Stromal cell-derived factor 1 (SDF1), or C-X-C motif chemokine 12 (CXCL 12), was implicated in the progression of psoriasis vulgaris to psoriatic arthritis (PsA) in a new study. In the study, treatment with methotrexate was associated with downregulation of CXCL 12 expression of the keratinocytes in patients with psoriasis. Findings from this study were published in the Journal of Cosmetic Dermatology.

Patients with psoriasis vulgaris (n=10), PsA (n=10), and healthy controls (n=20) were included in the case-control study. A full medical history, clinical examination, and laboratory investigations were performed. Skin biopsies were taken for each patient, which were repeated 6 weeks following treatment with methotrexate. Biopsies were stained by CXCL 12 antibody.

Prior to treatment, patients with PsA had more expression of CXCL 12 than patients with psoriasis vulgaris (P =.0). Following treatment with methotrexate, the Psoriasis Area and Severity Index score decreased from a median of 31.6 to 14.1 in patients with psoriasis vulgaris (P =.0007) and decreased from a median of 32.1 to 10.3 in patients with PsA (P =.04). In patients with psoriasis vulgaris, the researchers observed a significant reduction in CXCL 12 expression in keratinocytes following methotrexate therapy (P =.009).

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A significant decrease in the expression of CXCL 12 was also observed in keratinocytes of patients with psoriasis after methotrexate treatment compared with before treatment (P =.0007). There was a moderate correlation between the percentage posttreatment decrease in Psoriasis Area and Severity Index score with the percentage decrease of CXCL 12 expression in the total keratinocytes of patients with psoriasis (r = 0.484; P =.015).

Limitations of the study include the small number of participants and the inclusion of only 1 therapy for assessment.

Based on their findings, the researchers suggest “CXCL 12 can be used as a biological marker of disease severity of psoriasis patients.”

The authors had no conflicts of interest to disclose.

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Reference:

Abdelaal NH, Elhefnawy NG, Abdulmonem SR, Sayed S, Saleh NA, Saleh MA. Evaluation of the expression of the stromal cell-derived factor-1 alpha (CXCL 12) in psoriatic patients after treatment with methotrexate [published online May 22, 2019]. J Cosmet Dermatol. doi:10.1111/jocd.12994