The molecular basis of systemic associations in psoriasis

Psoriasis is an inflammatory disease with systemic associations, many of which have unclear molecular bases. The aim of this study is to investigate the upregulated pathways in psoriasis. We conducted microarray reactions on blood-extracted RNA from two groups of patients: those with psoriasis and metabolic syndrome (n=9) compared to those with psoriasis only (n=9). We identified 187 upregulated genes in psoriasis and metabolic syndrome compared to psoriasis only. Examined using Wikipathways, we have identified pathways and molecules involved in seven associations of psoriasis: malignancy, angiogenesis, keratinocyte senescence and hyperproliferation, the metabolic syndrome, increased cilia formation, circadian rhythm disturbance, and Alzheimer’s disease. We have then verified our results by comparing our psoriasis samples (n=18) with healthy controls (n=30) and described new pathways and molecules involved in four other associations: non-alcoholic fatty liver disease, end-stage renal disease arrhythmia, and pulmonary fibrosis. This report enhances our understanding of each association and lays the groundwork to study these associations at a genomic level. It also offers a great opportunity to employ these genes for prognostic measures and to develop personalized and targeted treatments.