Archives of Dermatological Research

, Volume 304, Issue 6, pp 471–474 | Cite as

Serum levels of antimicrobial peptides and proteins do not correlate with psoriasis severity and are increased after treatment with fumaric acid esters

  • T. Gambichler
  • F. G. Bechara
  • N. Scola
  • S. Rotterdam
  • P. Altmeyer
  • M. Skrygan
Short Communication


Overexpression of antimicrobial peptides and proteins (AMPs) such as human β-defensin-2 (hBD2), LL37, and psoriasin has frequently been observed in lesional skin of psoriasis patients. We aimed to evaluate whether circulating AMP levels correlate with disease severity, and change under therapy with fumaric acid esters (FAE). We studied psoriasis patients who underwent systemic therapy using oral FAE (Fumaderm®). An enzyme-linked immunosorbent assay for the detection of serum protein expression of hBD2, LL37, and psoriasin was performed at baseline and after 12-week therapy. After 12-week FAE treatment of 28 patients, the median PASI significantly (P < 0.0001) decreased from 27.1 to 12.5. In psoriasis patients, mean ± SD serum hBD2, psoriasin, and LL37 levels at baseline were 295.6 ± 93.5 pg/ml, 79.4 ± 32.7 ng/ml, and 106.3 ± 90 ng/ml, respectively, which were significantly increased when compared to healthy controls (110 ± 53.7 pg/ml, P ≤ 0.0001; 3.1 ± 0.7 ng/ml, P ≤ 0.0001; 3.8 ± 0.9 ng/ml, P = 0.0004, respectively). After 12-week FAE treatment, a significant increase of serum hBD2 (339.7 ± 74.3 pg/ml; P = 0.0046), psoriasin (106 ± 58.9 ng/ml; P = 0.0014), and LL37 (136.6 ± 115.1 ng/ml; P = 0.0035) was observed. Correlation studies did not reveal significant relationships between serum AMP levels and PASI (r < 0.1; P > 0.05). In contrast to AMP expression in psoriatic skin serum, AMP levels seem not to correlate with disease severity. Increased serum AMP protein levels in psoriasis resolution are an unexpected observation that needs to be investigated more in detail in future studies.


Psoriasis Antimicrobial peptides and proteins Human β-defensin Psoriasin Cathelicidin LL37 



This investigator-initiated trial was funded in part by Biogen Idec GmbH (Ismaning, Germany).


  1. 1.
    Anderson KS, Wong J, Polyak K, Aronzon D, Enerbäck C (2009) Detection of psoriasin/S100A7 in the sera of patients with psoriasis. Br J Dermatol 160:325–332PubMedCrossRefGoogle Scholar
  2. 2.
    Büchau AS, Gallo RL (2007) Innate immunity and antimicrobial defense systems in psoriasis. Clin Dermatol 25:616–624PubMedCrossRefGoogle Scholar
  3. 3.
    Gambichler T, Skrygan M, Tomi NS, Othlinghaus N, Brockmeyer NH, Altmeyer P, Kreuter A (2008) Differential mRNA expression of antimicrobial peptides and proteins in atopic dermatitis as compared to psoriasis vulgaris and healthy skin. Int Arch Allergy Immunol 147:17–24PubMedCrossRefGoogle Scholar
  4. 4.
    Gambichler T, Kobus S, Kobus A, Tigges C, Scola N, Altmeyer P, Kreuter A, Bechara FG, Skrygan M (2011) Expression of antimicrobial peptides and proteins in etanercept-treated psoriasis patients. Regul Pept 167:163–166PubMedCrossRefGoogle Scholar
  5. 5.
    Gläser R, Meyer-Hoffert U, Harder J, Cordes J, Wittersheim M, Kobliakova J, Fölster-Holst R, Proksch E, Schröder JM, Schwarz T (2009) The antimicrobial protein psoriasin (S100A7) is upregulated in atopic dermatitis and after experimental skin barrier disruption. J Invest Dermatol 129:641–649PubMedCrossRefGoogle Scholar
  6. 6.
    Griffiths CEM, Barker JNWN (2007) Pathogenesis and clinical features of psoriasis. Lancet 370:263–271PubMedCrossRefGoogle Scholar
  7. 7.
    Harder J, Schröder JM (2005) Antimicrobial peptides in human skin. Chem Immunol Allergy 86:22–41PubMedCrossRefGoogle Scholar
  8. 8.
    Harder J, Schröder JM (2005) Psoriatic scales: a promising source for the isolation of human skin-derived antimicrobial proteins. J Leukoc Biol 77:476–486PubMedCrossRefGoogle Scholar
  9. 9.
    Jansen PA, Rodijk-Olthuis D, Hollox EJ, Kamsteeg M, Tjabringa GS, de Jongh GJ, van Vlijmen-Willems IM, Bergboer JG, van Rossum MM, de Jong EM, den Heijer M, Evers AW, Bergers M, Armour JA, Zeeuwen PL, Schalkwijk J (2009) Beta-defensin-2 protein is a serum biomarker for disease activity in psoriasis and reaches biologically relevant concentrations in lesional skin. PLoS ONE 4:e4725PubMedCrossRefGoogle Scholar
  10. 10.
    Leung TF, Ching KW, Kong APS, Wong GWK, Chan JCN, Hon KL (2011) Circulating LL-37 is a biomarker for eczema severity in children. J Eur Acad Dermatol Venerol. doi: 10.1111/j.1468-3083.2011.04083.x. (Epub ahead of print)
  11. 11.
    Mrowietz U, Christophers E, Altmeyer P (1999) Treatment of severe psoriasis with fumaric acid esters: scientific background and guidelines for therapeutic use: the German fumaric acid ester consensus conference. Br J Dermatol 141:424–429PubMedCrossRefGoogle Scholar
  12. 12.
    Mrowietz U, Rostami-Yazdi M, Neureither M, Reich K (2009) 15 years of fumaderm: fumaric acid esters for the systemic treatment of moderately severe and severe psoriasis vulgaris. J Dtsch Dermatol Ges 7(Suppl 2):S3–S16PubMedGoogle Scholar
  13. 13.
    Vähävihu K, Ala-Houhala M, Peric M, Karisola P, Kautiainen H, Hasan T, Snellman E, Alenius H, Schauber J, Reunala T (2010) Narrowband ultraviolet B treatment improves vitamin D balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis. Br J Dermatol 163:321–328PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • T. Gambichler
    • 1
  • F. G. Bechara
    • 1
  • N. Scola
    • 1
  • S. Rotterdam
    • 1
  • P. Altmeyer
    • 1
  • M. Skrygan
    • 1
  1. 1.Department of DermatologyRuhr-University BochumBochumGermany

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