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Running title: Oxidative stress in psoriasis

International Research Journal of Biochemistry and Biotechnology


Vol. 5(1), pp. 075-079, June, 2019. © www.premierpublishers.org, ISSN: 0524-0557

Research Article

Evaluation of Oxidative Stress and Stress Induced Serum


Protein Changes in Psoriasis
*Ashok Vanangamudi1, Divya Ramanathan2
1Assistant Professor, Department of Biochemistry, Karpagam Faculty of Medical Sciences and Research, Coimbatore,
India-641032
2Assistant Professor, Department of Physiology, Karpagam Faculty of Medical Sciences and Research, Coimbatore.

Psoriasis is a non-infectious, chronic inflammatory disease of the skin. This study aimed to
explore the oxidative stress and stress induced protein changes in psoriasis and to analyze the
possible interrelationship between these factors among psoriasis patients. This was a hospital-
based case control study which included 50 cases of psoriasis and 50 healthy controls. Serum
malondialdehyde was measured by thiobarbituric acid reactivity assay method. Protein carbonyl
(PC) was measured by Levine’s method. Protein bound sialic acid (PBSA) was measured using
modified Aminoff’s method using a spectrophotometer. Data analysis was done using SPSS
software version 16.0. Our results showed significant elevation in the oxidant status (MDA, PC
and PBSA) among the psoriasis cases compared to the controls. Multiple linear regression
analysis showed a linear relationship between MDA, PBSA and duration of psoriasis. Our study
provides evidence to increased ROS production, indicated by increased lipid peroxidation in
serum and stress induced protein changes in psoriasis. The findings of our study also suggest
that as the duration of psoriasis increases the level of oxidative stress also increases which is
indicated by the increase in MDA and PBSA levels.

Keywords: oxidative stress, malondialdehyde, Protein carbonyl, PBSA

INTRODUCTION
Psoriasis is a disorder of the skin characterized by psoriatic patients, the cell membrane of skin cells has
inflammation of the skin and hyperproliferation of increased arachidonic acid, which is the substrate for
keratinocytes. The most commonly affected are young or production of malondialdehyde. MDA is used as a
middle-aged adults (Camp RDR, 1998). Around 2% of the biomarker of oxidative stress and lipid peroxidation
general population worldwide are affected with psoriasis (Vijaykumar M et al 2014, Sikar A. 2012, Trouba K. 2002).
(Wolters M et al, 2005). The prevalence of psoriasis in The ROS can damage the proteins or induce chemical
Indian population varies from 0.4% - 2.4% (Dogra M et al, modification of amino acids in the proteins during the
2010). process of oxidative stress. Carbonyl groups are
introduced into proteins by reaction with ROS produced
The causes for psoriasis are genetic factor, trauma, skin during lipid peroxidation. The carbonyl content of serum
infection, drugs, emotional stress, alcohol and smoking. proteins is used as a biomarker of protein oxidation
The generation of reactive oxygen species (ROS) from (Stadtman E,1998).
neutrophils, keratinocytes and fibroblasts can lead to
neutrophil activation and they have major role in the
development of psoriasis (Vivian S 2013).

Oxidative stress is due to excessive production of reactive *Corresponding Author: Ashok Vanangamudi, Assistant
oxygen species (ROS) or defect in its removal Professor, Department of Biochemistry, Karpagam faculty
mechanisms. The free radicals generated by oxidative of medical sciences and research, Coimbatore, India-
stress causes oxidation of polyunsaturated fatty acids in 641032. E-mail: dr.ashokmbbs1986@yahoo.com, Tel:
cell membrane and results in the generation of lipid +919159572499, Co-Author Tel: +919074202158 Email:
peroxidation products like malondialdehyde (MDA). In divyaashok47@yahoo.in

Evaluation of Oxidative Stress and Stress Induced Serum Protein Changes in Psoriasis
Running title: Oxidative stress in psoriasis
Vanangamudi and Ramanathan 076

Sialic acid is the terminal carbohydrate in the glycan Statistical Analysis


moiety of glycoproteins. Sialic acid is a N-acetylated
derivative of neuraminic acid which increases during injury The data was presented as mean ± standard deviation
and inflammation (Devatdarova M, 1968). According to a (mean ± SD). Student t test was used to compare the
study by Rajapppa M et al (2016) serum levels of oxidative various parameters between psoriasis subjects and
stress and inflammatory markers like highly sensitive C- controls. Multiple linear regression analysis was done to
reactive protein, total sialic acid, protein bound sialic acid analyze the relationship between various parameters of
were significantly higher in psoriasis vulgaris patients as oxidative stress. P value of less than 0.05 was statistically
compared to the normal controls. This shows that oxidative significant.
stress and inflammatory markers like serum total sialic
acid and protein bound sialic acid are associated with the
pathogenesis of psoriasis. RESULTS

The objectives of the study were The comparison of various baseline characteristics of the
1. To analyze oxidative stress in patients with psoriasis study groups was shown in Table1. All data were
and compare it with normal controls. represented as mean ± standard deviation. In our study it
2. To estimate oxidative stress induced protein carbonyl was observed that the parameter of oxidative stress, MDA
content (PC) and protein bound sialic acid (PBSA) in was elevated (p<0.001) in psoriatic patients as compared
psoriasis and compare it with controls. to controls (Table2). Also, the stress induced serum
3. To find the correlation between oxidative stress, protein protein changes, PC and PBSA concentrations were high
carbonyls and protein bound sialic acid in patients with (p<0.001) in the patients with psoriasis as compared to
psoriasis. controls (Table2).

Regression analysis showed a linear relationship between


MATERIALS AND METHODS MDA and the duration of psoriasis (Table 3 and Figure 1).
Linear regression analysis showed a linear relationship
This was a hospital-based case control study. This study between PBSA and the duration of psoriasis (Table 3 and
was conducted after getting approval by the Institutional Figure 2).
Ethics Committee Sri Manakula Vinayagar Medical
College and Hospital, Pondicherry. The duration of study
was two years 2013-2015.The sample size was 100 which DISCUSSION
included 50 cases of psoriasis and 50 healthy controls. The skin is a vulnerable target for oxidative injury by free
radicals, as it is continuously exposed to UV radiation and
Inclusion criteria other environmental stresses which generate reactive
oxygen species (Dipali P et al 2009). In normal cells, there
Cases: Patients diagnosed to have psoriasis in the will be a balance between oxidative damage and
Department of Dermatology. protection by antioxidant protections. However inadequate
Controls: Normal healthy controls, non-psoriatric patients antioxidant protection mechanisms or excess free radical
attending dermatology outpatient department. production generates a condition known as oxidative
stress (Trouba K et al 2002).
Exclusion criteria
Psoriasis is a chronic inflammatory disorder of the skin
1. Psoriasis patients with systemic illness like diabetes which is characterized by increased proliferation of
mellitus, renal failure, coronary artery disease and keratinocytes and inflammation in the epidermis and
history of recent drug intake for treatment. dermis (Young CN et al 2008). Various environmental and
2. Any subjects with systemic infections and chronic genetic factors, as well as intracellular and intercellular
inflammatory conditions. mediators, are found to play an important role in the
3. Any subjects who were not willing to give informed pathogenesis of psoriasis (Myers WA et al 2006).
consent.
Although there have been extensive studies (Jyothi RS et
Biochemical analysis al 2011, Zhou Q et al 2009, Mahmoud Y et al 2013) on the
role of oxidants and antioxidants levels in psoriasis, their
Serum total protein was estimated by Biuret method role in the etiopathogenesis of psoriasis remains
(Doumas BT. 1981). Serum MDA was estimated by controversial. It has been suggested that ROS production
thiobarbituric acid reactivity assay method (Satok K 1978). may play a vital role in the pathogenesis of psoriasis
12 Serum protein carbonyl was estimated by modified through mechanisms like activation of Nuclear factor-kB
Levine’s method (Chakraborthy H .2000). Serum protein (NF-kB), generation of cytokines, modulation of signaling
bound sialic acid was estimated by modified Aminoff’s pathways and activation of peroxisome proliferator-
method (Aminoff D 1961). activated receptors.

Evaluation of Oxidative Stress and Stress Induced Serum Protein Changes in Psoriasis
Running title: Oxidative stress in psoriasis
Int. Res. J. Biochem. Biotechnol. 077

Our study showed significant difference in the oxidant Camp RDR: Psoriasis In. Rook A, Wilkinson DS, Ebling
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serum malondialdehyde, protein carbonyl and protein Chakraborty H, Ray N. (2000) Lipid peroxidation
bound sialic acid. In the present study, serum MDA levels associated protein damage in rat brain crude
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protein damage. A study by VV Barygina et al (2013) healthy persons and patients with psoriasis. Vestn
showed that protein carbonyl was increased in patients Dermatol Venerol. 42(8):43-46.
with psoriasis compared to the control group. In our study Dipali P Kadam, Adinath N Suryakar, Rajesh D Ankush,
the serum PC were elevated in patients with psoriasis as Charushila Y Kadam, Kishor H Deshpande. (2010).
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Ind J Clin Biochem. 25(4):388–392.
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APPENDIX

Table 1: Comparison of baseline characteristics (mean ± standard deviation) in patients with psoriasis and controls
Parameters Cases(n=50) Controls(n=50) P value
Age (years) 41.20 ±9.21 41.56 ±8.99 0.82
Height(m) 1.48 ±0.08 1.49 ±0.07 0.60
Weight (kg) 60.22 ±7.96 59.80 ±8.83 0.83
BMI (kg/m2) 27.51 ±3.39 27.19 ±4.23 0.68
Systolic BP (mmHg) 116.96 ± 6.54 114.88 ±4.14 0.66
Diastolic BP (mmHg) 71.04 ±7.01 69.52 ±6.86 0.27
Pulse rate (beats/min) 76.16 ±7.01 75.70 ±6.58 0.72
Serum Total protein (g/dl) 7.18 ± 0.51 7.02 ±0.51 0.11
Duration of psoriasis (years) 5.02 ±2.55 - -
Data are presented as Mean ±SD.*P value ≤0.05 is statistically significant. Independent student t test
was used to analyze the data. BMI=Body mass index, BP=Blood pressure.

Table 2: Comparison of oxidative stress parameters (mean ± standard deviation) in patients with psoriasis and controls
Parameters Cases(n=50) Controls(n=50) P value
Serum MDA (µmoles/L) 6.31±2.68 3.65±1.48 <0.001*
Serum PC (µg/mg of protein) 2.88 ±0.75 2.43 ±0.35 <0.001*
Serum PBSA (nmol/mg of protein) 17.82 ±8.33 10.41±3.55 <0.001*
Data are presented as Mean ±SD.*P value ≤0.05 is statistically significant. Independent student t test was used to analyze
the data. MDA=Malondialdehyde, PC=Protein carbonyl, PBSA=Protein bound sialic acid.

Table 3: Linear regression analysis to find the effect of duration of psoriasis on parameters of oxidative stress
Independent Nonstandardized coefficients Standardized coefficients P value
Variables B value β
MDA 0.319 0.303 0.03*
PC -0.060 -0.018 0.90
PBSA 1.044 0.320 0.02*
* p<0.05 is considered statistically significant. MDA=Malondialdehyde, PC=Protein carbonyl, PBSA=Protein bound sialic
acid.

Evaluation of Oxidative Stress and Stress Induced Serum Protein Changes in Psoriasis
Running title: Oxidative stress in psoriasis
Int. Res. J. Biochem. Biotechnol. 079

Figure 1: Linear regression analysis between duration of psoriasis and MDA levels among the cases

Figure 2: Linear regression analysis between duration of psoriasis and Protein bound sialic acid (PBSA) levels among
the cases

Accepted 10 May 2019

Citation: Vanangamudi A, Ramanathan D (2019). Evaluation of Oxidative Stress and Stress Induced Serum Protein
Changes in Psoriasis. International Research Journal of Biochemistry and Biotechnology, 5(1): 075-079.

Copyright: © 2019 Vanangamudi and Ramanathan. This is an open-access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are cited.

Evaluation of Oxidative Stress and Stress Induced Serum Protein Changes in Psoriasis