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Circulating endothelial cell levels in psoriatic patients and their modification after an anti‐TNF‐alpha (Etanercept) treatment
Author(s) -
De Simone C.,
Caldarola G.,
Coco V.,
Palumbo S.,
Pocino K.,
Sgambato A.,
Maiorino A.,
Corbi M.,
Sandri M.T.,
Vendittelli F.,
Capoluongo E.
Publication year - 2014
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.12140
Subject(s) - medicine , etanercept , brachial artery , psoriasis , gastroenterology , endothelial dysfunction , biomarker , tumor necrosis factor alpha , psoriatic arthritis , immunology , blood pressure , biochemistry , chemistry
Abstract Background Endothelial function in psoriatic patients has been mainly evaluated through a high‐resolution ultrasound measurement of flow‐mediated vasodilation in the brachial artery, which is an operator‐dependent and technically demanding technique: this characteristic, together with different patient selection criteria, could account for the conflicting results emerging from different studies. Recently, Circulating Endothelial Cells ( CEC s) level has been suggested as a novel biomarker of vascular injury. Methods The number of CEC s was determined by a semi‐automated immunomagnetic system (CellSearch system) in peripheral blood of psoriatic patients ( n = 48) and healthy subjects ( n = 50). In 15 patients, CEC level was also evaluated after 6 months of treatment with an anti– TNF ‐alpha agent, Etanercept. The plasma levels of high‐sensitivity C‐reactive Protein (CRP), E‐selectin, VEGF and PAI ‐1 were measured by ELISA . The psoriasis severity was assessed by PASI score. Results A statistically significant difference ( P = 0.001) was found between CEC level in psoriatic patients (10.6 ± 9.4 cells/mL) vs. the control group (3.9 ± 0.9 cells/mL). This count inversely correlated with sE ‐selectin levels ( r 2 = 0.16; P = 0.03). After 6 months of therapy, patients experienced a significant ( P < 0.05) decrease in CEC levels (3.4 ± 1.3 cells/mL) and in PASI score (from 11.7 ± 8.1 to 2.1 ± 4.0). Conclusions The elevated CEC s level that we found in a sample of high selected psoriatic patients could be expression of endothelial damage. Lowering of CEC s count after treatment with Etanercept support the hypothesis that an effective systemic therapy of psoriasis may also improve the endothelial function.