Investigation of copd as a comorbidity and serum cytokine levels in psoriazis patients

INVESTIGATION OF COPD AS A COMORBIDITY AND SERUM CYTOKINE LEVELS IN PSORİAZİS PATIENTS Objectives ? Hypothesis: In this study, we planned to examine psoriatic patients according to the comorbidites and aimed to research chronic obstructive pulmonary diseases which was thought to be possibly in relation with disease?s severe and duration. Therewithal, by studying inflammatory cytokine levels in psoriatic patients, we aimed to investigate which mechanisms could lead possible association of psoriazis and COPD. Materials-Methods: We included 30 patients who were above 18, were diagnosed as psoriazis clinically and histopathologically and hadn?t any comorbidites; 30 patients who were older than 18, were being followed by our psoriazis clinic with diagnose of psoriazis and got one or more co-morbidities including hypertension, DM, hyperlipidemia, obesity, cardiovascular diseases and metabolic syndrome; and to determine a control group, we chose 28 healthy individuals in accord with patient group for age and gender. Blood samples and PA lung X-Rays were taken from all patients and control group. After they rested at least 15 minutes, pulmonary function tests were performed. In serum samples TNF-a, IL-1B, IL-6, IL8, IL-10, sICAM1, Endothelin-1, Endothelin-2 were studied as mediators. Findings: Body mass index (BMI) did not differ between groups (p>0.118). Smoking history were found significantly higher in psoriatic cases than control group (smoking rate was 56,2% in psoriatic cases and 20% in controls; chi-square:7,08 df:1 p<0.008). pulmonary function tests also did not show significant difference between groups (p>0.05). FEF25-75% values that shows early airway obstruction also did not show significant difference between groups (p=0.531). Since we assessed FEF25-75% values under 60% in favor of small airway disease, in 25 patients from psoriazis group (41,7%) this disease detected. In control group, 9 patients (28,6%) had small airway disease. Although case group had higher small airway disease rates, difference between case and control group were not statistically significant (Chi-square:0.894; df:1, p=0.344). COPD prevalence was 13.3% in psoriazis group. In addition, even though COPD prevalence was higher according to the literature data, we did not assigned any significant increase in studies cytokines. Cases and controls were compared according to the IL-1B, IL-6, IL-8, IL-10, TNF-a, sICAM parameters and group mean values. While sICAM was found significantly higher in the case group, IL-1B was found lower. Discussion and Conclusion: In this study COPD prevalence was %13.3; although this prevalence was higher than literature data, we did not find any significant increase in inflammatory cytokine levels which were being studied. sCAM-1 levels were detected higher in the patient group than control group, moreover, sICAM levels were found higher also in psoriazis with co-morbidities group than control group. There was no significant difference between psoriazis group and psoriazis with co-morbidities group. This situation that consistents with literature data may be caused by gradually increase in chronic inflammation in the psoriazis patients who have long term and severe illness and are fat. IL-1B levels which were found to be significantly lower than controls, did not show significant difference between high PASI score group and low PASI score group in a comparision that made between these two groups. By this result in our study, we found decrease in IL-1 levels as well as decrease in function which was mentioned in literature data before. Again, we thought that this situation could be result of patients? long term disease. Finding level of this cytokine low in serum which determines keratinocyte functions showed that this may regard with progression of inflammation more than keratinocyte disfunction at the advanced stages of illness. Given the fact that all data obtained in our study, co-morbidities are much more related with duration of Psoriazis than its severity and systemic effects which are due to inflammation could be seen on these patients more. Therefore, it is necessary that except well-known co-morbidities, COPD and other systemic inflammatory diseases must be researched in Psoriatic patients. Keywords: Psoriazis, co-morbidity, COPD, IL-1B(Beta), soluble ICAM, IL-6, IL-10