Session Information
Date: Sunday, November 8, 2015
Title: Cytokines, Mediators, Cell-cell Adhesion, Cell Trafficking and Angiogenesis Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Angiogenesis plays an important role in the pathogenesis of psoriasis. TNFa is an essential mediator that induces the expression of VEGF, which activates the endothelial cells, promoting angiogenesis.
Our aims were: a) to quantify the angiogenesis and the VEGF expression in healthy skin and in plaque psoriasis before and 6 months after starting adalimumab (ADA), and b) to correlate these parameters with clinical assessment scales.
Methods:
Prospective study of a series of patients with moderate/severe psoriasis who completed 6 months of treatment with ADA.Two biopsies of healthy skin and of plaque psoriasis were performed, one before starting ADA and the other was performed at 6 months. In each sample, an immunohistochemical study to VEGF, TNF‡ and CD31 was performed. Quantification of angiogenesis (CD31) was analyzed using an Automated Cellular Imaging sistem (DAKO).
Results:
Twenty three patients (13 W/10 M; mean age of 37±12 years) with a mean evolution of psoriasis of 19,9±13.1 years were included. Six patients also had (26%) arthritis. Comparison of clinical and histological parameters at baseline and at 6 months of treatment with ADA is shown in TABLE. At the baseline visit the following values were significantly higher in skin biopsy with psoriasis than in healthy skin: a) levels of angiogenesis (endothelial area positive-CD31): 2274.2±833.1 vs 810.6±425.2 (p<0.001); b) positive expression of VEGF: 87% vs 8.7% (p<0.001) y c) positive expression of TNF_: 82.6 vs 4.3% (p<0.001). A significant clinical and histological improvement in the expression of TNF, VEGF and angiogenesis was observed after treatment with ADA. The clinical parameters of psoriasis and angiogenesis (VEGF, TNF and CD31) only showed a significant correlation between the improvement in PASI and basal CD31. Thus, patients with lower baseline PASI had a greater response to therapy (r=0.590; p<0.003).
Conclusion:
In this series, ADA reduces the levels of VEGF and angiogenesis in plaque psoriasis. This fact seems to suggest that a part of their effect is due to inhibition of angiogenesis.
TABLE
|
|
Baseline |
month 6 |
p |
|
Clinical improvement |
|||
|
BSA (%) |
37.9±16.3 |
3.1±5.5 |
<0.001 |
|
PASI (0-72) |
18.9±7.8 |
1.3±2.1 |
<0.001 |
|
NAPSI hands (0-80) |
5.4±10.5 |
1.5±3.9 |
0.26 |
|
PGA psoriasis (0-6) |
3.9±0.6 |
0.7±0.6 |
<0.001 |
|
PASE total score (15-75) |
32.5±15.9 |
25.2±13.0 |
0.007 |
|
PASE (functional) (8-40) |
15.9±8.7 |
12.1±6.2 |
0.013 |
|
PASE symptoms (7-35) |
16.6±7.7 |
13.1±7.3 |
0.014 |
|
BASDAI |
2.61±2.77 |
1.26±1.31 |
0.11 |
|
BASFI |
1.31±1.97 |
0.82±1.62 |
0.29 |
|
Patients with arthritis |
26.1% |
15.0% |
0.004 |
|
Histological improvement in simple with psoriasis |
|||
|
VEGF (% positive) |
86.9% |
17.4% |
<0.001 |
|
VEGF (% negative) |
13.1% |
82.6% |
<0.001 |
|
TNF‡ (% positive) |
82.6% |
8.6% |
<0.001 |
|
TNF‡ (% negative) |
17.4% |
8.6% |
<0.001 |
|
CD31 (median [IQR]) |
2117 [843-1590] |
987 [684-1590] |
<0.001 |
To cite this abstract in AMA style:
Santos-Gómez M, Riancho-Zarrabeitia L, Blanco R, Gonzalez-Vela C, Hernández JL, Armesto S, González López MA, Loricera J, Calvo-Río V, Marcellán M, Drake M, Hermana-Ramírez S, Pons E, Fuentevilla P, Corrales A, Pina T, Palmou N, Gonzalez-Gay MA. Prospective Study of the Effect of Treatment with Adalumumab in Angiogenesis in Moderate or Severe Psoriasis for a Period of 6 Months [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/prospective-study-of-the-effect-of-treatment-with-adalumumab-in-angiogenesis-in-moderate-or-severe-psoriasis-for-a-period-of-6-months/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/prospective-study-of-the-effect-of-treatment-with-adalumumab-in-angiogenesis-in-moderate-or-severe-psoriasis-for-a-period-of-6-months/