. SCCA 2 may be a useful biomarker in psoriasis, reflecting T‐helper 17‐type inflammation – the main determinant of the severity of psoriasis.