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Skin sodium accumulates in psoriasis and reflects disease severity

Item Type:Article
Title:Skin sodium accumulates in psoriasis and reflects disease severity
Creators Name:Maifeld, A. and Wild, J. and Karlsen, T.V. and Rakova, N. and Wistorf, E. and Linz, P. and Jung, R. and Birukov, A. and Gimenez-Rivera, V.A. and Wilck, N. and Bartolomaeus, T. and Dechend, R. and Kleinewietfeld, M. and Forslund, S.K. and Krause, A. and Kokolakis, G. and Philipp, S. and Clausen, B.E. and Brand, A. and Waisman, A. and Kurschus, F.C. and Wegner, J. and Schultheis, M. and Luft, F.C. and Boschmann, M. and Kelm, M. and Wiig, H. and Kuehne, T. and Müller, D.N. and Karbach, S. and Markó, L.
Abstract:Sodium can accumulate in the skin, at concentrations exceeding serum levels. High sodium environment can lead to pathogenic T helper (Th)17 cell expansion. Psoriasis is a chronic inflammatory skin disease in which interleukin (IL)-17-producing Th17 cells play a crucial role. In an observational study, we measured skin sodium content in psoriasis patients and age-matched healthy controls by (23)Na-magnetic resonance imaging (MRI). Patients with a psoriasis area and severity index (PASI)>5 showed significantly higher sodium and water content in the skin, but not in other tissues, compared to those with lower PASI or healthy controls. Skin sodium concentrations measured by (23)Na-spectroscopy or by atomic adsorption spectrometry in ashed-skin biopsies verified findings with (23)Na-MRI. In vitro Th17 cell differentiation of naïve CD4(+) cells from psoriatic patients markedly induced IL-17A expression under increased NaCl concentrations. The imiquimod-induced psoriasis mouse model replicated the human findings. Extracellular tracer (51)Cr-EDTA measurements in imiquimod- and sham-treated skin showed similar extracellular volumes, rendering excessive water of intracellular origin. Chronic genetic IL-17A-driven psoriasis mouse models underlined the role of IL-17A in dermal sodium accumulation and inflammation. Our data describe skin sodium as a pathophysiological feature of psoriasis, which could open new avenues for its treatment.
Keywords:Atomic Spectrophotometry, Cell Differentiation, Cultured Cells, Inbred C57BL Mice, Interleukin-17, Lymphocyte Activation, Psoriasis, Severity of Illness Index, Skin, Sodium, Sodium Chloride, Spectrum Analysis, Th17 Cells, Animals, Mice
Source:Journal of Investigative Dermatology
Page Range:166-178
Date:January 2022
Official Publication:https://doi.org/10.1016/j.jid.2021.06.013
PubMed:View item in PubMed

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