Skip to main content

Advertisement

Log in

Association of total oxidant status, total antioxidant status, and malondialdehyde and catalase levels with psoriasis: a systematic review and meta-analysis

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Although oxidative stress plays a major role in psoriasis, the association between oxidative stress biomarker levels and psoriasis in humans remains controversial. Relevant articles were retrieved by searching the following databases: PubMed, Web of Science, and EMBASE, without any time limit (updated March 10th, 2019). The pooled weighted mean difference (WMD) and 95% confidence interval (CI) for the total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA), and catalase (CAT) were calculated for each study. Heterogeneity test, publication bias analysis, and sensitivity analysis were performed. A total of 28 case-control studies, containing a combined total of 2724 subjects (1485 psoriasis patients and 1239 healthy controls), were enrolled in this meta-analysis. The combined results showed a significant difference in the TAS levels (WMD = − 0.213 mmol/L, p < 0.001, 95% CI = − 0.216 to − 0.165), TOS levels (WMD = 2.196 μmol/L, p < 0.001, 95% CI = 1.667 to 2.726), MDA levels (WMD = 1.854 nmol/L, p < 0.001, 95% CI = 1.494 to 2.215), and CAT levels (WMD = − 22.341 kU/L, p = 0.008, 95% CI = − 38.934 to − 5.748) between psoriasis patients and controls. Moreover, the combined results showed a significant difference in the TAS, MDA, and CAT levels in patients with mild vs. moderate psoriasis and moderate vs. severe psoriasis. TAS and CAT levels in psoriasis patients were significantly lower than in healthy controls, whereas the TOS and MDA levels were significantly higher. Furthermore, the TAS, MDA, and CAT levels are associated with the severity of disease. These results indicate that redox imbalances play a major role in the pathogenesis of psoriasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

WMD:

weighted mean difference

CI:

confidence interval

TOS:

total oxidant status

TAS:

total antioxidant status

MDA:

malondialdehyde

CAT:

catalase

References

  1. Scher JU, Ogdie A, Merola JF, Ritchlin C (2019) Preventing psoriatic arthritis: focusing on patients with psoriasis at increased risk of transition. Nat Rev Rheumatol 15:153–166

    PubMed  Google Scholar 

  2. Springate DA, Parisi R, Kontopantelis E, Reeves D, Griffiths CEM, Ashcroft DM (2017) Incidence, prevalence and mortality of patients with psoriasis: a U.K. population-based cohort study. Br J Dermatol 176:650–658

    CAS  PubMed  Google Scholar 

  3. Kofoed K, Skov L, Zachariae C (2015) New drugs and treatment targets in psoriasis. Acta Derm Venereol 95:133–139

    PubMed  Google Scholar 

  4. Bos JD, De Rie MA (1999) The pathogenesis of psoriasis: immunological facts and speculations. Immunol Today 20:40–46

    CAS  PubMed  Google Scholar 

  5. Lai R, Xian D, Xiong X, Yang L, Song J, Zhong J (2018) Proanthocyanidins: novel treatment for psoriasis that reduces oxidative stress and modulates Th17 and Treg cells. Redox Rep 23:130–135

    CAS  PubMed  Google Scholar 

  6. Peluso I, Cavaliere A, Palmery M (2016) Plasma total antioxidant capacity and peroxidation biomarkers in psoriasis. J Biomed Sci 23:52

    PubMed  PubMed Central  Google Scholar 

  7. Karababa F, Yesilova Y, Turan E, Selek S, Altun H, Selek S (2013) Impact of depressive symptoms on oxidative stress in patients with psoriasis. Redox Rep1 8:51–55

    Google Scholar 

  8. Gavan N, Popa R, Orasan R, Maibach H (1997) Effect of percutaneous absorption of fluocinolone acetonide on the activity of superoxide dismutase and total antioxidant status in patients with psoriasis. Skin Pharmacol 10:178–182

    CAS  PubMed  Google Scholar 

  9. Asha K, Singal A, Sharma SB, Arora VK, Aggarwal A (2017) Dyslipidaemia & oxidative stress in patients of psoriasis: emerging cardiovascular risk factors. Indian J Med Res 146:708–713

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Toker A, Kadi M, Yildirim AK, Aksoy H, Akçay F (2009) Serum lipid profile paraoxonase and arylesterase activities in psoriasis. Cell Biochem Funct 27:176–180

    CAS  PubMed  Google Scholar 

  11. Sürücü HA, Aksoy N, Ozgöztas O, Sezen H, Yesilova Y, Turan E (2015) Prolidase activity in chronic plaque psoriasis patients. Postepy Dermatol Alergol 32:82–87

    PubMed  PubMed Central  Google Scholar 

  12. Kadam DP, Suryakar AN, Ankush RD, Kadam CY, Deshpande KH (2010) Role of oxidative stress in various stages of psoriasis. Indian J Clin Biochem 5:388–392

    Google Scholar 

  13. Li X, Miao X, Wang H, Wang Y, Li F, Yang Q, Cui R, Li B (2016) Association of serum uric acid levels in psoriasis: a systematic review and meta-analysis. Medicine (Baltimore) 95:e3676

    CAS  Google Scholar 

  14. Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605

    Google Scholar 

  15. Hashemi M, Mehrabifar H, Daliri M, Ghavami S (2010) Adenosine deaminase activity, trypsin inhibitory capacity and total antioxidant capacity in psoriasis. J Eur Acad Dermatol Venereol 24:329–334

    CAS  PubMed  Google Scholar 

  16. Utaş S, Köse K, Yazici C, Akdaş A, Keleştimur F (2002) Antioxidant potential of propylthiouracil in patients with psoriasis. Clin Biochem 35:241–246

    PubMed  Google Scholar 

  17. Nemati H, Houshang N, Khodarahmi R, Reza K, Sadeghi M, Masoud S, Ebrahimi A, Ali E, Rezaei M, Mansour R et al (2014) Antioxidant status in patients with psoriasis. Cell Biochem Funct 32:268–273

    CAS  PubMed  Google Scholar 

  18. Kökçam I, Naziroğlu M (1999) Antioxidants and lipid peroxidation status in the blood of patients with psoriasis. Clin Chim Acta 289:23–31

    PubMed  Google Scholar 

  19. Relhan V, Gupta SK, Dayal S, Pandey R, Lal H (2002) Blood thiols and malondialdehyde levels in psoriasis. J Dermatol 29:399–403

    CAS  PubMed  Google Scholar 

  20. Wacewicz M, Socha K, Soroczyńska J, Niczyporuk M, Aleksiejczuk P, Ostrowska J, Borawska MH (2017) Concentration of selenium, zinc, copper, Cu/Zn ratio, total antioxidant status and c-reactive protein in the serum of patients with psoriasis treated by narrow-band ultraviolet B phototherapy: a case-control study. J Trace Elem Med Biol 44:109–114

    CAS  PubMed  Google Scholar 

  21. Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A, Quintanilha A, Teixeira F (2001) Dislipidemia and oxidative stress in mild and in severe psoriasis as a risk for cardiovascular disease. Clin Chim Acta 303:33–39

    CAS  PubMed  Google Scholar 

  22. Rajappa M, Shanmugam R, Munisamy M, Chandrashekar L, Rajendiran KS, Thappa DM (2016) Effect of antipsoriatic therapy on oxidative stress index and sialic acid levels in patients with psoriasis. Int J Dermatol 55:e422–e430

    CAS  PubMed  Google Scholar 

  23. Sezer U, Şenyurt SZ, Gündoğar H, Erciyas K, Üstün K, Kimyon G, Kırtak N, Taysı S, Onat AM (2016) Effect of chronic periodontitis on oxidative status in patients with psoriasis and psoriatic arthritis. J Periodontol 87:557–565

    CAS  PubMed  Google Scholar 

  24. Rocha-Pereira P, Santos-Silva A, Rebelo I, Figneiredo A, Quintanilha A, Teixeira F (2004) Erythrocyte damage in mild and severe psoriasis. Br J Dermatol 150:232–244

    CAS  PubMed  Google Scholar 

  25. Vanizor Kural B, Orem A, Cimşit G, Yandi YE, Calapoglu M (2003) Evaluation of the atherogenic tendency of lipids and lipoprotein content and their relationships with oxidant-antioxidant system in patients with psoriasis. Clin Chim Acta 328:71–82

    CAS  PubMed  Google Scholar 

  26. Sikar Aktürk A, Özdoğan HK, Bayramgürler D, Çekmen MB, Bilen N, Kıran R (2012) Nitric oxide and malondialdehyde levels in plasma and tissue of psoriasis patients. J Eur Acad Dermatol Venereol 26:33–837

    Google Scholar 

  27. Baz K, Cimen MYB, Kokturk A, Yazici AC, Eskandari G, Ikizoglu G, Api H, Atik U (2003) Oxidant / antioxidant status in patients with psoriasis. Yonsei Med J 44:987–990

    PubMed  Google Scholar 

  28. Pujari VM, Suryakar AN, Ireddy S (2010) Oxidants and antioxidant status in psoriasis patients. Biomed Res 21:221–223

    Google Scholar 

  29. Asefi M, Vaisi-Raygani A, Bahrehmand F, Kiani A, Rahimi Z, Nomani H, Ebrahimi A, Tavilani H, Pourmotabbed T (2012) Paraoxonase 1 (PON1) 55 polymorphism, lipid profiles and psoriasis. Br J Dermatol 167:1279–1286

    CAS  PubMed  Google Scholar 

  30. Coimbra S, Oliveira H, Reis F, Belo L, Rocha S, Quintanilha A, Figueiredo A, Teixeira F, Castro E, Rocha-Pereira P, Santos-Silva A (2010) Psoriasis therapy and cardiovascular risk factors: a 12-week follow-up study. Am J Clin Dermatol 11:423–432

    PubMed  Google Scholar 

  31. Attwa E, Swelam E (2011) Relationship between smoking-induced oxidative stress and the clinical severity of psoriasis. J Eur Acad Dermatol Venereol 25:782–787

    CAS  PubMed  Google Scholar 

  32. Gabr SA, Al-Ghadir AH (2012) Role of cellular oxidative stress and cytochrome c in the pathogenesis of psoriasis. Arch Dermatol Res 304:451–457

    CAS  PubMed  Google Scholar 

  33. Kaur S, Zilmer K, Leping V, Zilmer M (2013) Serum methylglyoxal level and its association with oxidative stress and disease severity in patients with psoriasis. Arch Dermatol Res 305:489–494

    CAS  PubMed  Google Scholar 

  34. Basavaraj KH, Vasu Devaraju P, Rao KS (2013) Studies on serum 8-hydroxy guanosine (8-OHdG) as reliable biomarker for psoriasis. J Eur Acad Dermatol Venereol 27:655–657

    CAS  PubMed  Google Scholar 

  35. Emre S, Metin A, Demirseren DD, Kilic S, Isikoglu S, Erel O (2013) The relationship between oxidative stress, smoking and the clinical severity of psoriasis. J Eur Acad Dermatol Venereol 27:e370–e375

    CAS  PubMed  Google Scholar 

  36. Yildirim M, Inaloz HS, Baysal V, Delibas N (2003) The role of oxidants and antioxidants in psoriasis. J Eur Acad Dermatol Venereol 17:34–36

    CAS  PubMed  Google Scholar 

  37. Zhou Q, Mrowietz U, Rostami-Yazdi M (2009) Oxidative stress in the pathogenesis of psoriasis. Free Radic Biol Med 47:891–905

    CAS  PubMed  Google Scholar 

  38. West J, Ogston S, Foerster J (2016) Safety and efficacy of methotrexate in psoriasis: a meta-analysis of published trials. PLoS One 11:e0153740

    PubMed  PubMed Central  Google Scholar 

  39. Ogawa E, Sato Y, Minagawa A, Okuyama R (2018) Pathogenesis of psoriasis and development of treatment. J Dermatol 45:264–272

    CAS  PubMed  Google Scholar 

  40. Bacchetti T, Campanati A, Ferretti G, Simonetti O, Liberati G, Offidani AM (2013) Oxidative stress and psoriasis: the effect of antitumour necrosis factor-α inhibitor treatment. Br J Dermatol 168:984–989

    CAS  PubMed  Google Scholar 

  41. Caso F, Postiglione L, Covelli B, Ricciardone M, Di Spigna G, Formisano P, D’Esposito V, Girolimetto N, Tasso M, Peluso R et al (2019) Pro-inflammatory adipokine profile in psoriatic arthritis: results from a cross-sectional study comparing PsA subset with evident cutaneous involvement and subset “sine psoriasis.”. Clin Rheumatol. https://doi.org/10.1007/s10067-019-04619-w

    PubMed  Google Scholar 

Download references

Funding

This work was supported by Tai’an City Technology Development Project (201340629).

Author information

Authors and Affiliations

Authors

Contributions

YC Z and Z M designed the study; YC Z, ZS L, Y M, and Z M collected the data; YC Z, ZS L, Y M, and Z M performed the statistical analysis; YC Z and Z M wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhen Mu.

Ethics declarations

Disclosures

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Y., Li, Z., Ma, Y. et al. Association of total oxidant status, total antioxidant status, and malondialdehyde and catalase levels with psoriasis: a systematic review and meta-analysis. Clin Rheumatol 38, 2659–2671 (2019). https://doi.org/10.1007/s10067-019-04676-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-019-04676-1

Keywords

Navigation