Clearing of psoriasis documented by laser Doppler perfusion imaging contrasts remaining elevation of dermal expression levels of CD31

A.G.M. Hendriks, P.C.M. van de Kerkhof, C.S. de Jonge, M. Lucas, W. Steenbergen, M.M.B. Seyger

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Background: Vascular modifications represent a key feature in psoriatic plaques. Previous research with Laser Doppler Perfusion Imaging (LDPI) revealed a remarkable heterogeneity in the cutaneous perfusion within homogenous-appearing psoriatic lesions. Insights in the relation between perfusion during treatment and related biological changes are lacking.

Objectives: To study the effect of calcipotriol-betamethasone dipropionate ointment on the microcirculation and the expression levels of immunohistochemical markers in psoriatic lesions compared to the distant uninvolved skin.

Methods: Psoriatic lesions of fourteen patients were treated once a day during 8 weeks. Clinical SUM scores and the perfusion intensity by means of LDPI were assessed every 2 weeks. After 8 weeks, a biopsy from the target lesion and one from the distant uninvolved skin were taken and stained for psoriasis-related markers, like IL-17 and CD31.

Results: After 8 weeks, seven patients reached a SUM score of 0 or 1, and were classified as good-responders. The other patients were classified moderate-responders. The perfusion intensity decreased in all lesions during therapy. In the good-responders, all investigated psoriasis-related proteins within the treated lesions reached the expression level found within the distant uninvolved skin. The expression of CD31, however, was significantly higher in the treated lesions as compared to the distant uninvolved skin (p = 0.0156). In the moderate responders, almost all expression levels remained significantly elevated compared to the uninvolved skin.

Conclusions: In the skin of good-responders the expression of dermal CD31+ endothelium remains significantly elevated within the treated lesions compared with the distant uninvolved skin, whereas a marked reduction in the perfusion intensity and SUM score was found. This indicates that clinical improvement might outrun endothelial changes.
Original languageEnglish
Pages (from-to)340-345
Number of pages6
JournalSkin research and technology
Volume21
Issue number3
DOIs
Publication statusPublished - 2015

Fingerprint

Perfusion Imaging
Psoriasis
Lasers
Skin
Perfusion
Interleukin-17
Microcirculation
Ointments
Endothelium
Blood Vessels
Biopsy

Keywords

  • Laser Doppler perfusion imaging (LDPI)
  • Plaque heterogeneity
  • TOPCam
  • Psoriasis
  • Microcirculation
  • Calcipotriol
  • Betamethasone dipropionate ointment

Cite this

Hendriks, A.G.M. ; van de Kerkhof, P.C.M. ; de Jonge, C.S. ; Lucas, M. ; Steenbergen, W. ; Seyger, M.M.B. / Clearing of psoriasis documented by laser Doppler perfusion imaging contrasts remaining elevation of dermal expression levels of CD31. In: Skin research and technology. 2015 ; Vol. 21, No. 3. pp. 340-345.
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title = "Clearing of psoriasis documented by laser Doppler perfusion imaging contrasts remaining elevation of dermal expression levels of CD31",
abstract = "Background: Vascular modifications represent a key feature in psoriatic plaques. Previous research with Laser Doppler Perfusion Imaging (LDPI) revealed a remarkable heterogeneity in the cutaneous perfusion within homogenous-appearing psoriatic lesions. Insights in the relation between perfusion during treatment and related biological changes are lacking.Objectives: To study the effect of calcipotriol-betamethasone dipropionate ointment on the microcirculation and the expression levels of immunohistochemical markers in psoriatic lesions compared to the distant uninvolved skin.Methods: Psoriatic lesions of fourteen patients were treated once a day during 8 weeks. Clinical SUM scores and the perfusion intensity by means of LDPI were assessed every 2 weeks. After 8 weeks, a biopsy from the target lesion and one from the distant uninvolved skin were taken and stained for psoriasis-related markers, like IL-17 and CD31.Results: After 8 weeks, seven patients reached a SUM score of 0 or 1, and were classified as good-responders. The other patients were classified moderate-responders. The perfusion intensity decreased in all lesions during therapy. In the good-responders, all investigated psoriasis-related proteins within the treated lesions reached the expression level found within the distant uninvolved skin. The expression of CD31, however, was significantly higher in the treated lesions as compared to the distant uninvolved skin (p = 0.0156). In the moderate responders, almost all expression levels remained significantly elevated compared to the uninvolved skin.Conclusions: In the skin of good-responders the expression of dermal CD31+ endothelium remains significantly elevated within the treated lesions compared with the distant uninvolved skin, whereas a marked reduction in the perfusion intensity and SUM score was found. This indicates that clinical improvement might outrun endothelial changes.",
keywords = "Laser Doppler perfusion imaging (LDPI), Plaque heterogeneity, TOPCam, Psoriasis, Microcirculation, Calcipotriol, Betamethasone dipropionate ointment",
author = "A.G.M. Hendriks and {van de Kerkhof}, P.C.M. and {de Jonge}, C.S. and M. Lucas and W. Steenbergen and M.M.B. Seyger",
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Clearing of psoriasis documented by laser Doppler perfusion imaging contrasts remaining elevation of dermal expression levels of CD31. / Hendriks, A.G.M.; van de Kerkhof, P.C.M.; de Jonge, C.S.; Lucas, M.; Steenbergen, W.; Seyger, M.M.B.

In: Skin research and technology, Vol. 21, No. 3, 2015, p. 340-345.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Clearing of psoriasis documented by laser Doppler perfusion imaging contrasts remaining elevation of dermal expression levels of CD31

AU - Hendriks, A.G.M.

AU - van de Kerkhof, P.C.M.

AU - de Jonge, C.S.

AU - Lucas, M.

AU - Steenbergen, W.

AU - Seyger, M.M.B.

PY - 2015

Y1 - 2015

N2 - Background: Vascular modifications represent a key feature in psoriatic plaques. Previous research with Laser Doppler Perfusion Imaging (LDPI) revealed a remarkable heterogeneity in the cutaneous perfusion within homogenous-appearing psoriatic lesions. Insights in the relation between perfusion during treatment and related biological changes are lacking.Objectives: To study the effect of calcipotriol-betamethasone dipropionate ointment on the microcirculation and the expression levels of immunohistochemical markers in psoriatic lesions compared to the distant uninvolved skin.Methods: Psoriatic lesions of fourteen patients were treated once a day during 8 weeks. Clinical SUM scores and the perfusion intensity by means of LDPI were assessed every 2 weeks. After 8 weeks, a biopsy from the target lesion and one from the distant uninvolved skin were taken and stained for psoriasis-related markers, like IL-17 and CD31.Results: After 8 weeks, seven patients reached a SUM score of 0 or 1, and were classified as good-responders. The other patients were classified moderate-responders. The perfusion intensity decreased in all lesions during therapy. In the good-responders, all investigated psoriasis-related proteins within the treated lesions reached the expression level found within the distant uninvolved skin. The expression of CD31, however, was significantly higher in the treated lesions as compared to the distant uninvolved skin (p = 0.0156). In the moderate responders, almost all expression levels remained significantly elevated compared to the uninvolved skin.Conclusions: In the skin of good-responders the expression of dermal CD31+ endothelium remains significantly elevated within the treated lesions compared with the distant uninvolved skin, whereas a marked reduction in the perfusion intensity and SUM score was found. This indicates that clinical improvement might outrun endothelial changes.

AB - Background: Vascular modifications represent a key feature in psoriatic plaques. Previous research with Laser Doppler Perfusion Imaging (LDPI) revealed a remarkable heterogeneity in the cutaneous perfusion within homogenous-appearing psoriatic lesions. Insights in the relation between perfusion during treatment and related biological changes are lacking.Objectives: To study the effect of calcipotriol-betamethasone dipropionate ointment on the microcirculation and the expression levels of immunohistochemical markers in psoriatic lesions compared to the distant uninvolved skin.Methods: Psoriatic lesions of fourteen patients were treated once a day during 8 weeks. Clinical SUM scores and the perfusion intensity by means of LDPI were assessed every 2 weeks. After 8 weeks, a biopsy from the target lesion and one from the distant uninvolved skin were taken and stained for psoriasis-related markers, like IL-17 and CD31.Results: After 8 weeks, seven patients reached a SUM score of 0 or 1, and were classified as good-responders. The other patients were classified moderate-responders. The perfusion intensity decreased in all lesions during therapy. In the good-responders, all investigated psoriasis-related proteins within the treated lesions reached the expression level found within the distant uninvolved skin. The expression of CD31, however, was significantly higher in the treated lesions as compared to the distant uninvolved skin (p = 0.0156). In the moderate responders, almost all expression levels remained significantly elevated compared to the uninvolved skin.Conclusions: In the skin of good-responders the expression of dermal CD31+ endothelium remains significantly elevated within the treated lesions compared with the distant uninvolved skin, whereas a marked reduction in the perfusion intensity and SUM score was found. This indicates that clinical improvement might outrun endothelial changes.

KW - Laser Doppler perfusion imaging (LDPI)

KW - Plaque heterogeneity

KW - TOPCam

KW - Psoriasis

KW - Microcirculation

KW - Calcipotriol

KW - Betamethasone dipropionate ointment

U2 - 10.1111/srt.12198

DO - 10.1111/srt.12198

M3 - Article

VL - 21

SP - 340

EP - 345

JO - Skin research and technology

JF - Skin research and technology

SN - 0909-752X

IS - 3

ER -