Objective To analyze whether there is a causal association between psoriasis and Alzheimer disease (AD) by a two-sample two-way Mendelian randomization (MR) method. Methods In the forward study, the single nucleotide polymorphisms (SNPs) associated with psoriasis were obtained from the comprehensive statistical data of the genome-wide association study database as the instrumental variables, and AD as the outcome; in the reverse study, the SNPs associated with AD were taken as instrumental variables, and psoriasis as the outcome. Using two-sample two-way MR analysis, the odds ratio (OR) value and 95% confidence interval (CI) of regression models, namely inverse variance weighted (IVW) method, MR-Egger regression method, weighted median method, simple pattern method, and weighted pattern method, were used to evaluate the causal relationship between psoriasis and AD. Cochran’s Q test was used to assess the heterogeneity of genetic instrumental variables, MR-Egger intercept method was used to test the horizontal pleiotropy of the assessment, “leave-one-out” method was used to assess the sensitivity of a SNP to the effect of causality, and the symmetry of funnel plot was observed to assess bias. Results A total of 19 SNPs associated with psoriasis were included as instrumental variables in the forward study. The IVW analysis of the forward study showed that there was a causal correlation between psoriasis and AD [OR=1.032, 95%CI (1.014, 1.051), P<0.001], and MR-Egger regression method [OR=1.042, 95%CI (1.012, 1.073), P=0.013], weighted median [OR=1.048, 95%CI (1.023, 1.074), P<0.001], and weighted model [OR=1.046, 95%CI (1.020, 1.073), P=0.002] all supported this result. Heterogeneity test (IVW result: Q=13.752, P=0.745; MR-Egger regression result: Q=13.134, P=0.727), MR-Egger intercept method (Egger intercept=–0.004, P=0.442), the results of “leave-one-out” method and funnel plot showed that the results of MR analysis were reliable. A total of 127 AD-related SNPs were included as instrumental variables in the reverse study. In reverse research, there was no evidence to support the AD could increase the risk of psoriasis (P>0.05). Heterogeneity test (IVW result: Q=232.496, P<0.001; MR-Egger regression result: Q=232.119, P<0.001) suggested heterogeneity, but MR-Egger intercept method (Egger intercept=0.003, P=0.652), the results of “leave-one-out” method and funnel plot showed that the results of MR analysis were reliable. Conclusion There is a causal association between psoriasis and AD, and psoriasis may increase the risk of AD.
Objective To assess the efficacy and safety of adalimumab on plaque psoriasis. Methods We searched the MEDLINE (1966 to December 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 12, 2009), EMbase (1980 to December 2009), CBM (1978 to December 2009), and CNKI (1979 to December 2009) to collect randomized controlled trials (RCTs) of adalimumab for plaque psoriasis. The language was confined to English and Chinese. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses by using the Cochrane Collaboration’s RevMan 4.2 software. Results Three RCTs involving 1?630 patients with chronic moderate or severe plaque psoriasis were included and assessed. At the end of 4th, 8th, 12th and 16th week, the PASI 75s of subcutaneous injection every other week in adalimumab (EOW) group were obviously higher than that of placebo group and methotrexate group. While at the end of 24th week and 60th week, the PASI 75s showed no difference between adalimumab EOW and placebo group. Twelve weeks after subcutaneous injection each week with adalimumab (QW), PASI 75 was obviously higher than those of placebo and EOW groups. However, at the end of 24th week and 60th week, there was no significant difference between adalimumab QW and placebo followed by adalimumab EOW. At end of week 12-16, there was no difference between adalimumab EOW group and placebo group in the incidence of adverse effects, with the exception of pain on injection site and upper respiration viral infection. At week 12-60, there was no difference between adalimumab QW and EOW groups in the incidence of adverse effects, with the exception of all serious adverse effects. Conclusion The limited evidence indicates that subcutaneous injection of adalimumab every other week for 12-16 weeks is safe and efficient for patients with moderate or severe plaque psoriasis. The efficacy can’t be enhanced when the treatment is prolonged to 24 weeks. The once-a-week protocol has no obvious advantage over every other week protocol. More RCTs are required to verify these conclusions owing to the limitations of the present study.
Objective To explore the relationship between the gut microbiome (GM) and psoriasis using a two-sample two-way Mendelian randomization (MR) approach. Methods The forward analysis uses the gut microbiota as the exposure factor, and its genetic data are derived from the genome-wide association study dataset published by the MiBioGen consortium. Psoriasis was used as the outcome variable, and its genetic data were obtained from the UK Biobank. The reverse MR analysis, on the other hand, took psoriasis as the exposure and the specific gut microbiota taxonomic units identified in the forward analysis as the outcome variable. MR analysis was conducted using maximum likelihood, MR Egger regression, weighted median, inverse variance weighting (IVW), and weighted models to study the causal relationship between the gut microbiota and psoriasis. Then, sensitivity analyses including horizontal pleiotropy test, Cochran’s Q test, and leave-one-out analysis were used to evaluate the reliability of the results. Results A total of 51 single nucleotide polymorphisms from 5 fungi were included in the forward study. The forward IVW analysis results showed that, the class Mollicutes [odds ratio (OR)=1.003, 95% confidence interval (CI) (1.001, 1.006), P=0.004], genus Lachnospiraceae FCS020 group [OR=1.003, 95%CI (1.000, 1.006), P=0.041], and phylum Tenericutes [OR=1.003, 95%CI (1.001, 1.006), P=0.004] were causally associated with an increased risk of psoriasis. The family Victivallaceae [OR=0.998, 95%CI (0.997, 1.000), P=0.005] and order Pasteurellales [OR=0.998, 95%CI (0.996, 1.000), P=0.047] were also linked to a decreased risk of psoriasis. The results of the sensitivity analysis were robust. There was no evidence of a reverse causal relationship from psoriasis to the identified bacterial taxa found in the results of reverse MR analysis results. Conclusions The abundance of three species, class Mollicutes, genus Lachnospiraceae and phylum Tenericutes, may increase the risk of psoriasis. The abundance of two species, family Victivallaceae and order Pasteurellales may reduce the risk of psoriasis. These results provide new directions for the prevention and treatment of psoriasis in the future, but further research is needed to explore how the aforementioned microbiome affects the progression of psoriasis.
Objective To assess the clinical effectiveness and safety of compound glycyrrhizin combined with acitretin for psoriasis. Methods The databases such as PubMed, The Cochrane Library, SpringerLink, CNKI, VIP, WanFang Data and CBM were searched to collect the randomized controlled trials (RCTs) about compound glycyrrhizin combined with acitretin vs. acitretin alone for psoriasis. Meanwhile, The Chinese Journal of Dermatovenereology, China Journal of Leprosy and Skin Diseases and the grey literature were also searched. The retrieval time was from January 2000 to March 2012. According to the Cochrane Reviewer’s Handbook, two reviewers independently screened the literature, extracted the data and assessed the methodological quality of the included studies. Then the meta-analysis was performed using RevMan5.0 software. Results A total of 17 RCTs involving 1 365 patients were included. The results of meta-analysis showed that, the regimen of compound glycyrrhizin combined with acitretin was superior to acitretin alone; there were significant differences in the total effective rate (OR=3.39, 95%CI 2.55 to 4.52, Plt;0.000 01) and in the incidence of skin and mucous membrane dryness (OR=0.54, 95%CI 0.32 to 0.98, P=0.04), skin erythema (OR=0.43, 95% CI 0.24 to 0.76, P=0.004), elevated AST and ALT (OR=0.13, 95%CI 0.04 to 0.41, P=0.000 5) and elevated blood lipid (OR=0.48, 95%CI 0.30 to 0.77, P=0.002). But no significant difference was found in the incidence of dry and cracked lips (OR=0.50, 95%CI 0.10 to 2.50, P=0.40). There was publication bias shown by funnel plot analysis. Conclusion The compound glycyrrhizin combined with acitretin for psoriasis can obviously increase the cure rate and effective rate, and reduce the incidence of adverse reaction, such as dryness of skin and mucous membrane, skin erythema, elevated AST and ALT, and elevated blood lipid. For the limitation of quality and quantity of included studies, this conclusion still needs to be proved by conducting more high quality researches.
目的：探讨银屑病合并蛋白尿患者的临床特点。方法：回顾性分析1996年1月～2005年8月收治的银屑病合并蛋白尿者临床资料，并与银屑病非蛋白尿者的临床特点比较。结果：银屑病合并不明原因蛋白尿48例，皮肤受累面积与蛋白尿程度无相关关系（P＞0.05），但银屑病合并蛋白尿组的银屑病病程更短,肾脏病理荧光表现为IgA沉积为主。蛋白尿组皮肤受累面积与非蛋白尿组皮肤受累面积比较，无统计学意义（P＞0.05），蛋白尿组和非蛋白尿组的病程也无统计学差异（P＞0.05）。结论：银屑病合并不明原因蛋白尿值得重视，有必要对其发病机制、临床特点、病理特征进行深入的研究。
目的 通过对白芍总苷治疗前后寻常型银屑病患者血清中白介素（IL）-22水平的研究，探讨其治疗寻常型银屑病的作用机制。 方法 2009年10月－2010年8月采用双抗体夹心酶联免疫吸附法，检测30例寻常型银屑病患者，经白芍总苷治疗前后及健康对照组20例外周血清中IL-22浓度的变化，分析其在治疗前、后与银屑病皮损面积和严重程度指数（PASI）评分的相关性。 结果 寻常型银屑病患者血清IL-22浓度[（90.50 ± 51.80）pg/mL]较对照组[（40.10 ± 17.20）pg/mL]升高，白芍总苷治疗后血清中IL-22水平[（48.70 ± 23.90）pg/mL]较治疗前降低（P＜0.05），并与对照组差异无统计学意义（P＞0.05）；治疗前、后患者血清IL-22水平与PASI评分呈正相关。结论 白芍总苷可能通过调节IL-22发挥治疗寻常型银屑病的作用。
Objective To assess the relationship between IFN-γ and psoriasis. Methods We searched The Cochrane Library (Issue 3, 2005), MEDLINE (1996 to 2005) and the China Biological Medicine Database (1978 to 2005). The search was conducted in November 2005. The quality of included clinical controlled trials, case studies and cohort studies was evaluated independently by three reviewers. RevMan 4.2.8 software was used. Results In total, 23 studies were included, involving 612 psoriasis patients and 441 healthy controls. All studies did not provide sufficient detail, on the random sampling and the specificity of the kits used for the analyses. Compared with the controls, the serum or plasma IFN-γ in psoriasis patients showed significantly higher levels (SMD=0.89, 95%CI 0.29 to 1.48; and RR=6.20, 95%CI 1.78 to 21.61). The concentration of IFN-γ in supernatant obtained from cultured cells showed slightly higher levels (SMD=0.99, 95%CI -0.01 to 1.99; and RR=5.54, 95%CI 2.03 to 15.13). Conclusion The evidence currently available shows that the increase of IFN-γ may be relevant to psoriasis. However, these results could be affected by the high risk of selection, confounding and detection bias of included studies. More persuasive evidence, from high quality studies, is needed.
ObjectiveTo systematically review the long-term efficacy of biologics for moderate to severe plaque psoriasis. MethodsPubMed, EMbase, Web of Science and The Cochrane Library were electronically searched to collect randomized controlled trials (RCTs) on the long-term efficacy of approved biologics for moderate to severe plaque psoriasis from inception to May 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, the network meta-analysis was performed by using Stata 16.0 software. ResultsA total of 26 RCTs were included. The results of network meta-analysis showed that among 11 biologics, the most effective biologics were risankizumab, followed by bimekizumab, brodalumab, guselkumab, and ixekizumab, and followed by secukinumab, adalimumab, ustekinumab, and etanercept was the last. ConclusionCurrent evidence shows that risankizumab is likely to be the best option for long-term treatment of moderate-to-severe plaque psoriasis. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.