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- Title
Evaluation the Clinical efficacy and Immunological Pathways under Micronutrients in Combination with Methotrexate Therapy in Chronic Plaque of Psoriatic Patients.
- Authors
Yousefzadeh, Hadis; Azad, Farahzad Jabbari; Banihashemi, Mahnaz; Rastin, Maryam; Mahmoudi, Mahmoud
- Abstract
Objective: Psoriasis is a T cell-mediated autoimmune disease with elevated level of pro-inflammatory cytokines belonging mainly to Th1 and Th17 pathways. We investigated whether treatment with micronutrients supplement along with methotrexate (MTX) is able to induce significant modulation in mRNA expression of T cell immune patterns and its correlation with clinical response. Material and Methods: Thirty patients suffered from plaque type psoriasis with Psoriasis Area and Severity Index (PASI) higher than 10 were recruited; 15 non- micronutrients taker (NMT) patients, treated by MTX daily (0.2-0.3 mg/kg/week) and 15 micronutrients taker (MT) patients treated by MTX plus micronutrient supplement daily for 12 weeks. Blood samples were collected at baseline and after 12 weeks. TaqMan quantitative real-time polymerase chain reaction was applied to analyses the expression of T-bet, IL-12, IFN- γ (Th1); GATA-3, IL-4 (Th2); IL-17, IL-23, RORγt (Th17); Foxp3M IL-2 (Treg). Disease severity measured by PASI scoring system. Results: Patients in showed noticeable and more rapid reduction of PASI score, scaling and involvement of lesions compared to group A (P=0.04; P=0.01; P=0.03, respectively). Respect to PASI-75 cut-point, expression of IFN-γ in MT group with upper PASI-75 was significantly lower than in related patients in NMT group (P=0.05). In addition, mRNA expressions of GATA3 and IL-4 in MT group with upper PASI-75 were significantly higher than patients in NMT group respectively (P=0.05, P=0.04). In addition, better clinical response in MT group was associated with decrease in expression of IL-17 and RORγt levels concomitant significant increment of Foxp3 expression (P<0.05). Conclusion: According to significant attenuating of PASI score and up regulation of regulatory pathway in favor of MT group, we suggest consumption of micronutrients in combination MTX in psoriasis patients. Our results contribute to a better understanding of methotrexate immune-pathogenesis mechanisms and its correlation to clinical response in psoriasis.
- Subjects
PSORIASIS; IMMUNE response; METHOTREXATE
- Publication
Iranian Journal of Allergy, Asthma & Immunology, 2018, Vol 17, p200
- ISSN
1735-1502
- Publication type
Abstract