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| Item Type: | Article |
|---|---|
| Title: | Skin sodium accumulates in psoriasis and reflects disease severity |
| Creators Name: | Maifeld, A., Wild, J., Karlsen, T.V., Rakova, N., Wistorf, E., Linz, P., Jung, R., Birukov, A., Gimenez-Rivera, V.A., Wilck, N., Bartolomaeus, T., Dechend, R., Kleinewietfeld, M., Forslund, S.K., Krause, A., Kokolakis, G., Philipp, S., Clausen, B.E., Brand, A., Waisman, A., Kurschus, F.C., Wegner, J., Schultheis, M., Luft, F.C., Boschmann, M., Kelm, M., Wiig, H., Kuehne, T., Müller, D.N., 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 |
| ISSN: | 0022-202X |
| Publisher: | Elsevier |
| Volume: | 142 |
| Number: | 1 |
| Page Range: | 166-178 |
| Date: | January 2022 |
| Additional Information: | Copyright © 2021 The Authors. Published by Elsevier, Inc. on behalf of the Society for Investigative Dermatology. This manuscript version is made available under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA. |
| Official Publication: | https://doi.org/10.1016/j.jid.2021.06.013 |
| PubMed: | View item in PubMed |
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