Goeckerman Regimen Reduces Alarmin Levels and PASI Score in Paediatric Patients with Psoriasis

Holmannová, Drahomíra; Císařová, Barbora; Borský, Pavel; Fiala, Zdeněk; Andrýs, Ctirad; Hamáková, Květoslava; Švadláková, Tereza; Krejsek, Jan; Palička, Vladimír; Kotingová, Lenka; Borská, Lenka

doi:10.14712/18059694.2022.3

Acta Medica > Archive > 2021, Vol. 64 > Issue 4 > Goeckerman Regimen Reduces Alarmin…

Acta Med. 2021, 64: 204-212

https://doi.org/10.14712/18059694.2022.3

Goeckerman Regimen Reduces Alarmin Levels and PASI Score in Paediatric Patients with Psoriasis

Drahomíra Holmannová^a, Barbora Císařová^a, Pavel Borský^a,b, Zdeněk Fiala^a, Ctirad Andrýs^c, Květoslava Hamáková^d, Tereza Švadláková^a,c, Jan Krejsek^c, Vladimír Palička^e, Lenka Kotingová^a, Lenka Borská^a

^aInstitute of Preventive Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
^bInstitute of Pathological Physiology, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
^cInstitute of Clinical Immunology and Allergology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
^dClinic of Dermal and Venereal Diseases, University Hospital, Hradec Králové, Czech Republic
^eInstitute of Clinical Biochemistry and Diagnostics, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic

Received August 31, 2021
Accepted December 20, 2021

Background. Psoriasis is a chronic systemic inflammatory disease with (extra-)cutaneous manifestations. Inflammation is associated with cellular stress and tissue damage which lead to the release of alarmins (signals of danger). Goeckerman regimen (GR) is a highly efficacious treatment consisting of the application of pharmaceutical crude tar and UVB light exposure. The reduction of inflammatory processes in the skin is accompanied by changes in the levels of inflammatory markers - alarmins (HMBG-1, S100A7, S1000A8, S100A9, S100A12, IL-17, IL-22, and IL-33). Methods. The alarmin levels in sera of 19 paediatric patients with psoriasis were determined before and after GR using commercial ELISA kits. The Psoriasis area severity index (PASI) was used to determine the disease severity. Results. GR reduced both PASI and the levels of all measured alarmins. The levels of S100A7, S100A9, IL-22, IL-33, and HMGB-1 were significantly decreased. Positive correlations between IL-22 and PASI, between S100A9 and IL-17, S100A9 and IL-22, and a negative correlation between S100A8 and IL-33 were found. Conclusions. Goeckerman regimen is a very effective, safe and low-cost therapy. We confirmed, it modulates the immune system reactivity, ameliorates the severity of the disease and reduces the levels of alarmins reflecting the presence and intensity of inflammation.

Keywords

alarmins, children, psoriasis, HMGB1, S100.

Funding

The study was supported by Charles University, Faculty of Medicine in Hradec Králové, the Czech Republic, by projects Q40-09, Q40-10, Q40-11, Cooperation – Health Sciences and SVV-260543/2020.